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Nonalcoholic fatty liver disease definitions and phenotypes

Nonalcoholic fatty liver disease definitions and phenotypes
Phenotypes Definitions
Nonalcoholic fatty liver disease (NAFLD) Inclusive term referring to the full spectrum of disease
Indicates fatty infiltration of the liver in the absence of significant alcohol, genetic diseases, or medications that cause steatosis
Fatty infiltration is typically defined as fat >5% of the liver by imaging, direct quantification, or histologic estimation
Nonalcoholic fatty liver (NAFL) Steatosis without specific changes to suggest steatohepatitis, with or without fibrosis
Pediatric nonalcoholic steatohepatitis (NASH) Hepatic steatosis with inflammation, with or without ballooning injury to hepatocytes and fibrosis
Type 1  Venule (zone 3)-centered injury pattern or confluent pattern, typically with ballooning
Type 2  Portal predominant (zone 1)-centered injury pattern, often without ballooning
NAFLD with fibrosis NAFL or NASH with periportal, portal, or sinusoidal or bridging fibrosis
NAFLD with cirrhosis Cirrhosis in the setting of NAFLD
Other terms such as "presumed NAFLD" (also "clinical NAFLD" or "suspected NAFLD") are terms used in the literature with varying meanings. These terms are often used when a biopsy has not been performed to confirm the diagnosis.
From: Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: Recommendations from the expert committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr 2017; 64:319. DOI: 10.1097/MPG.0000000000001482. Copyright © 2017 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
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