Monitoring chronological change by liver-to-spleen attenuation ratio for secondary hepatic steatosis for a short term

Clin J Gastroenterol. 2020 Dec;13(6):1219-1224. doi: 10.1007/s12328-020-01165-w. Epub 2020 Jun 27.

Abstract

Parenteral nutrition-associated liver disease (PNALD) causes hepatic steatosis and moderate liver enzyme elevation due to lack of enteral nutrition and deficiency of some nutrients. However, the period for recovery from PNALD after a nutritional intervention is unknown with no report. Herein, we report a case of a 44-year-old Japanese woman with severe fatty infiltration of the liver due to malnutrition. Our nutritional support team administered appropriate total parenteral, especially fat and carnitine, nutrition to improve her malnutrition. Chronological changes in liver-to-spleen attenuation ratio were also considered because of her disease state. Computed tomography demonstrated improved attenuation of the liver, and the liver enzymes level normalized after 5 weeks from appropriate nutrition. Understanding the nutritional condition of a patient may help in elucidating an appropriate treatment strategy.

Keywords: Malnutrition; NAFLD; NASH; NST; PNALD.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fatty Liver* / complications
  • Fatty Liver* / diagnostic imaging
  • Female
  • Humans
  • Liver Diseases*
  • Parenteral Nutrition
  • Spleen