Management of non-alcoholic fatty liver disease incidentally detected during other medical assessments

Abstract

Elevated liver enzyme levels are a frequent incidental finding in primary care, and non-alcoholic fatty liver disease is the main cause of incidental elevation of liver enzymes worldwide. The features of the disease vary from simple steatosis, characterized by a benign prognosis, to non-alcoholic steatohepatitis and cirrhosis, increasing morbidity and mortality. In this case report, abnormal liver activity was incidentally detected during other medical assessments. The patient was treated with silymarin 140 mg three times daily, resulting in decreased serum liver enzyme levels over treatment with a good safety profile. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series

Chronic liver disease and management with silymarin: an introductory review of a clinical case collection

“…10 Furthermore, the prolonged and excessive usage of herbal supplements, traditional medicines and dietary supplements has emerged as a significant contributor to HILI. 18,24 Notably, in the collection of clinical cases across the globe presented in this series, [5][6][7][8][9][10] at least one risk factor was found to be present in all the described CLD cases (except for DILI). This finding is in alignment with the available literature around NAFLD/MAFLD, where most patients have one or more risk factors, including overweight/obesity, T2D, dyslipidaemia or cardiovascular complications like hypertension.…”

“…Notably, the most promising results were observed in the case presented by Torre, 5 where 4 months of silymarin treatment reduced AST levels by 36 U/L, ALT levels by 74 U/L, and gamma-glutamyl transferase levels by 71 U/L. In a second case report by Lee and Tee, 9 the results were even more striking as, after only 1 month of silymarin treatment, a reduction of 302 U/L, 131 U/L and 74 U/L was observed for ALT, AST and alkaline phosphatase values, respectively, and the level of reductions was maintained for 4.5 years. This hepatic liver enzyme level normalization was consistently observed across all reported cases.…”

“…This review is an opening paper to the clinical case collection entitled 'Current clinical use of silymarin in the treatment of toxic liver diseases: a case series', focused on the management and treatment of major liver diseases with silymarin. [5][6][7][8][9][10]…”

Review and expert opinion on MAFLD, oxidative stress and multifunctional management

“…Various studies have been conducted or are ongoing to further confirm the evidence on silymarin and improve its clinical use. [54][55][56][57][58][59]…”