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Non-Alcoholic Fatty Liver Disease
Non-Alcoholic Steatosis Hepatitis

Images

WIKIDATA, CC BY-SA 3.0

Presentation

NAFLD is now present in 17% to 33% of Americans, has a worldwide distribution, and parallels the frequency of central adiposity, obesity, insulin resistance, metabolic syndrome and type 2 diabetes. NASH could be present in one third of NAFLD cases. [ncbi.nlm.nih.gov]

Entire Body System

  • Fatigue

    Due to progressive fatigue, he underwent an orthotopic liver transplantation complicated by a 36-kg weight gain. Sixteen months posttransplantation, a liver biopsy revealed the recurrence of NASH. [ncbi.nlm.nih.gov]

    However, some have fatigue, malaise, or right upper quadrant abdominal discomfort. Hepatomegaly develops in about 75% of patients. [msdmanuals.com]

Gastrointestinal

  • Right Upper Quadrant Pain

    His postoperative course was complicated by a 50-kg weight loss and continued right upper quadrant pain. Repeat liver biopsy revealed NASH with accompanying micronodular cirrhosis. [ncbi.nlm.nih.gov]

    Other symptoms might be present, such as right upper quadrant pain or acanthosis nigricans, the latter being frequently observed in NASH patients, or hepatomegaly found in 30–40% of children with NAFLD.Liver biopsies for diagnosis in children should be [en.wikipedia.org]

Workup

This delay in diagnosis is illustrated in our case of a 53-year-old man who presented with hepatic hydrothorax and ascites, whose workup revealed cirrhosis due to NAFLD. [dx.doi.org]

Treatment

This review discusses some of the major obstacles to drug development for NASH treatment. [ncbi.nlm.nih.gov]

Lifestyle modification is the foundation of treatment for patients with nonalcoholic steatosis. [dx.doi.org]

Prognosis

We identified 34 studies comprising 368,569 unique patients that characterized disparities in NAFLD prevalence, severity, or prognosis. [ncbi.nlm.nih.gov]

Expert commentary : This meta-analysis indicated that for NAFLD patients, obesity (according to ethnic-specific BMI cut-off points to define obesity) could predict a worse long-term prognosis. [doi.org]

Prognosis is often good unless complications (eg, variceal hemorrhage) develop. 1. [msdmanuals.com]

Etiology

BACKGROUND: Iron overload disorders are hereditary hemochromatosis and secondary etiologies other than hereditary hemochromatosis. We describe 2 boys presenting with iron overload. [ncbi.nlm.nih.gov]

Epidemiology

As a result, specialty societies, including the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver, have developed guidance on the epidemiology, diagnosis, and treatment of NAFLD and NASH [ncbi.nlm.nih.gov]

Pathophysiology

Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. [ncbi.nlm.nih.gov]

This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. [doi.org]

Prevention

Although the drugs being developed may prevent progression to cirrhosis or may decrease negative liver outcomes, their effects on cardiometabolic health and cancer prevention remain unknown. [ncbi.nlm.nih.gov]

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