Advanced hepatic fibrosis and cirrhosis due to nonalcoholic fatty liver disease in Sri Lankan children: a preliminary report

Abstract

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases and may progress to advanced hepatic fibrosis and cirrhosis in some patients. Cirrhosis due to NAFLD is considered extremely rare in children in the Asia-Pacific region. We report the characteristics of 5 children with advanced hepatic fibrosis and cirrhosis due to NAFLD. Four of them were obese, and all of them had high alanine transaminase levels and ultrasonographic evidence of fatty liver. None had diabetes mellitus or hyperlipidemia. The calculated HOMA-IR was more than two in all five cases. Liver biopsy showed stage III fibrosis in 2 patients and stage IV fibrosis (cirrhosis) in 3.

Non‐alcoholic fatty liver disease: Confronting the global epidemic requires better awareness

“…As obesity among children becomes increasingly common, 3 similar trends are being observed in the pediatric population; NAFLD has been reported to occur in 3% of the general pediatric population and in 53% of obese children 4,5 . There are even disturbing reports of NAFLD with advanced fibrosis and cirrhosis in young children, and NAFLD in toddlers 6,7 . NAFLD is now probably the most common cause of liver disease in the pre‐adolescent and adolescent age groups 8…”

Non-alcoholic fatty liver disease and its associations among adolescents in an urban, Sri Lankan community

“…Non-alcoholic fatty liver disease (NAFLD) and Metabolic Syndrome (MetS) are two interrelated major global public health problems. NAFLD is considered the commonest liver disease in children and may cause significant liver damage, and leading to cirrhosis in some of them [ 1 , 2 ]. MetS is a clustering of obesity, atherogenic dyslipidaemia, hypertension and insulin resistance, with the potential for increased risk of serious long term consequences [ 3 ].…”

Prevalence and risk factors for non‐alcoholic fatty liver disease among adults in an urban Sri Lankan population

“…Published data suggest that it contributes significantly to the burden of liver disease in the country. For example, NAFLD is the commonest histological diagnosis in Sri Lankan patients undergoing liver biopsies for unexplained elevation of transaminases, 19 and even young children have been reported with NASH associated with advanced hepatic fibrosis 20 …”

“…For example, NAFLD is the commonest histological diagnosis in Sri Lankan patients undergoing liver biopsies for unexplained elevation of transaminases, 19 and even young children have been reported with NASH associated with advanced hepatic fibrosis. 20 Although liver biopsy still remains the gold standard for diagnosis and staging of NASH, NAFLD can be identified with a reasonably high sensitivity using imaging: ultrasonography, computed tomography (CT) and magnetic resonant imaging. 14 The objective of our study was to determine the prevalence of NAFLD and its associated risk factors in an urban adult Sri Lankan population.…”