help with liver pathology report

[nikki353]

My 17 year old daughter had  a liver biopsy done when she had her gallbladder out it came back.

A. Moderate mixed micro-and macrovesicular steatosis involving approximately 50% of the hepatocytes.
B. Mildly to moderately active steatohepatitis nafld score = 5/8
C. Delicate centrizonal subsinsoidal fibrosis and focal mild portal fibrosis ( fibrosis stage =1-2/4)

Im so worried there is something awrong with her I called the doctors office to see whats going on and no calls was returned to me and we go see him in june but i cant wait. Can someone please help me .

[nikki353]

Thank you very much

[mikesimon]

Well, it's obvious I am not a professional because I neglected to mention seeing a hepatologist or gastroenterologist. With liver issues I prefer a hepatologist but in many areas one is not available. In that case a gastroenterologist is the next best choice.

It's natural to be nervous but I don't think there is any need to get worked up. This is not an emergency situation and there is no magic bullet treatment for NAFLD. Almost always diet and exercise is the primary approach and your Daughter can start that before seeing the doctor. Just take it easy and don't get yourself or your Daughter worked up. You are doing exactly what you should be doing by seeing a specialist. Once your Daughter gets seen and you guys discuss the options with the specialist you'll have a plan and a lot of guidance and then you'll do what you need to do to get well and stay well. A whole lot of people have fatty liver disease and never even know it unless they have blood work done.

I believe that everything will workout just fine. I hope you can relax until your appointment because I do believe that the specialist will not be alarmed by your Daughter's situation.

Good luck,
Mike

[nikki353]

Thank you my daughter does see an Endocrinologist and she was referred to a liver specialist and Im waiting to see him. The endocrinolist does think she is insulin resistance and waiting on the liver specialist to confrim this.Im just so nervous.

[mikesimon]

I understand your concern but please, do not panic. I am not a doctor or in the medical field in any capacity so my opinion should be considered in that context.
Having said that, my opinion is that your Daughter's biopsy report suggests moderate non-alcohol fatty liver disease(NAFLD).
NAFLD is frequently seen in overweight and obese patients. In these cases weight loss and dietary changes along with exercise is the primary approach to managing the disease. There have been some recent reports that Vitamin E may be associated with improvement in NAFLD.
Insulin resistance is frequently a factor in the development of NAFLD and there are studies that suggest that some oral diabetes medication can be beneficial.
While I do not think that your Daughter needs to panic - and you don't either - she should see a specialist to help you treat this disease. In a minority of case this disease can progress to nonalcoholic steatohepititis (NASH) and NASH is a much more serious condition which can lead to cirrhosis of the liver. Therefore it is advisable to manage this disease as soon as possible.
While NAFLD can progress to NASH that is not common and the majority of patients with NAFLD do not progress and live a normal life. Nevertheless I would advise you to get a referral to an Endocrinologist soon and get started managing your Daughter's disorder.

I wish you the very best of luck,
Mike