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]
- Camping
Birkebæk, Peter Holland-Fischer, Jan Solvig, Arne Hørlyck, Kurt Kristensen, Søren Rittig and Hendrik Vilstrup, Effect of a 10-week Weight Loss Camp on Fatty Liver Disease and Insulin Sensitivity in Obese Danish Children, Journal of Pediatric Gastroenterology [doi.org]
Musculoskeletal
- Osteopenia
Pioglitazone is associated with osteopenia, fluid retention and weight gain. Obeticholic acid causes pruritus in a substantial proportion of subjects and elafibranor has been associated with transient rises in creatinine. [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]
Psychiatrical
- Impulsivity
Francisca Velázquez-Marín, Pilar Sainz de Baranda, Florentina Guzmán-Aroca, Carmen Fernández-Hernández, Ernesto Doménech-Abellán, Dolores Abellán-Rivero, Guadalupe Ruiz-Merino, Juan Madrid-Conesa and Manuel Canteras-Jordana, Acoustic radiation force impulse [doi.org]
The EASL suggest using fibrosis tests such as elastometry, acoustic radiation force impulse imaging and serum biomarkers in order to reduce the number of biopsies. [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]