RT Book, Section
A1 Triggs, Nicole
A1 Himes, Ryan
A2 Kline, Mark W.
SR Print(0)
ID 1182909343
T1 Fatty Liver Disease
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182909343
RD 2024/04/19
AB Fatty  liver  disease  describes  the  accumulation  of  excess  fat  in  liver  cells.  Fatty  liver  may  cause  no  damage,  but  in  some  cases,  the  excess  fat  leads  to  inflammation  in  the  liver,  known  as  steatohepatitis.  In  adults,  fatty  liver  has  traditionally  been  most  frequently  associated  with  alcohol  ingestion.  Therefore,  the  term  nonalcoholic  is  used  to  differentiate  the  disorders  described  in  this  section  from  alcohol-induced  fatty  liver.  Nonalcoholic  fatty  liver  disease  (NAFLD)  is  an  umbrella  term  describing  a  spectrum  of  liver  abnormalities  from  bland  steatosis  to  hepatocellular  injury,  fibrosis,  and  even  cirrhosis,  resulting  from  fat  accumulation.  Nonalcoholic  steatohepatitis  (NASH)  is  a  subtype  of  NAFLD  characterized  by  steatosis,  ballooning  hepatocyte  degeneration,  and  inflammation  (Fig.  421-1).  A  large  variety  of  acquired  and  inherited  conditions  can  result  in  fatty  liver  disease  (Table  421-1),  but  by  far,  the  most  common  cause  in  the  pediatric  population  is  related  to  overweight  and  obesity.  In  the  United  States,  69%  of  adults  and  30%  of  children  are  overweight  or  obese  (see  also  Chapter  24).  As  the  prevalence  of  obesity  has  increased,  so  has  the  prevalence  of  comorbid  diseases,  such  as  NAFLD.  NASH  was  first  reported  by  Ludwig  and  colleagues  in  1980,  when  they  described  hepatic  histologic  findings  similar  to  alcoholic  steatohepatitis  in  adults  not  consuming  significant  amounts  of  alcohol.  In  1983,  Moran,  and  colleagues  described  NASH  in  obese  children.  Although  bland  steatosis  alone  is  thought  to  be  nonprogressive,  or  very  slowly  progressive,  NASH  can  progress  to  cirrhosis,  and  NASH-related  cirrhosis  has  been  reported  in  children  as  young  as  10  years  of  age.  Currently,  NAFLD  is  considered  to  be  the  most  common  reason  for  unexplained  abnormal  liver  tests  in  the  pediatric  population  and  the  most  common  chronic  liver  disease  in  the  Western  world.