Fatty Liver Diagnosis: Key Criteria And Insights

To diagnose fatty liver disease, several important factors must be considered. First, the patient should have no history of chronic or excessive alcohol consumption, as this could lead to alcoholic fatty liver disease, which is a different condition altogether.

A thorough evaluation must also rule out other specific diseases that can cause fatty liver, such as viral hepatitis, drug-induced liver disease, total parenteral nutrition, and Wilson's disease. These conditions may mimic non-alcoholic fatty liver disease and must be excluded for an accurate diagnosis.

In addition to the absence of these conditions, patients may present with non-specific symptoms and clinical signs. These can include fatigue, indigestion, discomfort or pain in the liver area, and enlargement of the liver or spleen. These signs are not unique to fatty liver disease but are commonly observed in affected individuals.

Metabolic syndrome is often associated with fatty liver. Common features include overweight or visceral obesity, elevated fasting blood glucose levels, dyslipidemia, and hypertension. These factors not only increase the likelihood of fatty liver but also raise the risk of more severe liver damage over time.

From a laboratory perspective, serum transaminases and gamma-glutamyl transferase (GGT) levels may be mildly to moderately elevated. Imaging studies, such as ultrasound, CT, or MRI, should align with the radiological criteria for diffuse fatty liver infiltration.

In more definitive cases, a liver biopsy may be recommended. This allows for a histological assessment that can confirm the presence and severity of fatty liver disease according to established pathological criteria. While not always necessary, a biopsy provides the most accurate diagnosis, especially when uncertainty remains after initial testing.