Non-alcoholic fatty liver disease natural history, complications and prognosis: Difference between revisions
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*Common complications of NAFLD include:<ref name="pmid27063276">{{cite journal| author=Chacko KR, Reinus J| title=Extrahepatic Complications of Nonalcoholic Fatty Liver Disease. | journal=Clin Liver Dis | year= 2016 | volume= 20 | issue= 2 | pages= 387-401 | pmid=27063276 | doi=10.1016/j.cld.2015.10.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27063276 }} </ref><ref name="pmid26378641">{{cite journal| author=Vanni E, Marengo A, Mezzabotta L, Bugianesi E| title=Systemic Complications of Nonalcoholic Fatty Liver Disease: When the Liver Is Not an Innocent Bystander. | journal=Semin Liver Dis | year= 2015 | volume= 35 | issue= 3 | pages= 236-49 | pmid=26378641 | doi=10.1055/s-0035-1562944 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26378641 }} </ref> | *Common complications of NAFLD include:<ref name="pmid27063276">{{cite journal| author=Chacko KR, Reinus J| title=Extrahepatic Complications of Nonalcoholic Fatty Liver Disease. | journal=Clin Liver Dis | year= 2016 | volume= 20 | issue= 2 | pages= 387-401 | pmid=27063276 | doi=10.1016/j.cld.2015.10.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27063276 }} </ref><ref name="pmid26378641">{{cite journal| author=Vanni E, Marengo A, Mezzabotta L, Bugianesi E| title=Systemic Complications of Nonalcoholic Fatty Liver Disease: When the Liver Is Not an Innocent Bystander. | journal=Semin Liver Dis | year= 2015 | volume= 35 | issue= 3 | pages= 236-49 | pmid=26378641 | doi=10.1055/s-0035-1562944 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26378641 }} </ref> | ||
**[[Fibrosis]] | **[[Fibrosis]] | ||
**[[Cirrhosis]] | **[[Cirrhosis]]. Amon patients with both [[hepatic steatosis]] and elevated [[liver function tests]], the incidence rate of cirrhosis is 3.37 (95% CI: 2.34-4.86) per 1000 1000 person-years. | ||
**[[Internal bleeding]] | **[[Internal bleeding]] | ||
**Encepholopathy | **Encepholopathy | ||
Revision as of 20:25, 2 February 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
If left untreated non-alcoholic fatty liver disease may progress to fibrosis and, later cirrhosis. Studies of serial liver biopsies estimate a 26-37% rate of hepatic fibrosis and 2-15% rate of cirrhosis in less than 6 years. Common complications of NAFLD include fibrosis, cirrhosis, internal bleeding, encephalopathy. The presence of fibrosis and cirrhosis associated with a particularly poor prognosis among patients with NAFLD.
Natural History, Complications and Prognosis
Natural History
- The symptoms of NAFLD usually develop in the 40th decade of life, and usually asymptomatic at first.
- After following NAFLD patients for long-term the outcome of the disease is as follows
- If left untreated, patients with NAFLD may progress to develop hepato-cellular carcinoma (HCC). But it is directly propotional to the degree of fibrosis and advanced cirrhosis
- Children who are positive with NAFLD are also prone to short lifespan when compared to general population.[1]
Complications
- Common complications of NAFLD include:[2][3]
- Fibrosis
- Cirrhosis. Amon patients with both hepatic steatosis and elevated liver function tests, the incidence rate of cirrhosis is 3.37 (95% CI: 2.34-4.86) per 1000 1000 person-years.
- Internal bleeding
- Encepholopathy
Non-alcoholic fatty liver disease, especially if with cirrhosis, may be associated with thrombocytopenia[4][5].
Prognosis
- Depending on the extent of the fibrosis and cirrhosis at the time of diagnosis, the prognosis may vary.[6]
- Histology is the most reliable means to grade the severity of the disease and thus estimate prognosis.
- The presence of fibrosis and cirrhosis associated with a particularly poor prognosis among patients with NAFLD. [7]
References
- ↑ Calzadilla Bertot L, Adams LA (2016). "The Natural Course of Non-Alcoholic Fatty Liver Disease". Int J Mol Sci. 17 (5). doi:10.3390/ijms17050774. PMC 4881593. PMID 27213358.
- ↑ Chacko KR, Reinus J (2016). "Extrahepatic Complications of Nonalcoholic Fatty Liver Disease". Clin Liver Dis. 20 (2): 387–401. doi:10.1016/j.cld.2015.10.004. PMID 27063276.
- ↑ Vanni E, Marengo A, Mezzabotta L, Bugianesi E (2015). "Systemic Complications of Nonalcoholic Fatty Liver Disease: When the Liver Is Not an Innocent Bystander". Semin Liver Dis. 35 (3): 236–49. doi:10.1055/s-0035-1562944. PMID 26378641.
- ↑ Rivera-Álvarez M, Córdova-Ramírez AC, Elías-De-La-Cruz GD, Murrieta-Álvarez I, León-Peña AA, Cantero-Fortiz Y; et al. (2021). "Non-alcoholic fatty liver disease and thrombocytopenia IV: its association with granulocytopenia". Hematol Transfus Cell Ther. doi:10.1016/j.htct.2021.06.004. PMID 34312112 Check
|pmid=value (help). - ↑ Panke CL, Tovo CV, Villela-Nogueira CA, Cravo CM, Ferreira FC, Rezende GFM; et al. (2020). "Evaluation of thrombocytopenia in patients with non-alcoholic fatty liver disease without cirrhosis". Ann Hepatol. 19 (1): 88–91. doi:10.1016/j.aohep.2019.05.011. PMID 31575467.
- ↑ Suman, A.; Khullar, V.; Limaye, A. (2016). "Complications of Non-Alcoholic Fatty Liver Disease". Journal of Hepatology. 64 (2): S473. doi:10.1016/S0168-8278(16)00798-4. ISSN 0168-8278.
- ↑ Jepsen P, Grønbæk H (2011). "Prognosis and staging of non-alcoholic fatty liver disease". BMJ. 343: d7302. doi:10.1136/bmj.d7302. PMID 22102440.