Diagnostic challenges of nonalcoholic fatty liver disease (NAFLD) in children of normal weight - 14/06/11

Doi : 10.1016/j.clinre.2011.04.001

Jason Y.K. Yap ^a,^h, Constance O’Connor ^a, Diana R. Mager ^f,^h, Glenn Taylor ^b,^g, Eve A. Roberts ^a,^⁎,^c,^d,^e
^a Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
^b Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
^c Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
^d Department of Medicine, University of Toronto, Toronto, Ontario, Canada
^e Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
^f Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
^g Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada
^h Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

Corresponding author. Tel.: +1 416 813 6171; fax: +1 416 813 4972.

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Summary

Background

Nonalcoholic fatty liver disease (NAFLD) is generally regarded as affecting the overweight or obese. Though previously reported, the notion that NAFLD occurs in the presence of normal body weight (adult BMI<25) is unfamiliar in adults and problematic in children. Normal-body-weight NAFLD accounts for approximately 15% of all NAFLD and may be more prevalent with certain ethnicities.

Case

We describe a case of a child who appeared to have normal-body-weight NAFLD, on the basis of typical age of presentation, ultrasonographically evident hepatic steatosis and compatible liver histology, including a NAFLD activity score of 7, but was shown conclusively to have cystic fibrosis. Further we present a clinical strategy for diagnosis of childhood NAFLD, which would discriminate between this patient and actual normal-body-weight NAFLD children in our clinical practice.

Conclusion

NAFLD requires affirmative diagnostic criteria and should not be merely a diagnosis of exclusion.

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Abbreviations

Case report

Discussion

Disclosure of interest

Esportazione

Vol 35 - N° 6-7

P. 500-505 - Giugno 2011 Ritorno al numero

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Diagnostic challenges of nonalcoholic fatty liver disease (NAFLD) in children of normal weight - 14/06/11

Summary

Background

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Conclusion

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