Conclusion
CFLD is not uncommon in CF as one third of the CF patients were found to have liver involvement in this Egyptian patient population diagnosed clinically, biochemically and/or by ultrasound. CFLD incidence was elevated in male individuals, patients with duration of illness > 5 years, patients with weight and height < 5th percentile, early onset of disease before the age of 9 months, history of meconium ileus, patients not adherent to fat-soluble vitamins as well as pancreatic enzyme replacements, patients with severe CF disease and patients with class I and II genetic mutation. More studies from low- and middle-income countries like Egypt, are needed to help understand the nature of the disease, improve patients’ quality of life, improve survival and help improve the disease outcome globally.