Shalby MM, et al. - In this investigation, researchers evaluated the serum cytokeratin-18 (CK-18) diagnostic value in children with chronic liver disease (CLD) and correlated their serum level with liver histology and other liver biomarkers. This research comprised two groups, one group included children with CLD, and the other group included healthy matched age and gender subjects as a control group, complete history and clinical examination, and serum CK-18 was measured using the sandwich enzyme-linked immunosorbent assay technique. According to results, CK-18 levels were related to a change in hepatocyte and portal tract as it was elevated with cirrhosis and fibrosis stage as it was elevated with moderate and severe fibrosis compared to mild fibrosis, also it revealed a gradual increase as per child Pugh score. A positive correlation was found between CK-18 levels and Total IgG, paediatric end-stage liver disease score and model for end-stage liver disease scores, the best CK-18 cutoff point was 624 ng/mL, with 93.06% sensitivity, 62.5% specificity, and 90.0% diagnostic accuracy for fibrosis detection. Findings suggested that CK-18 could be used in children with CLD as a non-invasive diagnostic marker.