{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:26Z","timestamp":1784557046098,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>\n                      A 72-year-old man with type 2 diabetes volunteered to participate in the control group of a clinical study. The study evaluated non-alcoholic fatty liver disease in patients with kidney disease. The patient was followed at a gastroenterology department due to Crohn\u2019s disease and post-operative bile acid malabsorption. The patient had no symptoms or biochemical findings suggesting liver disease. Surprisingly, a transient elastography (FibroScan\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ) suggested advanced fibrosis with a median of 16.1 kPa. A liver biopsy showed non-alcoholic steatohepatitis (NASH)-cirrhosis. The diagnosis was only made incidentally and highlights how NASH-cirrhosis may be overlooked due to the lack of symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Clinicians treating high-risk populations, including patients with type 2 diabetes and\/or components of the metabolic syndrome, should be aware of the frequently occurring co-existence with non-alcoholic fatty liver disease (NAFLD) and especially non-alcoholic steatohepatitis (NASH).<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Liver enzymes may be in the normal range even in people with steatosis, NASH, or even cirrhosis.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The diagnosis of NAFLD should include evaluation of hepatic fibrosis as this is the most important prognostic factor for liver-related complications and mortality.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Guidelines about systematic screening for NAFLD in patients with type 2 diabetes are incongruent.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0350","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T08:41:32Z","timestamp":1672044092000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Incidental finding of non-alcoholic steatohepatitis-cirrhosis"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-6588","authenticated-orcid":true,"given":"Therese","family":"Adrian","sequence":"first","affiliation":[{"name":"Department of Nephrology, Copenhagen University Hospital \u2013 Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Hornum","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Copenhagen University Hospital \u2013 Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip Krag","family":"Knop","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"},{"name":"Center for Clinical Metabolic Research, Copenhagen University Hospital \u2013 Gentofte Hospital, Hellerup, Denmark"},{"name":"Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark"},{"name":"Copenhagen University Hospital \u2013 Steno Diabetes Center Copenhagen, Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Lotte Gluud","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"},{"name":"Gastro Unit, Medical Division, Copenhagen University Hospital \u2013 Amager and Hvidovre Hospital, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Hepatology","first-page":"1388","article-title":"EASL\u2013EASD\u2013EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease","volume":"64","year":"2016","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) & European Association for the Study of Obesity (EASO). EASL\u2013EASD\u2013EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Journal of Hepatology2016641388\u20131402. (https:\/\/doi.org\/10.1016\/j.jhep.2015.11.004)"},{"key":"bib2","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","unstructured":"Chalasani NYounossi ZLavine JECharlton MCusi KRinella MHarrison SABrunt EMSanyal AJ. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology201867328\u2013357. (https:\/\/doi.org\/10.1002\/hep.29367)10.1002\/hep.29367"},{"key":"bib3","series-title":"Journal of Hepatology","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.jhep.2019.06.021","article-title":"The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis","volume":"71","author":"Younossi","year":"2019","unstructured":"Younossi ZMGolabi Pde Avila LPaik JMSrishord MFukui NQiu YBurns LAfendy ANader F. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. Journal of Hepatology201971793\u2013801. (https:\/\/doi.org\/10.1016\/j.jhep.2019.06.021)10.1016\/j.jhep.2019.06.021"},{"key":"bib4","series-title":"Gut","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1136\/gut.2010.216077","article-title":"Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease","volume":"59","author":"McPherson","year":"2010","unstructured":"McPherson SStewart SFHenderson EBurt ADDay CP. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut2010591265\u20131269. (https:\/\/doi.org\/10.1136\/gut.2010.216077)10.1136\/gut.2010.216077"},{"key":"bib5","series-title":"Archives of Internal Medicine","article-title":"The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). Alcohol use disorders identification test","volume":"158","author":"Bush","year":"1998","unstructured":"Bush KKivlahan DRMcDonell MBFihn SDBradely KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). Alcohol use disorders identification test. Archives of Internal Medicine1998158 1789\u20131795. (https:\/\/doi.org\/10.1001\/archinte.158.16.1789)"},{"key":"bib6","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1002\/hep.27368","article-title":"Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up","volume":"61","author":"Ekstedt","year":"2015","unstructured":"Ekstedt MHagstr\u00f6m HNasr PFredrikson MSt\u00e5l PKechagias SHultcrantz R. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology2015611547\u20131554. (https:\/\/doi.org\/10.1002\/hep.27368)10.1002\/hep.27368"},{"key":"bib7","series-title":"European Journal of Gastroenterology and Hepatology","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1097\/MEG.0000000000001679","article-title":"Non-alcoholic fatty liver disease in inflammatory bowel disease patients","volume":"32","author":"Karaivazoglou","year":"2020","unstructured":"Karaivazoglou KKonstantakis CTourkochristou EAssimakopoulos SFTriantos C. Non-alcoholic fatty liver disease in inflammatory bowel disease patients. European Journal of Gastroenterology and Hepatology202032903\u2013906. (https:\/\/doi.org\/10.1097\/MEG.0000000000001679)10.1097\/MEG.0000000000001679"},{"key":"bib8","series-title":"New England Journal of Medicine","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1056\/NEJMoa2028395","article-title":"A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis","volume":"384","author":"Newsome","year":"2021","unstructured":"Newsome PNBuchholtz KCusi KLinder MOkanoue TRatziu VSanyal AJSejling ASHarrison SA & NN9931-4296 Investigators. A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis. New England Journal of Medicine20213841113\u20131124. (https:\/\/doi.org\/10.1056\/NEJMoa2028395)10.1056\/NEJMoa2028395"},{"key":"bib9","series-title":"Lancet. Gastroenterology and Hepatology","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/S2468-1253(21)00261-2","article-title":"Efficacy of peroxisome proliferator-activated receptor agonists, glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors for treatment of non-alcoholic fatty liver disease: a systematic review","volume":"7","author":"Mantovani","year":"2022","unstructured":"Mantovani AByrne CDTargher G. Efficacy of peroxisome proliferator-activated receptor agonists, glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors for treatment of non-alcoholic fatty liver disease: a systematic review. Lancet. Gastroenterology and Hepatology20227367\u2013378. (https:\/\/doi.org\/10.1016\/S2468-1253(21)00261-2)10.1016\/S2468-1253(21)00261-2"},{"key":"bib10","series-title":"European Radiology","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s00330-010-1905-5","article-title":"The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis","volume":"21","author":"Bohte","year":"2011","unstructured":"Bohte AEVan Werven JRBipat SStoker J. The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis. European Radiology20112187\u201397. (https:\/\/doi.org\/10.1007\/s00330-010-1905-5)10.1007\/s00330-010-1905-5"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2022\/1\/EDM22-0350.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2022\/1\/EDM22-0350.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2022\/1\/EDM22-0350.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:03Z","timestamp":1784555283000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":10,"URL":"https:\/\/doi.org\/10.1530\/edm-22-0350","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,1]]}}}