Current Concepts in Pediatric Nonalcoholic Fatty Liver Disease

• Autores: Sarah E. Fleet, Jay H. Lefkowitch, J.E. Lavine
• Localización: Gastroenterology clinics of North America, ISSN 0889-8553, Vol. 46, Nº. 2, 2017 (Ejemplar dedicado a: Liver Pathology), págs. 217-231
• Idioma: inglés
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• Resumen

  • 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.