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Slovenska pediatrija 2021; 28: 154-158

https://doi.org/10.38031/slovpediatr-2021-3-05en

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Review article

NON-ALCOHOLIC STEATOHEPATITIS IN CHILDREN − A PRACTICAL APPROACH WITH CASE REPORT

Ana Šinkovec
Ambulanta Polhek, Polhov Gradec, Slovenija

Milanka Živanović
Inštitut za patologijo, Medicinska fakulteta, Univerza v Ljubljani, Ljubljana, Slovenija

Martin Thaler
Služba za radiologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Jernej Brecelj
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko, Pediatrična klinika, Univerzitetni klinični center Ljubljana in Katedra za pediatrijo, Medicinska fakulteta, Univerza v Ljubljani, Ljubljana, Slovenija

Abstract

Paediatric non-alcoholic fatty liver disease is a chronic liver disease resulting from excessive fat accumulation in the liver. It is closely associated with obesity and some other risk factors. In the last few years, its prevalence in the developed world has been increasing rapidly alongside paediatric obesity. It is generally asymptomatic and is accidentally dis-covered when diagnosing other diseases or during systematic examinations. The additional presence of inflammatory signs is characteristic of non-alcoholic steatohepatitis, which may progress to cirrhosis and end-stage liver disease. The initial diagnosis is based on non-invasive methods (blood tests, ultrasound), but in some cases, the definite diagnosis is based on liver biopsy. Other causes of liver disease and hepatic steatosis must be excluded. The frequency and methods of follow-up are dependent on the presence of risk factors and the severity of the liver changes. First-line treatment is based on lifestyle changes with weight reduction, minimizing risk factors and increasing physical activity. Medical treatment or nutritional supplements are currently not prescribed due to insufficient evidence. A practical approach to a child with fatty liver disease is illustrated by a case presentation.

Key words: child, non-alcoholic steatohepatitis, non-alcoholic fatty liver disease, recommendations