Medical history (history of illness) represents an important component in the diagnosis of steatosis hepatis (fatty liver). Family history What is the general health status of your relatives? Are there any liver diseases in your family that are common? Social history What is your profession? Are you exposed to harmful working substances in your profession? … Fatty Liver (Steatosis Hepatis): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia characterized by deficiency of apolipoprotein B48 and B100; defect in the formation of chylomicrons leading to fat digestion disorders in children, resulting in malabsorption (disorder of food absorption). Endocrine, nutritional … Fatty Liver (Steatosis Hepatis): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by steatosis hepatis (fatty liver): Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus type 2 – 2 out of 3 diabetic patients have a fatty liver. Metabolic syndrome – clinical name for the symptom combination of obesity (overweight), hypertension (high blood … Fatty Liver (Steatosis Hepatis): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye), with attention to skin and mucous membrane color and hydration status. Abdomen (abdomen) Shape of the abdomen? Skin color? … Fatty Liver (Steatosis Hepatis): Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count (alcohol consumption: MCV ↑). Fasting glucose (fasting blood glucose, fasting plasma glucose; preprandial plasma glucose; venous). HbA1c (long-term blood glucose value) Ferritin (iron stores) [ferritin ↑, in 29-50% of cases]. Triglycerides Total cholesterol and LDL/HDL ratio Liver parameters – alanine aminotransferase (ALT, GPT), … Fatty Liver (Steatosis Hepatis): Test and Diagnosis
Therapeutic targets Reduction of insulin resistance (decreased or abolished action of the hormone insulin) with decreased cardiovascular end-organ damage. Prevention of progression (progression) to nonalcoholic steatohepatitis (NASH) and/or hepatocellular carcinoma (HCC). In proven NASH, to prevent progressive fibrosis with development of cirrhosis (irreversible (non-reversible) damage to the liver and marked remodeling of liver tissue) and … Fatty Liver (Steatosis Hepatis): Drug Therapy
A risk group indicates the possibility that the disease may be associated with the risk of vital substance deficiency (micronutrients). The complaint fatty liver indicates a vital substance (micronutrient) deficiency for: Vitamin A Zinc The above vital substance recommendations (micronutrients) were created with the help of medical experts. All statements are supported by scientific studies … Fatty Liver (Steatosis Hepatis): Micronutrient Therapy
To prevent nonalcoholic fatty liver, attention must be paid to reducing individual risk factors. Behavioral risk factors (= metabolic risk factors). Diet Excessive caloric intake, especially with a high-carbohydrate diet Increased fructose intake is considered an independent risk factor for nonalcoholic fatty liver disease (NAFLD). Also, excessive fructose intake may promote hepatic inflammation (chronic inflammation … Fatty Liver (Steatosis Hepatis): Prevention
In most cases, fatty liver is not noticed by those affected. However, the following symptoms and complaints may indicate steatosis hepatis (fatty liver): Slight pressure pain in the right upper abdomen.
Pathogenesis (development of disease) Normally, the liver contains less than 5 percent fat. The increased supply of triglycerides (neutral fats) in the serum causes more of them to be stored in the liver (fatty liver disease). If more than half of the hepatocytes (liver cells) contain fat droplets, this is called fatty liver, which leads … Fatty Liver (Steatosis Hepatis): Causes
General measures Aim for normal weight! – Necessary therapeutic measure of the first order! Notice: In particular, obesity and insulin resistance (decreased or abolished action of the hormone insulin) play a prominent role in the progression (progression) of non-alcoholic fatty liver (NAFLD) to non-alcoholic steatohepatitis (NASH). Insulin resistance, inflammation, and alterations in adipokines and angiogenesis … Fatty Liver (Steatosis Hepatis): Therapy
Mandatory medical device diagnostics. Liver ultrasonography (ultrasonography of the liver) – for basic diagnosis of nonalcoholic fatty liver (NAFLD) [steatosis hepatis (fatty liver): compare echogenicity liver with renal cortex (normal: isoechogenic; steatosis hepatis: liver more echogenic); sensitivity (percentage of diseased patients in whom the disease is detected by use of the procedure, ie. a positive … Fatty Liver (Steatosis Hepatis): Diagnostic Tests
