Medical Management of NASH - University of Pittsburgh

Medical Management of NASH

Jaideep Behari, MD, PhD

UPMC Fatty Liver, Obesity and Wellness (UPMC FLOW?) Clinic UPMC Center for Liver Diseases Division of Gastroenterology, Hepatology, & Nutrition University of Pittsburgh School of Medicine

Overview of the presentation

Part 1: Background and new terminology for 2020

Part 2: Clinical challenges in management

Part 3: A practical framework for clinical management

Part 1

Background and new terminology for 2020

Clinical case

70 year old female had abdominal US for mild selflimited RUQ pain BMI 31, no DM, dyslipidemia on statin No alcohol ALT 35, AST 22 US reports "echogenic liver suggestive of fatty infiltration of the liver"

US at initial diagnosis

1 year later after 13% weight loss

= Liver = Kidney

Liver ? spleen attenuation < -10 on noncontrast CT

Dunn, 2013, Liver International

Histology of nonalcoholic steatohepatitis (NASH)

NASH is characterized by chicken-wire pattern of liver fibrosis

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