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Model for Distinguishing Nonalcoholic Steatohepatitis (NASH) from Cryptogenic Chronic Hepatitis

Purpose: To evaluate a patient with a chronic liver disease of unknown cause for findings suggestive of nonalcholic steatohepatitis (NASH) based on the model of Tanaka et al.

Description

Tanaka et al developed a simple model for distinguishing patients with nonalcoholic steatohepatitis (NASH) and mild steatosis from patients with cryptogenic chronic hepatitis. The authors are from Shinshu University and Showa Inan General Hospital in Japan.


 

Patient selection: adult Japanese

 

If the patient has moderate to marked steatosis, then hepatic ultrasound is useful for the diagnosis of NASH. It is less useful if steatosis is mild.

 

Parameters if mild steatosis is present:

(1) body mass index (BMI)

(2) serum ferritin in ng/mL

Parameter

Finding

Points

body mass index

<= 25.2 kg per square meter

0

 

> 25.2 kg per square meter

1

serum ferritin

<= 142 ng/mL

0

 

> 142 ng/mL

1

 

total risk score =

= SUM(points for both parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 2

 

Total Score

Diagnosis

0

cryptogenic chronic hepatitis; NASH excluded

1

favor cryptogenic chronic hepatitis

2

favor NASH

 

Limitation:

• The normal reference range for serum ferritin was not reported.

 


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Specialty

Objective

ICD-10