Non-alcoholic fatty liver disease classification
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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
Non-alcoholic fatty liver disease may be classified based on clinical presentation into non-alcoholic fatty liver and non-alcoholic steatohepatitis.
Classification
Non-alcoholic fatty liver disease may be classified based on clinical presentation into non-alcoholic fatty liver and non-alcoholic steatohepatitis.[1][2][3]
| Based on clinical presentation | |
|---|---|
| Non-alcoholic fatty aliver | Non-alcoholic steatohepatitis |
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| Based on histopathology | |
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Histopathological classification
Histological classification of NASH inlcudes Grading and staging.
Grading
NAFLD activity score is employed for grading steatohepatitis of NASH. NAS represents the sum of scores for steatosis, lobular inflammation, and ballooning.[4][5]
| Component | Range | Score |
|---|---|---|
| Steatosis | <5% | 0 |
| 5-33% | 1 | |
| 34-66% | 2 | |
| >66% | 3 | |
| Lobular Inflammation | None | 0 |
| <2 focci | 1 | |
| 2-4 | 2 | |
| >4 | 3 | |
| Hepatocyte Balloning | None | 0 |
| Few ballooned cells | 1 | |
| Many ballooned cells | 2 | |
| Interpretation | 0-2 | Non-diagnostic |
| 3-4 | Borderline | |
| 5-8 | Diagnostic |
Staging
Based on the degree of fibrosis on biospy NASH can be classified into 4 stages.
| Staging | |
|---|---|
| Stage 1 |
Zone 3 fibrosis |
| Stage 2 | Perisinusoidal and portal/periportal fibrosis |
| Stage 3 | Bridging fibrosis |
| Stage 4 | Cirrhosis |
References
- ↑ Hashimoto E, Tokushige K, Ludwig J (2015). "Diagnosis and classification of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: Current concepts and remaining challenges". Hepatol Res. 45 (1): 20–8. doi:10.1111/hepr.12333. PMID 24661406.
- ↑ Cobbina E, Akhlaghi F (2017). "Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters". Drug Metab Rev. 49 (2): 197–211. doi:10.1080/03602532.2017.1293683. PMC 5576152. PMID 28303724.
- ↑ Monteiro JM, Monteiro GM, Caroli-Bottino A, Pannain VL (2014). "Nonalcoholic fatty liver disease: different classifications concordance and relationship between degrees of morphological features and spectrum of the disease". Anal Cell Pathol (Amst). 2014: 526979. doi:10.1155/2014/526979. PMC 4333905. PMID 25763333.
- ↑ 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".