Non-alcoholic fatty liver disease other diagnostic studies: Difference between revisions
Aditya Ganti (talk | contribs) |
Aditya Ganti (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Non alcoholic fatty liver disease}} | {{Non alcoholic fatty liver disease}} | ||
{{CMG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
Revision as of 16:35, 22 December 2017
|
Non-Alcoholic Fatty Liver Disease Microchapters |
|
Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case studies |
|
Non-alcoholic fatty liver disease other diagnostic studies On the Web |
|
American Roentgen Ray Society Images of Non-alcoholic fatty liver disease other diagnostic studies |
|
FDA on Non-alcoholic fatty liver disease other diagnostic studies |
|
CDC on Non-alcoholic fatty liver disease other diagnostic studies |
|
Non-alcoholic fatty liver disease other diagnostic studies in the news |
|
Blogs on Non-alcoholic fatty liver disease other diagnostic studies |
|
Directions to Hospitals Treating Non-alcoholic fatty liver disease |
|
Risk calculators and risk factors for Non-alcoholic fatty liver disease other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Liver biopsy may be helpful in the diagnosis of non-alcoholic fatty liver disease. Findings on biopsy include macrovesicular steatosis, inflammation, ballooning degeneration, zone 3 perivenular/periportal/perisinusoidal fibrosis and, finally, mallory bodies.
Other Diagnostic Studies
- Liver biopsy is considered as a gold-standard for diagnosing, grading, and staging NAFLD.
- Requires dexterity and skill
- Invasive test
- Associated with significant bleeding risk in patients with clotting abnormalities due to hepatic disease.
Complications
Complications of liver biopsy are rare but include
- Pain
- Hypotension
- Peritonitis
- Intraperitoneal hemorrhage
- Biliary injury
Findings
Classically, biopsy reveals:[1][2]
- Macrovesicular steatosis
- Inflammatory cells
- Ballooning degeneration
- Zone 3 perivenular/periportal/perisinusoidal fibrosis
- Mallory bodies
Interpretation
- Histologic changes in NAFLD are very similar to those in alcoholic hepatitis and may also mimic those seen in chronic HCV infection
- The spectrum of abnormalities varies from simple bland steatosis to NASH, in which steatosis is associated with mixed inflammatory cell infiltration, mostly lobular, and liver injury.
- Cell injury is manifested by hepatocyte ballooning as well as by Mallory hyaline and acidophilic bodies.
- Fibrosis is classically perisinusoidal/perivenular and may lead to bridging fibrosis and cirrhosis.
- Although portal tracts are relatively spared in adult NAFLD, children with this condition may have a predominance of portal inflammation and fibrosis as opposed to lobular involvement.
- Compared with alcoholic hepatitis, NASH is associated with a higher prevalence of nuclear vacuoles and steatosis, while alcoholic hepatitis tends to produce periportal and pericellular fibrosis.
- Alcoholic hepatitis presents with identical histology but patient history and/or biochemistry will indicate prolonged, excessive alcohol intake.[3]
References
- ↑ Angula P. Nonalcoholic Fatty Liver Disease. NEJM. 2002 346(16):1221-31
- ↑ Brunt EM, Janney CG, Di Bisceglie AM et al. Nonalcoholic steatohepatitis: A proposal for grading and staging the histological lesions. Am. J. Gastroenterol. 1999; 94(9):2467-2474
- ↑ Skelly et al. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol 2001;35:195-9