Cirrhosis due to Non-Alcoholic Steatohepatitis (NASH)

Abstract

Objective : NAFLD (Non Alcoholic Fatty Liver Disease) includes two pathologically different disorders, which have different prognoses: non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) / (NASH). / Non-Alcoholic SteatoHepatitis the latter covers a wide spectrum of disease severity, including fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The prevalence of NAFLD in Latin America has increased in parallel with changes in obesity, physical inactivity, and type 2 diabetes, with direct clinical and economic impacts. 61% of NAFLD patients in South America have been shown to have non-alcoholic steatohepatitis (NASH); Hence the importance of identifying patients at risk, through medical history, laboratory tests, and non-invasive tests for fibrosis FIB-4. In case of classifying with indeterminate risk, a transient vibration-controlled ultrasound elastography (FibroScan) will be performed and the factors that lead them to be diagnosed with NAFLD with advanced fibrosis (NASH) are corrected, which is the fastest cause of increase in hepatocellular carcinoma and it is a main indication for liver transplantation in many Latin American countries. Conclusion: The patient under study since 2018 was in early stages with fib-4 stage (f2-f3: 1.75) INTERMEDIATE risk stage. The AASDL patients who are in stage (fib-4: f2 –f3) 22% of patients, in an average of 29 months progress to cirrhosis. Given the complexity of the care posed by patients with obesity, diabetes, cardiovascular disease, and NAFLD with fibrosis, a successful intervention requires a cohesive multidisciplinary team