Overview of Pediatric Nonalcoholic Fatty Liver Disease with a Focus on Histology

Nonalcoholic fatty liver disease (NAFLD) is a condition in which excessive fat builds up in the liver of a person who has never drank excessive alcohol. This disease includes simple steatosis and nonalcoholic steatohepatitis (NASH). The hepatic manifestation of the metabolic syndrome is known as NAFLD/NASH. Pediatric NAFLD has risen in recent years, along with an increase in the frequency of childhood obesity. The frequency of pediatric NAFLD is believed to be between 2.6 and 9.6 percent, and it is linked to sex, age, and ethnicity. The "two-hit" concept is largely recognised when it comes to the aetiology of NAFLD, and oxidative stress is assumed to play a key role in the second hit. Despite the importance of clinical symptoms, laboratory data, and imaging results, liver biopsy remains the gold standard for diagnosing NAFLD/NASH. In addition, liver biopsy is essential for assessing the degree of necro-inflammatory change and fibrosis in NASH. There are two forms of steatohepatitis (type 1 and type 2 NASH), with type 2 NASH being present in up to 51% of juvenile NAFLD patients. We and others have seen, however, that type 1 and 2 patterns frequently overlap. Despite the fact that medication has been investigated in clinical trials, diet and exercise remain the foundation of NAFLD/NASH treatment.