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Steatohepatitis, Nonalcoholic (NASH)

Cornelia P Charles, M.D. and Talwinder Kaur Nagi, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Nonalcoholic steatohepatitis (NASH), recently renamed metabolic dysfunction-associated steatohepatitis (MASH) is a chronic liver disease causing hepatocellular injury and inflammatio...

DIAGNOSIS

HISTORY

  • Most patients with NAFLD and NASH are asymptomatic and are often diagnosed after incidentally noting elevated liver biochemical tests or hepatic steatosis on imaging.

  • If symptomatic, p...

TREATMENT

Maximize control of comorbidities and avoid factors that promote the progression of liver disease. 

GENERAL MEASURES

  • Weight loss of at least 5-7% of body weight helps stabilize steatosis. Grea...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • All patients should be tested for hepatitis A and B and vaccinated, if not immune.

  • Consider screening patients with NASH cirrhosis for hepatocellular carcinoma acc...

REFERENCES

1
Sheka AC, Adeyi O, Thompson J, et al. Nonalcoholic steatohepatitis: a review JAMA. 2020;323(12):1175–1183. Published correction appears in JAMA. 2020;323(16):1619.
2
Rinella ME, Neuschwander...

CODES

ICD10

  • K75.81 Nonalcoholic steatohepatitis (NASH)

  • K76.0 Fatty (change of) liver, not elsewhere classified

SNOMED

  • 442685003 nonalcoholic steatohepatitis (disorder)

  • 197315008 Non-alcoholic fatty liver (...

CLINICAL PEARLS

  • The prevalence of NAFLD and NASH is higher in patients with metabolic syndrome or any one of its components (diabetes, obesity, hypertriglyceridemia).

  • Liver biopsy is the gold standard ...

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