Non-invasive diagnosis and follow-up of non-alcoholic fatty liver disease - 12/01/22
, Maeva Guillaume b, Charlotte Bouzbib c, Adrien Lannes a, Raluca Pais c, Sarra Smatti d, Bertrand Cariou d, Christophe Bureau e, Nathalie Ganne-Carrié f, i, Marc Bourlière g, k, Victor de Lédinghen h, jBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | NAFLD must be investigated when liver steatosis, abnormal liver enzymes or hyperferritinemia is detected in a metabolic context. |
• | A single non-invasive test is sufficient to rule-out advanced liver fibrosis in NAFLD. |
• | A blood fibrosis test in agreement with an elastography measurement allow ruling in advanced liver fibrosis in NAFLD. |
• | Liver biopsy can be considered in a patient with NAFLD if results are likely to modify the patient management. |
• | Referral to the liver specialist of a patient with NAFLD should be considered if advanced liver fibrosis is suspected, first by a simple test of liver fibrosis further confirmed by a specialized test (liver elastography or specialized blood test). |
Abstract |
NAFLD is a frequent disease that affects 25% of the worldwide population. There is no specific diagnostic test for NAFLD, and the diagnosis mainly relies on the elimination of the other causes of chronic liver diseases with liver biopsy kept for unsure diagnoses. Non-invasive tests are now available to assess NAFLD severity and therefore to help physicians decide on the patient management and follow-up. These non-invasive tests can also be used to define pathways that organize referrals from primary care and diabetology clinics to the liver specialist, with the ambition to improve the screening of asymptomatic patients with NAFLD and advanced liver disease. NAFLD being the liver expression of the metabolic syndrome, physicians need also take care to screen for diabetes and to evaluate the cardiovascular risk in those patients. These recommendations from the French Association for the Study of the Liver (AFEF) aim at providing guidance on the following questions: how to diagnose NAFLD; how non-invasive tests should be used to assess NAFLD severity; how to follow patients with NAFLD; when to perform liver biopsy in NAFLD; and how to decide referral to the liver specialist for a patient with NAFLD.
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Vol 46 - N° 1
Article 101769- janvier 2022 Retour au numéro
Article précédent
- Non-invasive diagnosis and follow-up of rare genetic liver diseases
- Rodolphe Sobesky, Olivier Guillaud, Charlotte Bouzbib, Philippe Sogni, Aurélia Poujois, France Woimant, Jean Charles Duclos-Vallée, Marc Bourlière, Victor de Lédinghen, Nathalie Ganne-Carrié, Christophe Bureau
- Non-invasive diagnosis and follow-up of primary biliary cholangitis
- Christophe Corpechot, Alexandra Heurgue, Florence Tanne, Pascal Potier, Bertrand Hanslik, Marie Decraecker, Victor de Lédinghen, Nathalie Ganne-Carrié, Christophe Bureau, Marc Bourlière
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