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Flashcards in NAFLD Deck (13):
1

what is the most common liver abn in kids 2-19

more common in girls or boys

nonalcoholic fatty liver disease NAFLD

more common in boys

2

what is NAFLD

what is the more benign and the more severe version
are they both reversible

A condition in which excess fat accumulates in the liver of people who drink little or no alcohol.

benign is steatosis (just fat infiltrating liver cells without inflm)--likely reversible
nonalcoholic stateohepatitis involves inflm of liver and hepatocellular damage that can lead to cirrhosis--irreversible

3

what are potential complications of NAFLD

cirrhosis of liver, atheroclerosis and other cardiovascular issues, maybe inc risk of DM II or other metb issues
could progress to death or need transplant

4

how do you get definitive Dx of NAFLD

liver biopsy

5

what are the risk factors for NAFLD

mainly overnutrition and sedentary lifestyle
Obesity--especially visceral adiposity
High Blood Cholesterol
Type Two Diabetes
Malnutrition--excess fructose in soft drinks
Rapid Weight Gain or loss
Medication: steroids, exposure to toxins and
chemicals

6

patho of NAFLD

unclear
overnutrition and sedentary lifestyle and poor diet eg fructose leads to insulin resistance, metb syndrome, change in lipogenesis and obstr sleep apnea

they may have mitochondrial dysfx

genes might be involved

cytokines involved

7

major mnfts of NAFLD

in gen it is asymptomatic

faituge
wt loss
malaise
pain in upper R abd

kid is often obese making liver palpation difficult but if you could you would feel mild-mod hepatomegaly
-many kids have acanthosis nigricans

8

what is acanthosis nigricans

what does it often signify

Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, forehead, and other areas.

often in those w prediabetes or insulin issues. and the overwt or those w dark skin

9

dx of NAFLD

is liver biopsy used freq

as biopsy is invasive, $$, there are complications so other tests are done first

10

what blood testsdo they run first for NAFLD and which are sensitive and specific

what is the most common finding

-most common is mild-mod elevation of serum ALT
-mild GGT
insulin resistance tests (hyperinsulinemia might be firt indication)
-hypertriglyceridemia and lipid profile
uric acid
-CK 18 a biomarker

no test is really sensitive or specific

11

imaging for NAFLD Dx
which of the following is not used and why
US, CT, MRI

US and MRI mostly
CT uses radiation. no good for kids!

12

if a kid is obese what tests would they likely run to check for NAFLD

liver transaminases and US.. if this indicates theres poss NAFLD then check for insulin resistance then run other tests and if highly suspicious then biopsy

13

tx of NAFLD

lifestyle to dec risk factors as theres no direct Tx

-wt loss (not rapid eg >few lbs a wk)
-change diet to high fruit and veg and low fat low GI
-dec screen time
-inc exercise to 150mins a wk or 75 vigorous exercise. more is better of course
-avoid tylenol and ETOH other hepatotoxins
-manage other issues eg DM II etc
-antioxidant vitamins might be useful..eg vit E...unclear

liver transplant if severe