Morbid Obesity Associated with Non-Alcoholic Fatty Liver Disease and Complicated by Severe Non-Cirrhotic Portal Hypertension: A Case Report from Rural Kenya
DOI:
https://doi.org/10.54536/ajmsi.v2i2.1907Keywords:
Obesity, Non-Alcoholic Fatty Liver Disease, NAFLD, Portal Hypertension, Non-Cirrhotic Portal Hypertension, KenyaAbstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease and is closely linked with obesity and metabolic syndrome. Portal hypertension in NAFLD typically occurs in the cirrhotic phase of the disease and may present with esophageal varices, splenomegaly with splenic sequestration syndrome, ascites, and features of liver failure. However, recent experimental and clinical data show the occurrence of portal hypertension in NAFLD in the absence of fibrosis or cirrhosis. We present such a clinical case from rural Kenya in this study with the literature review that proposes novel mechanisms for such non-cirrhotic portal hypertension in NAFLD.
Downloads
References
Afshin, A., Forouzanfar, M. H., Reitsma, M. B., Sur, P., Estep, K., Lee, A., Marczak, L., Mokdad, A. H., Moradi-Lakeh, M., Naghavi, M., Salama, J. S., Vos, T., Abate, K. H., Abbafati, C., Ahmed, M. B., Al-Aly, Z., Alkerwi, A., Al-Raddadi, R., Amare, A. T., . . . Murray, C. J. L. (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med, 377(1), 13-27. https://doi.org/10.1056/NEJMoa1614362
Apovian, C. M. (2016). Obesity: definition, comorbidities, causes, and burden. Am J Manag Care, 22(7 Suppl), s176-185.
Araújo, A. R., Rosso, N., Bedogni, G., Tiribelli, C., & Bellentani, S. (2018). Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future. Liver Int, 38 Suppl 1, 47-51. https://doi.org/10.1111/liv.13643
Baffy, G. (2018). Origins of Portal Hypertension in Nonalcoholic Fatty Liver Disease. Dig Dis Sci, 63(3), 563-576. https://doi.org/10.1007/s10620-017-4903-5
Cotter, T. G., & Rinella, M. (2020). Nonalcoholic Fatty Liver Disease 2020: The State of the Disease. Gastroenterology, 158(7), 1851-1864. https://doi.org/10.1053/j.gastro.2020.01.052
Mauro, E., & Gadano, A. (2020). What’s new in portal hypertension? Liver Int, 40 Suppl 1, 122-127. https://doi.org/10.1111/liv.14366
Mburu, A. N., Laving, A., Macharia, W. M., & Sande, J. (2023). Prevalence of non-alcoholic fatty liver disease in overweight and obese children seeking ambulatory healthcare in Nairobi, Kenya. BMJ Open Gastroenterol, 10(1). https://doi.org/10.1136/bmjgast-2022-001044
Mendes, F. D., Suzuki, A., Sanderson, S. O., Lindor, K. D., & Angulo, P. (2012). Prevalence and indicators of portal hypertension in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol, 10(9), 1028-1033.e1022. https://doi.org/10.1016/j.cgh.2012.05.008
Nababan, S. H. H., & Lesmana, C. R. A. (2022). Portal Hypertension in Nonalcoholic Fatty Liver Disease: From Pathogenesis to Clinical Practice. J Clin Transl Hepatol, 10(5), 979-985. https://doi.org/10.14218/jcth.2021.00593
Powell, E. E., Wong, V. W., & Rinella, M. (2021). Non-alcoholic fatty liver disease. Lancet, 397(10290), 2212-2224. https://doi.org/10.1016/s0140-6736(20)32511-3
Simonetto, D. A., Liu, M., & Kamath, P. S. (2019). Portal Hypertension and Related Complications: Diagnosis and Management. Mayo Clin Proc, 94(4), 714-726. https://doi.org/10.1016/j.mayocp.2018.12.020
Younossi, Z. M., Stepanova, M., Afendy, M., Fang, Y., Younossi, Y., Mir, H., & Srishord, M. (2011). Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol, 9(6), 524-530.e521; quiz e560. https://doi.org/10.1016/j.cgh.2011.03.020
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Vonwicks C. Onyango, Kenneth H. Makokha, Samuel M. Gachie, Boniface Mutiso, Nicholas M. Mutuma, Paul M. Kamau

This work is licensed under a Creative Commons Attribution 4.0 International License.