Öznur KÜÇÜK, Mehmet UĞRAŞ, Ayça VİTRİNEL, Suat BİÇER

ÇOCUKLARDA ALKOLİK OLMAYAN YAĞLI KARACİĞER HASTALIĞI Non Alcoholic Fatty Liver Disease In Children

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 %7-16sında siroz gelişmiştir. Tedavide kilo verme ve egzersiz en önemli rolü oynamakta- dır. İlaçlar konusunda çocuklarda kesinleşmiş veriler yoktur.

Non Alcoholic Fatty Liver Disease In Children

Obesity and its complications are increasing with improving lifestyles in our century. The prevalence of non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis (NAFLD/NASH) is thought to be more than expected. The diagnosis is particularly made incidentally by finding elevated ALT/AST ratio, enlarged liver on ultrasonographic examination. But on the other hand this disease can lead to cirrhosis during childhood. Liver biopsy is gold-standart if performed among patients who fulfill some suggested criteria. There are no precise data about clinical outcome. Obesity, insülin resistance and dislipidemia are the factors that can lead to worse histolojical findings and poorer prognosis as well. Isolated steatosis has the best prognosis, whereas the prognosis gets worse when fibrosis is added to hepatocyte injury. Cirrhosis is seen in 7-16% of patients at the time of liver biopsy. weight reduction and excercising have the most important role in treatment.There is no strict data about drugs for children.

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