Non-alcoholic fatty liver disease screening
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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".