Page 26 - Clinical Biochemistry

• Affects 3.5-5% of the population.
• The rates of progression to cirrhosis have been estimated at between 5% and 20% over 10
years.
• There aren't any non-invasive means of predicting which patients are at risk of
progression, and there are no agreed guidelines on how to monitor progression.
Management of NASH
• The patient should lose weight and exercise.
• Pharmacological treatment of Insulin-resistance.
• Treatment of Hyperlipidemia.
• Hepatocyte-Protective treatment.
Diagnosis
NAFLD is a diagnosis of exclusion
-Alcoholic Hepatitis.
-Drug induced Hepatitis (tamoxifen, amiodarone).
-Viral Hepatitis.
-Autoimmune Hepatitis.
Laboratory Investigations
• None of the currently used tests are specific for the diagnosis of NAFLD.
• Aminotransferase elevation (< 4 times).
Liver biopsy
➢ The gold standard for both diagnosis & prognosis.
➢ Is not necessary in a typical patient.
Limitations:
• Invasive.
• Risk of complications.