Non-alcoholic fatty liver disease screening: Difference between revisions
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==Screening== | ==Screening== | ||
* There is insufficient evidence to recommend routine screening for NAFLD | * There is insufficient evidence to recommend routine screening for NAFLD in general population.<ref name="pmid28544608">{{cite journal| author=Koot BGP, Nobili V| title=Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance? | journal=Obes Rev | year= 2017 | volume= 18 | issue= 9 | pages= 1050-1060 | pmid=28544608 | doi=10.1111/obr.12556 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28544608 }} </ref><ref name="pmid28213828">{{cite journal| author=Kummer S, Klee D, Kircheis G, Friedt M, Schaper J, Häussinger D et al.| title=Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis. | journal=Eur J Pediatr | year= 2017 | volume= 176 | issue= 4 | pages= 529-536 | pmid=28213828 | doi=10.1007/s00431-017-2876-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28213828 }} </ref><ref name="pmid27605111">{{cite journal| author=Glen J, Floros L, Day C, Pryke R, Guideline Development Group| title=Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance. | journal=BMJ | year= 2016 | volume= 354 | issue= | pages= i4428 | pmid=27605111 | doi=10.1136/bmj.i4428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27605111 }} </ref><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#sec8 |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> | ||
* | * However, screening for non-alcoholic fatty liver disease is recommended in population at high risk like [[obesity]], [[insulin resistance]], and [[metabolic syndrome]]. | ||
Revision as of 19:17, 21 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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Diagnosis |
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Treatment |
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Case studies |
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Non-alcoholic fatty liver disease screening On the Web |
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American Roentgen Ray Society Images of Non-alcoholic fatty liver disease screening |
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Directions to Hospitals Treating Non-alcoholic fatty liver disease |
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Risk calculators and risk factors for Non-alcoholic fatty liver disease screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
There is insufficient evidence to recommend routine screening for NAFLD in general population. However, screening is recommended in high-risk population groups(obesity, insulin resistance and patients with metabolic syndrome) as more than 50 million Americans have been estimated to have metabolic syndrome and about 80% of them have NAFD.
Screening
- There is insufficient evidence to recommend routine screening for NAFLD in general population.[1][2][3][4]
- However, screening for non-alcoholic fatty liver disease is recommended in population at high risk like obesity, insulin resistance, and metabolic syndrome.
| Incidental finding of Fatty liver on ultrasound | |||||||||||||||||||||||||||||||||||
| Check for persistently raised LFTs | |||||||||||||||||||||||||||||||||||
| Ask the patient for significant alcohol intake | |||||||||||||||||||||||||||||||||||
| NO | YES | ||||||||||||||||||||||||||||||||||
| Diagnose NAFLD | Consider other alcoholic related diseases | ||||||||||||||||||||||||||||||||||
Monitor severity of the disease
| Offer Enhanced Liver Fibrosis Test (ELF) | |||||||||||||||||||||||
| (>10.51) ELF Positive | (<10.51) ELF Negative | ||||||||||||||||||||||
| Indicating advanced fibrosis and risk of progression to cirrhosis | Typically Benign -- Advanced fibrosis unlikely | ||||||||||||||||||||||
| Refer the patient to Heptologist | |||||||||||||||||||||||
- On negative ELF test offer retest for every 3 years for adults and 2 years for children.
References
- ↑ Koot BGP, Nobili V (2017). "Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance?". Obes Rev. 18 (9): 1050–1060. doi:10.1111/obr.12556. PMID 28544608.
- ↑ Kummer S, Klee D, Kircheis G, Friedt M, Schaper J, Häussinger D; et al. (2017). "Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis". Eur J Pediatr. 176 (4): 529–536. doi:10.1007/s00431-017-2876-1. PMID 28213828.
- ↑ Glen J, Floros L, Day C, Pryke R, Guideline Development Group (2016). "Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance". BMJ. 354: i4428. doi:10.1136/bmj.i4428. PMID 27605111.
- ↑ "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".