Non-alcoholic fatty liver disease natural history, complications and prognosis: Difference between revisions
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*The symptoms of NAFLD usually develop in the 40th decade of life, And usually asymptomatic at first. | *The symptoms of NAFLD usually develop in the 40th decade of life, And usually asymptomatic at first. | ||
*After following NAFLD patients for long-term the outcome of the disease is as follows <ref name="urlThe Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology">{{cite web |url=http://www.gastrojournal.org/article/S0016-5085(12)00494-5/fulltext?referrer=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2F#sec5 |title=The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology |format= |work= |accessdate=}}</ref> | *After following NAFLD patients for long-term the outcome of the disease is as follows <ref name="urlThe Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology">{{cite web |url=http://www.gastrojournal.org/article/S0016-5085(12)00494-5/fulltext?referrer=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2F#sec5 |title=The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology |format= |work= |accessdate=}}</ref> | ||
**1) Patients with [[Non-alcoholic fatty liver disease|NAFLD]] has overall high morbidity and mortality rate and the common cause of death in NAFLD patients is cardiovascular disease. | **1) Patients with [[Non-alcoholic fatty liver disease|NAFLD]] has overall high [[morbidity]] and [[mortality]] rate and the common cause of death in NAFLD patients is cardiovascular disease. | ||
**2) Patients with [[NASH]] has more liver-related mortality rate | **2) Patients with [[NASH]] has more liver-related mortality rate | ||
* If left untreated, Patients with NAFLD may progress to develop hepato cellular carcinoma (HCC). But it is directly propotional to the degree of fibrosis and advanced cirrhosis | * If left untreated, Patients with NAFLD may progress to develop hepato cellular carcinoma ([[HCC]]). But it is directly propotional to the degree of [[fibrosis]] and advanced [[cirrhosis]] | ||
* Children who are positive with NAFLD are also prone to short lifespan when compared to general population.<ref name="urlNonalcoholic Fatty Liver Disease">{{cite web |url=http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/ |title=Nonalcoholic Fatty Liver Disease |format= |work= |accessdate=}}</ref> | * Children who are positive with NAFLD are also prone to short lifespan when compared to general population.<ref name="urlNonalcoholic Fatty Liver Disease">{{cite web |url=http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/ |title=Nonalcoholic Fatty Liver Disease |format= |work= |accessdate=}}</ref> | ||
===Complications=== | ===Complications=== | ||
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**[[Fibrosis]] | **[[Fibrosis]] | ||
**[[Cirrhosis]] | **[[Cirrhosis]] | ||
**Internal bleeding | **[[Internal bleeding]] | ||
**Encepholopathy | **Encepholopathy | ||
Revision as of 03:19, 18 December 2017
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Non-Alcoholic Fatty Liver Disease Microchapters |
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Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
NASH may progress to fibrosis and, later, cirrhosis. Studies of serial liver biopsies estimate a 26-37% rate of hepatic fibrosis and 2-15% rate of cirrhosis in less than 6 years.The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies.The natural history of nonalcoholic fatty liver disease:a clinical histopathological study.Long-term follow-up of patients with NAFLD and elevated liver enzymes. In 2001, NASH represented 2.9% of the indications of liver transplantation.The frequency of Nonalcoholic Steatohepatitis as a Cause of Advanced Liver Disease. The impact of NAFLD is manifest at each step along the spectrum of the disease. Studies in the United States and Sweden have revealed that both simple steatosis as well as steatohepatitis significantly reduce life expectancy, even when the diagnosis is made in children.The natural history of the non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years.
Natural History, Complications and Prognosis
Natural History
- The symptoms of NAFLD usually develop in the 40th decade of life, And usually asymptomatic at first.
- After following NAFLD patients for long-term the outcome of the disease is as follows [1]
- If left untreated, Patients with NAFLD may progress to develop hepato cellular carcinoma (HCC). But it is directly propotional to the degree of fibrosis and advanced cirrhosis
- Children who are positive with NAFLD are also prone to short lifespan when compared to general population.[2]
Complications
- Common complications of NAFLD include:[3]
- Fibrosis
- Cirrhosis
- Internal bleeding
- Encepholopathy
Prognosis
- Histology is the most reliable means to grade the severity of the disease and thus estimate prognosis because the diagnostic criteria for NAFLD as of now is low.
- The initial biopsy at the time of the diagnosis appears to be very valuable to predict the diagnosis.[2]
- Depending on the extent of the fibrosis and cirrhosis at the time of diagnosis, the prognosis may vary.[4]
- The presence of fibrosis and cirrhosis associated with a particularly poor prognosis among patients with NAFLD.
NAFLD Activity Score (NAS)[5][6]
Total NAS score represents the sum of scores for steatosis, lobular inflammation, and ballooning.
| Steatosis | S-Score |
|---|---|
| <5%† | 0 |
| 5–33% | 1 |
| 34–66% | 2 |
| >66% | 3 |
| Lobular Inflammation | L-Score |
| None♥ | 0 |
| <2 foci | 1 |
| 2–4 foci | 2 |
| >4 foci | 3 |
| Hepatocyte Balloning | B-Score |
| None | 0 |
| Few ballooned cells¥ | 1 |
| Many ballooned cells₩ | 2 |
| Interpretation
Ranges from 0-8 |
|
| |
References
- ↑ "The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology".
- ↑ 2.0 2.1 "Nonalcoholic Fatty Liver Disease".
- ↑ "Nonalcoholic Fatty Liver Disease Symptoms, Causes, and More".
- ↑ "Complications of Non-Alcoholic Fatty Liver Disease - Journal of Hepatology".
- ↑ Vizuete J, Camero A, Malakouti M, Garapati K, Gutierrez J (2017). "Perspectives on Nonalcoholic Fatty Liver Disease: An Overview of Present and Future Therapies". J Clin Transl Hepatol. 5 (1): 67–75. doi:10.14218/JCTH.2016.00061. PMC 5411359. PMID 28507929.
- ↑ "Transplant Pathology Internet Services".