Clinical Gastroenterology Vol.33 No.1(2)

Theme NASH 2018
Title Diagnosis of NASH -- The Algorithm and Related Problems
Publish Date 2018/01
Author Kazushi Sugimoto Department of Gastroenterology and Hepatology, Mie University School of Medicine
Author Yoshiyuki Takei Department of Gastroenterology and Hepatology, Mie University School of Medicine
[ Summary ] The guidelines indicate that viral hepatitis and autoimmune liver diseases should be excluded in the diagnosis of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) in cases with liver dysfunction or fatty liver. In addition, liver injury as a result of drugs that can cause fat deposition in the liver is increasing and should be also excluded. The most important differential diagnosis is alcoholic liver disease. The guidelines indicate that ethanol consumption should be less than 30 g/day for men and 20 g/day for women to diagnose them with NAFLD. However, sometimes the diagnosis of NAFLD is confusing, as it is difficult to evaluate the accurate amount of ethanol intake. Liver biopsy is currently the golden standard for differentiation of nonalcoholic fatty liver (NAFL) and NASH. The development of effective therapy for NAFLD and a useful biomarker with which we can follow up the clinical course of NAFLD non‒invasively is necessary in the near future.
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