13-Year-Old Successfully Treats Non-Alcoholic Steatohepatitis and Makes Full Recovery
A 13-year-old male patient was diagnosed with non-alcoholic steatohepatitis (NASH) after experiencing persistent fatigue and discomfort in the right upper quadrant of his abdomen. Despite being previously healthy, the patient's symptoms raised concerns, prompting a visit to the hospital. An ultrasound revealed severe fatty liver disease, and further tests ruled out other potential causes of liver damage. The patient was treated at the PLA Joint Logistic Support Force 988 Hospital in May 2021 using a combination of medication, dietary changes, and weight management. After three weeks of hospitalization and continued home care, he experienced a full recovery with normalized liver function and lipid levels.
Initial Assessment and Symptoms
The patient stood at 1.60 meters tall and weighed 82 kg. His diet primarily consisted of fried foods like chicken wings and burgers, and he consumed carbonated drinks in place of water. He rarely ate fruits or vegetables. One month prior to admission, he began experiencing fatigue, abdominal discomfort, and reduced appetite, which affected his concentration at school. Blood tests revealed elevated liver enzymes—ALT at 383 U/L and AST at 159 U/L—along with high triglycerides at 4.92 mmol/L. An ultrasound confirmed severe hepatic steatosis, leading to a diagnosis of non-alcoholic steatohepatitis.
Comprehensive Treatment Plan
Upon diagnosis, the medical team initiated a multifaceted treatment strategy. Medications included silibinin capsules to support liver cell repair and enhance detoxification, along with compound glycyrrhizin injections to reduce liver inflammation and improve function. In addition to pharmacological therapy, the patient underwent significant lifestyle modifications.
His family was counseled on the importance of balanced nutrition and hydration, with a focus on whole foods, vegetables, fruits, and whole grains. Daily water intake was increased to 1,000–1,500 ml, and portion control was introduced, aiming for 70–80% fullness per meal. Given his elevated liver enzymes, intense physical activity was avoided, and instead, light post-meal walks were encouraged.
Positive Outcomes and Follow-Up
After three weeks of inpatient care, the patient's liver enzyme levels declined, and his energy levels improved significantly, allowing him to return to school. Although his weight remained unchanged during hospitalization, his overall health showed marked improvement. One year later, a follow-up visit revealed fully normalized liver function and lipid profiles, with no signs of fatty liver on ultrasound. Standing at 1.75 meters tall and weighing 68 kg, the patient had transformed into a lean and healthy teenager.
Key Lifestyle Recommendations for Long-Term Health
To prevent relapse, ongoing lifestyle adjustments were emphasized:
Maintain a balanced diet with nutrient-rich meals, especially a hearty breakfast to fuel daily activities.
Engage in regular, moderate aerobic exercise to support metabolic health without overexertion.
Minimize intake of trans fats found in processed foods and opt for healthier oils like olive or tea seed oil.
Ensure adequate protein consumption from sources such as fish, lean meats, eggs, and dairy to support growth during adolescence.
Reflections on the Growing Prevalence of Metabolic Diseases in Youth
This case highlights the increasing incidence of obesity-related conditions like NASH among younger populations. Poor dietary habits and sedentary lifestyles are contributing to a rise in metabolic disorders such as diabetes, hypertension, and dyslipidemia. Early diagnosis and family involvement were crucial to this patient's recovery.
Without timely intervention, NASH can progress to irreversible liver damage, including cirrhosis and life-threatening complications. As healthcare professionals, it is vital to promote preventive health education and encourage sustainable lifestyle changes before disease progression occurs.