Liver & Gall Bladder
Which one of the following clinical procedures or tests should be used to confirm a diagnosis of nonalcoholic steatohepatitis? (AIIMS Nov 2014)
|A||Abdominal magnetic resonance imaging|
a. Nonalcoholic fatty liver disease (NAFLD) is a type of chronic hepatitis characterized by liver damage similar to alcohol-induced liver damage except it occurs in individuals who do not abuse alcohol.
b. Risk factors for NAFLD include diabetes mellitus, obesity, hyperlipidemia, and rapid weight loss.
c. Patients are usually asymptomatic, but can develop fatigue, malaise, right upper quadrant abdominal discomfort, and hepatomegaly.
d. Laboratory findings include elevated liver enzymes along with increased serum cholesterol, triglyceride, and glucose.
e. Ultrasonography reveals a diffuse increased density that is similar in appearance to cirrhosis.
f. Liver biopsy, which is the best diagnostic test for confirming the diagnosis, reveals macrovesicular steatosis, which refers to the accumulation of neutral lipid (triglyceride) in hepatocytes.
g. Steatosis can be divided into two types: macrovesicular steatosis, with a single large vacuole, peripheral nucleus, and microvesicular steato sis, with many small vacuoles, central nucleus.
h. Alcohol is the most common cause of macrovesicular steatosis, but it is also characteristic of NAFLD.
i. Nonalcoholic steatohepatitis (NASH) is a subtype of NAFLD and is characterized by the combination of steatosis, inflammation, and hepatocyte ballooning and necrosis.
j. The diagnosis of steatohepatitis can only be made with a liver biopsy.