Meltem UĞRAŞ, Öznur KÜÇÜK, Suat BİÇER, Ayça VİTRİNEL

ÇOCUKLARDA ALKOLİK OLMAYAN YAĞLI KARACİĞER HASTALIĞI

Gelişen yaşam koşulları ile obezite ve komplikasyonları da artmaktadır. Alkolik Olmayan Yağlı Kara- ciğer Hastalığı (AOYKH)/ Alkolik Olmayan Steatohepatit (AOSH) gerçek prevalansı tahmin edilenin daha üzerindedir. Tanının tesadüfen konulduğu ancak çocukluk çağında nadiren de siroza neden olan bu hastalık, rutin muayene sırasında artmış ALT/AST oranı, ultrason (USG) de belirgin karaci- ğer ile tanınabilir. Karaciğer biyopsisi özellikli hastalarda tanı koymada altın standarttır. Klinik gidiş hakkında net veriler yoktur. Obezite, insülin direnci ve dislipidemi durumlarında histolojik bulgular daha ilerlemiştir ve prognoz daha kötü olabilir. İzole yağlanma en iyi prognoza sahip iken, fibrozisin eşlik ettiği hepatosit hasarı varlığında prognoz daha kötüleşmektedir. Karaciğer biyopsisi sırasında hastaların %7-16’sında siroz gelişmiştir. Tedavide kilo verme ve egzersiz en önemli rolü oynamakta- dır. İlaçlar konusunda çocuklarda kesinleşmiş veriler yoktur.

Anahtar Kelimeler:

Çocuk, Non-alkolik yağlı karaciğer hastalığı, Siroz

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ĂƐƚĂǇĂ ǇĂƉŦůĂŶ ĞŬŽŬĂƌĚŝǇŽŐƌĂĮĚĞ ^Žů ǀĞŶƚƌŝŬƺů ;>sͿ ĚŝͲ ǇĂƐƚŽů ƐŽŶƵ ĕĂƉŦ͗ϰ͕ϴ İŵ >s ƐŝƐƚŽů ƐŽŶƵ ĕĂƉŦ͗ϯ͕ϰ İŵ ŝŶͲ ƚĞƌǀĞŶƚƌŝŬƺůĞƌ ƐĞƉƚƵŵ ĚŝǇĂƐƚŽůŝŬ ŬĂůŦŶůŦŒŦ͗ ϭ͕ϲ İŵ͕ ĂƌŬĂ ĚƵǀĂƌ ĚŝǇĂƐƚŽůŝŬ ŬĂůŦŶůŦŒŦ͗ϭ͕ϯ İŵ >s ĞũĞŬƐŝǇŽŶ ĨƌĂŬƐŝͲ ǇŽŶƵ͗ йϰϱ Žƌƚ ĕĂƉŦ͗Ϯ͕ϵ İŵ ƐŽů ĂƚƌŝǇƵŵ ĕĂƉŦ͗ ϰ͕Ϭ İŵ͕ ĂƉŝŬĂů ǀĞ ĂŶƚĞƌŝŽƌ ĚƵǀĂƌůĂƌ ŚŝƉŽŬŝŶĞƟŬ ŽůĂƌĂŬ ƐĂƉƚĂŶͲ ĚŦ͘ ,ĂƐƚĂǇĂ ďĂƔǀƵƌƵƐƵŶƵŶ ďŝƌŝŶİŝ ƐĂĂƟŶĚĞ ƐĂŒ ĨĞŵŽƌĂů

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