Non-alcoholic fatty liver disease screening

Non-Alcoholic Fatty Liver Disease Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case studies
Case #1
Non-alcoholic fatty liver disease screening On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Non-alcoholic fatty liver disease screening All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Non-alcoholic fatty liver disease screening
CDC on Non-alcoholic fatty liver disease screening
Non-alcoholic fatty liver disease screening in the news
Blogs on Non-alcoholic fatty liver disease screening
Directions to Hospitals Treating Non-alcoholic fatty liver disease
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:

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

Overview

There is insufficient evidence to recommend routine screening for NAFLD.But it can be aruged that at least for high risk profiles like obesity, insulin resistence and patients with metabolic syndrome should be screened for NAFLD. However, at present there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzymes have NAFLD and NASH and may be not enough for screening alone but with ultrasound which is sensitive can serve as a screenig tests.

Screening

• There is insufficient evidence to recommend routine screening for NAFLD.
• Most of the time NAFLD is accidental finding on routine ultrasound.
• NAFLD usually has no symptoms. So diagnosing the problem often starts after a blood test finds higher-than-normal levels of liver enzymes. A standard blood test could reveal these results.

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.