4.3 Article

Current Concepts in Pediatric Nonalcoholic Fatty Liver Disease

Journal

GASTROENTEROLOGY CLINICS OF NORTH AMERICA
Volume 46, Issue 2, Pages 217-+

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.gtc.2017.01.002

Keywords

Steatohepatitis; NASH; Obesity; Metabolic syndrome; Histopathology

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Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disease. Its increasing prevalence is a direct result of historically high rates of obesity. Hepatocyte lipid accumulation is the first step in a cascade of metabolic and inflammatory events thought to precipitate NAFLD. Histologic findings provide insight into these events. Lifestyle modification remains the primary therapy in children. Current recommendations include vitamin E treatment in those with biopsy-proven NASH. Trials of novel drugs are ongoing in adults. As efficacy/safety are established, these therapies may be tenable for use in children. At the current time, biopsy-driven histology endpoints are necessary to establish whether future therapies can improve pediatric or adult-type NASH in children.

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