Clinical hepatology: Profile of an urban, hospital-based practic

Abstract

To dispel the common notion that the practice of hepatology in North America largely consists of the care of middle-aged male patients with alcohol-induced liver disease, and, in the process, provide undergraduate and postgraduate students with a clearer picture of what patient profiles might resemble in an urban, hospital-based hepatology practice, 1,226 charts derived from referrals between July 1, 1987, and January 1, 1994, were retrospectively reviewed for the following information: year of referral, age and sex of the patient, practice of the referring physician, status of ongoing care, and principal diagnosis. The results of the study revealed the following: 1) referrals for assessment and care of patients with liver disease are increasing at a rapid rate, 2) the majority of referred patients are between the ages of 25 and 45 years, 3) there is an equal distribution of men and women, 4) referrals are most often from general practitioners (57%) and internists (27%), 5) turnover is common, with 56% of referred patients no longer being followed, and 6) a variety of liver disorders are seen, including acute and chronic viral hepatitis (47%), nonalcoholic steatohepatitis (11%), drug-induced liver disease (6%), alcoholic liver disease (5%), primary biliary cirrhosis (4%), primary sclerosing cholangitis (3%), autoimmune chronic hepatitis (3%), "cryptogenic" cirrhosis (3%), and miscellaneous or undiagnosed causes (20%). Thus, contrary to popular belief, in this urban, hospital-based practice, the majority of liver disease patients are not middle-aged alcoholics, but rather young adults with a variety of hepatobiliary disorders.

Hepatic steatosis in Cushing's syndrome: a radiological assessment using computed tomography

“…Non-alcoholic fatty liver disease (NAFLD) is a clinicopathological entity that is increasingly recognised as a possible precursor to cirrhosis and is now the second or third commonest liver disease in hepatology outpatient practice in North America (1). NAFLD encompasses a range of pathological abnormalities, including simple hepatic steatosis, steatonecrosis and steatohepatitis (2,3).…”

Nonalcoholic steatohepatitis: Summary of an AASLD Single Topic Conference

“…NAFLD is perhaps the most common of all liver disorders. [17][18][19][20][21][22][23] Wanless and Lentz 24 found steatosis in 70% of obese and 35% of lean patients and NASH in 18.5% of obese and 2.7% of lean patients in a consecutive autopsy study. Among obese patients, the prevalence of class 1 NAFLD (simple steatosis) is about 60%, whereas NASH is found in 20% to 25% and 2% to 3% have cirrhosis.…”

Correlation between bright echogenic liver, elevated liver enzymes and liver histology

“…It is probably the third common reason for referral to specialist in Gastroenterology and Hepatology (7,8). At the same time, Diabetes mellitus and obesity, two closely associated diseases, have been shown to be rapidly increasing in prevalence (9).…”