| Theme |
NASH -- Pathogenesis and Treatment |
| Title |
Diagnostic Criteria for NAFLD／NASH |
| Author |
Miwa Kawanaka |
Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School |
| Author |
Gotaro Yamada |
Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School |
| [ Summary ] |
Nonalcoholic fatty liver disease (NAFLD) includes the category of nonalcoholic fatty liver (NAFL) conditions. These are generally mild, nonalcoholic steatohepatitis (NASH) which progresses to cirrhosis, liver failure and liver cancer. The diagnosis of NAFLD is based on the following criteria, (1) intake of less than 20 g of ethanol per day, or (2) appropriate exclusion of HBV, HCV, autoimmune liver disease, drug induced liver injury or metabolic liver disorders. Liver biopsy is the most reliable approach to identify the presence of steatohepatitis and fibrosis in patients with NAFLD. NAFL is indicated by the presence of hepatic steatosis with no evidence of hepatocyte injury (ballooning). NASH is indicated by the presence of heptic steatosis and inflammation with ballooning with or without fibrosis. It is easy to diagnose typical NASH, histologically. However, some patients with mild stage NASH or with burn-out NASH are still difficult to accurately diagnose. |