Affordable Access

Nonalcoholic fatty liver disease in children: recent practice guidelines, where do they take us?

Authors
Type
Published Article
Journal
Current pediatric reviews
Publication Date
Volume
10
Issue
2
Pages
151–161
Identifiers
PMID: 25088269
Source
Medline
License
Unknown

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children and adolescents in the United States. It is strongly associated with childhood obesity, insulin resistance and metabolic syndrome. Although some children with NAFLD may remain asymptomatic, progression to nonalcoholic steatohepatitis (NASH), and to advanced stages of fibrosis and cirrhosis is well recognized. Unfortunately, despite the increase in awareness of this disease, there are still no reliable non-invasive diagnostic tests and liver biopsy remains the gold standard for the diagnosis of NASH and staging of fibrosis. In addition, there are no approved pharmacological treatments currently. Lifestyle modification remains the cornerstone of treatment. Team based multidisciplinary approach involving hepatologists, endocrinologists, exercise physiologist, dieticians, and cardiologists may lead to better outcomes. Recently, the American Association for the Study of Liver Diseases (AASLD) and European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) committees have made recommendations for the diagnosis and management of NAFLD in pediatric patients. This review focuses on current literature on epidemiology, natural history, pathogenesis along with summarizing the recent guidelines on diagnosis and treatment of pediatric NAFLD.

Statistics

Seen <100 times