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The Spectrum of Nonalcoholic Fatty Liver Disease

While nonalcoholic fatty liver disease (NAFLD) is a fairly prevalent condition, it is widely untreated in most patients. Dr. Halegoua-De Marzio reviews the progression and risk factors associated with NAFLD and the various forms in which it may present.

Moderated by:
Dina Halegoua-De Marzio, MD
Assistant Professor of Medicine, Director, Jefferson Fatty Liver Center, Fellowship Program Director, Transplant Hepatology, Sidney Kimmel Medical College at Thomas Jefferson University
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Expert Presentations
Dina Halegoua-De Marzio, MD
Assistant Professor of Medicine, Director, Jefferson Fatty Liver Center, Fellowship Program Director, Transplant Hepatology, Sidney Kimmel Medical College at Thomas Jefferson University
(1,323)
212 Comments
Dina Halegoua-De Marzio, MD
Assistant Professor of Medicine, Director, Jefferson Fatty Liver Center, Fellowship Program Director, Transplant Hepatology, Sidney Kimmel Medical College at Thomas Jefferson University
(1,145)
92 Comments
Dina Halegoua-De Marzio, MD
Assistant Professor of Medicine, Director, Jefferson Fatty Liver Center, Fellowship Program Director, Transplant Hepatology, Sidney Kimmel Medical College at Thomas Jefferson University
(1,207)
97 Comments
Latest Comments
"This was an exceptional evidence-based well-organized succinct presentation pertaining to a case study of a “45 Y/O ♂ with Hepatosplenomegalyan in your series on the spectrum of nonalcoholic fatty liver disease.  You methodically reviewed the present/past medical history, medications, physical examination and laboratory analysis MRMR electrograph and  imaging results

NASH Cirrhosis, factors associated with disease progression, mortality, mortality, diagnosis/staging, management were expounded upon as related to the spectrum of nonalcoholic fatty liver disease (NAFLD). 

Again, an great program with thought provoking questions throughout the presentation.  With the increasing numbers of undiagnosed/untreated pts with hepatitis C and other hepatic disorders, I felt that your program was pertinent for all PCPs to review.  With all of the new options through radiology, it is vital to be aware of the new guidelines and current treatments available to us.

Thank You,

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
97 Comments
"This was an exceptional evidence-based well-organized succinct presentation pertaining to a case study of a “52 Y/O ♂ with an Abnormal Liver in your series on the spectrum of nonalcoholic fatty liver disease.  You methodically reviewed the present, past medical history, medications, physical examination and laboratory analysis.  Preliminary diagnosis, NAFLD, elastrography were expounded upon as related to the spectrum of nonalcoholic fatty liver disease (NAFLD).  The importance of an ultrasound and elastrography tests were meticulously explained with rationales as to why these tests should be ordered in pts with elevated AST/ALT.

Lifestyle modifications with regard to diet, weight loss and aerobic exercise are the hallmark for all of us to adhere to in our own lives, however, for pts with diabetes and other comorbidities need to be informed of the consequences of noncompliance with their daily routines concerning these areas mentioned above.  I know we don’t want to use scare tactics, but they need to be well informed of the possible outcomes without adherence to these lifestyle modifications.

Compliance with follow-up appointments with their PCP is so important, unfortunately, many pts seem to be in denial of their conditions and don’t comply with recommendations provided.  Again, an great program with thought provoking questions throughout the presentation.  I look forward to reviewing the rest of your series.

I always thought that a liver biopsy was considered to the gold standard of treatment with abnormal liver enzymes.  Once you have D/C’d any medications possibly responsible for the abnormality in the liver enzymes, completed an ultrasound, and elastrography when should I as a FNP refer my pt for a liver biopsy?

QUESTION:

At what point would you do a liver biopsy?

Thanks,

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
92 Comments
 
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