| Theme |
Nonalcoholic Steatohepatitis (NASH) |
| Title |
Diagnostic Criteria for NASH |
| Author |
Norihito Yamauchi |
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine |
| Author |
Yoshio Sumida |
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine |
| Author |
Takeshi Okanoue |
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine |
| [ Summary ] |
Recently, much attention has been paid to nonalcoholic steatohepatitis (NASH) world wide, but an universal diagnostic criteria for NASH has not been. In this review, we give the outlines of the clinical and histological characteristics of NASH and an overview of the changes and controversial points of the criteria proposed. Essential factors for establishing NASH diagnoses are the following: (1) exclusion of alcoholism, (2) lack of other liver disease, and (3) identification of histological features, indistinguishable from alcoholic hepatitis. The absence of significant alcohol use has been defined in recent published studies as being an intake of less than 20g of alcohol per day. With the exception of viral hepatitis, none of the viral markers may generally be detected. Likewise, autoantibodies associated with liver disease should be negative, and other metabolic liver diseases may be ruled out serologically. Liver biopsy interpretation remains the "gold standard" for diagnosis of NASH. Although the histological criteria for the diagnosis of NASH are still controversial, histological lesions including macrovesicular steatosis, lobular inflammation and hepatocyte ballooning degeneration are considered essential findings to establishing a diagnosis of NASH. |