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
- Weight Gain
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, the side-effects associated with these drugs, which include osteopenia, increased fracture risk, fluid retention, congestive heart failure, bladder cancer, and long-term weight gain, have limited their adoption. [en.wikipedia.org]
After one weight-gain/weight-loss cycle, mice exhibited a loss in microbial isoflavonoid and steroid biosynthesis metagenomic function that led to exacerbated weight regain, body fat, and lower energy expenditure upon reintroducing HFD. [doi.org]
- 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]
- Falling
Author information 1 Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, 3300 Gallows Road, Falls Church, [ncbi.nlm.nih.gov]
Peter Jepsen (Department of Clinical Epidemiology, Aarhus University Hospital, Denmark), Zobair Younossi (Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA), Nila Rafiq (Center for Liver Diseases, Inova Fairfax Hospital [doi.org]
- Ascites
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]
or fatigue), or incidental imaging study findings (eg, cirrhotic liver, splenomegaly, varices, or ascites). [emedicine.com]
Furthermore, this continued after therapeutic paracentesis (removal of ascitic fluid from abdomen) ( 58 ), suggesting that translocation of bacterial DNA was ongoing. [doi.org]
- Rigor
The natural course of the disease has not been rigorously characterized, particularly with respect to the contributions of underlying obesity, type 2 diabetes, and other comorbidities and the treatments provided for these comorbidities. [ncbi.nlm.nih.gov]
Many agents have shown promising results in preliminary pilot trials, however, there have been few treatment modalities examined in rigorous randomised double blind placebo controlled trials with adequate statistical power. [dx.doi.org]
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]
Patients with high serum titers of autoantibodies and other features suggesting autoimmune liver disease (eg, very high aminotransferases or high globulin levels) should undergo a more thorough workup for autoimmune liver disease. [emedicine.com]
Thomas Jensen, Amanda Wieland, Melanie Cree-Green, Kristen Nadeau and Shelby Sullivan, Clinical workup of fatty liver for the primary care provider, Postgraduate Medicine, 10.1080/00325481.2019.1546532, (1-12), (2018). [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. [jama.jamanetwork.com]
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]