Liver Symposium - Non Alcoholic Fatty Liver Disease, Autoimmune Disease and Liver transplantation Flashcards
(28 cards)
What is the pathology of Non alcoholic fatty liver disease
Simple steatosis
causes
Non alcoholic steatoheaptits
which further develops into
Fibrosis and cirrhosis
Define simple steatosis
Infiltration of liver cells with fat cells
Define Nonalcoholic steatoheaptits
liver inflammation and damage caused by a buildup of fat in the liver
What are the metabolic risk factors of NonAlcoholic Fatty Liver Disease
Diabetes mellitus
Obesity
Hypertriglyceridemia
Hypertension
What are the other risk factors for Non alcoholic fatty liver disease
Age Ethnicity (e.g. Hispanics) Genetic factors (e.g. PNPLA3 gene)
What imaging is sued in diagnosis Non alcoholic fatty liver disease
Ultrasound (Fibrocan determine how much fibrosis or fat)
MR/CT
MR spectum - see fat
What are the three biomarker used in the diagnosis of nonalcoholic fatty liver disease
AST/ALT ratio - see is its alcohol or not (AST.>ALT)
Enhanced Liver fibrosis pannel
Cytokertatin 18
What is the additional test used in the diagnosis of non alcoholic fatty liver disease
Liver biopsy
Define a high risk patient for NAFLD
> 45 years
Diabettic
BMI >30
> 1 (AST>ALT)
Platelets count low
Low albumin
(3 or more patient at high risk)
What is non drug treatment of Non alcoholic fatty liver disease
Diet
Exercise
for weigh reduction
Weight reduction surgeries
What is the drug treatment for non alcoholic fatty liver disease
Insulin sensitizers e.g. Metformin, Pioglitazone
Glucagon-like peptide-1 (GLP-1) analogues
e.g. Liraglutide
Farnesoid X nuclear receptor ligand
e.g. Obeticholic acid
Vitamin E
What are three examples of autoimmune diseases of the liver
Automimmune hepatitis
Primary Biliary cholangitis
Primary sceloring cholangitis
What is signs of autoimmune hepatitis
Elevated IgG
Antibodies:
Type 1: ANA, SMA
Type 2: LKM1
Type 3: SLA
Abnormal liver function test
What treatment doe autoimmune hepatitis respond well to
Long term azathioprine
and steroid
What us primary bilary cholangitis
Inflammation of the Intrahepatic bile duct
Symptoms primary bilary cholangitis
Fatigue
Pruritus - itchy skin
What is shown in the biochemical tests for primary biliary cholangitis
Antimitochondrial antibody postive
IgM elevated
What is the treatment of primary biliary cholangitis
Ursodeoxycholic acid - flushes out bile
What is primary sectoring cholangitis
Inflammation of intra and extra hepatic bile duct
What is best used in diagnosis primary sceloring cholangitis
Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary
What is a biomarker forprimary sceloring cholangitis
pANCA positive
What is the treatment forprimary sceloring cholangitis
Liver transplant
Biliary stent
When conditions require a liver transplant
Chronic liver poor predicted survival or poor quality of life
Hepatocellular carcinoma
Acute liver failure
Genetic diseases e.g. primary oxaluria, tyrosemia
What is the main contradictions for liver transplantation
Active substance or alcohol abuse
