Non-alcoholic fatty liver disease screening: Difference between revisions

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== Screening modalities ==
== Screening modalities ==
* Serum tests of liver function
* Serum tests of liver function
{{Family tree/start}}
{{Family tree ||| | A01 | | | |A01= Incidental finding of Fatty liver on ultrasound}}
{{Family tree | | | | |!| | | | | }}
{{Family tree ||| | A01 | | | |A01= Check for persistently raised LFTs}}
{{Family tree | | | | |!| | | | | }}
{{Family tree || | | B01 | | | |B01= Ask the patient for significant alcohol intake}}
{{Family tree | |,|-|-|^|-|-|.| | }}
{{Family tree | C01 | | | | C02| |C01= NO| C02= YES}}
{{familytree  | |!| | | | | |!| | | | | | | | | | }}
{{Family tree | D01 | | | | D02 |D01= Diagnose NAFLD| D02= Consider other<br> alcoholic related diseases}}
{{Family tree/end}}
'''Monitor severity of the disease'''
{{Family tree/start}}
{{Family tree | | | | | | A01 | | | |A01= Offer Enhanced Liver Fibrosis Test (ELF)}}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | |,|-|-|^|-|-|.| | }}
{{Family tree | | | C01 | | | | C02 |C01= (>10.51)  ELF  Positive| C02= (<10.51) ELF Negative}}
{{Family tree | | | |!| | | | | |!| | }}
{{Family tree | | | D01 | | | | D02 |D01= Indicating advanced fibrosis and risk of progression to cirrhosis| D02= Typically Benign -- Advanced fibrosis unlikely}}
{{Family tree | | | |!| | | | | | | | }}
{{Family tree | | | E01 | | | | |E01= Refer the patient to Heptologist}}
{{Family tree/end}}
* On negative ELF test offer retest for every 3 years for adults and 2 years for children.


==References==
==References==

Revision as of 20:38, 22 December 2017

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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

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, American Gastroenterological Association Technical Review recommends screening for non-alcoholic fatty liver disease in population at high risk such as obesity, insulin resistance, and metabolic syndrome.
  • Screening is however complicated by the lack of accurate, noninvasive diagnostic tools for NAFLD and the lack of clear treatment that can be proposed to the patient.

Screening modalities

  • Serum tests of liver function

References

  1. 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.
  2. 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.
  3. 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.
  4. "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".

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