An obese patient with disturbed liver enzymes: Not always non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of liver disease in the western world. Even in patients with several risk factors for metabolic syndrome, one has to remain vigilant and needs to exclude other causes of liver disease, such as viral hepatitis, auto-immune liver disease and storage diseases. If the treatment of NAFLD by weight loss does not result in an improvement of the disturbed liver tests, further investigation is warranted. One of the well-known mimickers of NAFLD is Wilson's disease. This is an inherited autosomal recessive disorder characterised by copper accumulation in affected tissues, mainly in the liver and brain. Liver disease in Wilson's disease can present with a broad spectrum of abnormalities, ranging from asymptomatic disturbed liver tests to liver cirrhosis and even acute liver failure. Diagnosing Wilson's disease is extremely important as the disease is - if untreated - universally fatal. The treatment consists of chelation therapy (D-penicillamine, trientine, zinc) or a liver transplantation.

Jaar van publicatie:2015