Alcohol Associated Liver Disease & Non Alcoholic Fatty Liver Disease

Question 1

Good prognosis for ALD

Answer 1

Alcoholic Steatosis/ Fatty liver
Recovers with abstinence

Question 2

Alcoholic Hepatitis

Answer 2

Jaundice and liver failure
Rapid onset of jaundice with fever, ascites and encephalopathy
Liver is usually enlarged and tender
Elevated transaminases usually <300 IU
AST:ALT > 2:1
Raised GGT
Increased INR, Bilirubin and WCC

↑ Creatinine indicates poor prognosis

Macrocytic Anaemia
Thrombocytopenia
Leucocytosis

Marker of alcohol consumption
Carbohydrate deficient transferrin ↑

Question 3

NAFLD spectrum

Answer 3

ranges from simple steatosis (steatosis without injury); steatosis with lobular inflammation (NASH) to fibrosis and/or cirrhosis as result of NAFLD

Question 4

Laboratory findings of NAFDL

Answer 4

typically mild elevation of transaminases –> seldom > 5X ULN GGT ± ALP elevated 2- 5X