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Abstract: A 13-year-old male patient, usually healthy, had been suffering from right abdominal discomfort and lethargy for the past 1 month. His parents brought him to the hospital for examination, and the ultrasound suggested severe fatty liver, while other causes of liver injury were excluded, and he was diagnosed with non-alcoholic steatohepatitis. The patient’s liver function and blood lipids returned to normal, and his mental state gradually improved.
Basic information】Male, 13 years old
Disease Type】Non-alcoholic steatohepatitis
Hospital】The 988th Hospital of the PLA Joint Logistics and Security Forces
Date of consultation】May 2021
Treatment plan】Medication (silymarin capsules, compound glycyrrhizin injection, compound glycyrrhizin tablets) + diet modification + weight loss
Treatment Period】Hospitalization for 3 weeks, home medication according to doctor’s prescription
Treatment effect】The condition was effectively controlled, the indicators have returned to normal, and the discomfort symptoms were relieved.
I. Initial consultation
The patient is a 13-year-old male, 1.60 meters tall, weighing 82 kg. The patient usually likes to eat fried foods such as chicken wings and burgers, never drinks plain water, does not like to eat fruits, and drinks carbonated drinks as water. One month before admission, he began to feel uncomfortable on the right side of his abdomen, was weak, ate less, dozed off in class, and had no energy. He was admitted to the hospital to check liver function: glutamic aminotransferase 383U/L, glutamic aminotransferase 159U/L, bilirubin and protein were basically normal, triglycerides 4.92mmol/L, ultrasound indicated: severe fatty liver.
II. Treatment history
The patient was admitted to the hospital for a comprehensive examination and was clearly diagnosed with non-alcoholic steatohepatitis with severe liver function impairment. In terms of treatment plan, in addition to medication, it is important to adjust the diet structure and reduce body weight. Silymarin capsules were given, which can repair the damaged liver cells and improve the detoxification ability of the liver. At the same time, compound glycyrrhizin injection was given intravenously to control the inflammatory response of liver cells and improve liver function. The patient’s non-alcoholic steatohepatitis is closely related to poor dietary habits. After admission, he communicated with his family several times about the treatment plan, strictly controlled his diet, ensured coarse and fine meals three times a day, ate more vegetables, fruits and potatoes, ensured drinking 1000-1500ml of plain water daily, and was 7-8 minutes full at each meal. Due to the abnormal liver function, it was not suitable for strenuous exercise, so his family members were allowed to accompany him to walk for 15-30 minutes after three meals. After 3 weeks of hospitalization, transaminases decreased, and although there was no significant weight loss, mental and physical strength returned to normal, and he was subsequently discharged with silymarin capsules and compound glycyrrhetinic acid tablets.
III. Treatment effect
One year later, the patient’s liver function and blood lipids were completely normal, and the fatty liver was not seen in the ultrasound, and the patient was already a 1.75m thin and tall guy, and his weight was successfully reduced to 68kg.
IV. Notes
I am very pleased that after treatment the patient indicators are good in all aspects, but if you relax your vigilance, and then resume the previous habits, the disease will still recur, once again advise patients and families, must pay attention to the following points.
1, diet should be moderate, do not overeat, breakfast must be eaten well to ensure sufficient energy to study, noon food variety to be rich, meat, vegetables, fruit can not be less, dinner can be properly reduced, light vegetarian food can be, do not eat within 2 hours before bedtime.
2, choose aerobic exercise suitable for you and stick to it, the amount of exercise at one time should not be too large and the time should not be too long to prevent injury to joints and ligaments.
3, strictly control the intake of trans fatty acids, such as pastries, instant noodles, butter, etc., and can use unsaturated fatty acid fats for cooking, such as olive oil, camellia oil, etc.
4, the patient is currently in adolescence, belonging to the growth spurt, can not affect the body nutrition supplement because of weight loss, it is recommended to supplement more high-quality protein such as fish, shrimp, milk, lean meat, eggs and other foods.
V. Personal insight
With the improvement of living standards, followed by obesity brought about by a variety of diseases, such as fatty liver, diabetes, hypertension, hyperlipidemia and many other metabolic diseases gradually younger and more serious. Poor diet and living habits seriously threaten people’s health. The patient in this case was relatively lucky to be diagnosed and treated in time, and to have family members to cooperate and encourage. Some patients do not take it seriously and feel that the disease is not a big problem, but they do not know that once cirrhosis is formed it is difficult to reverse it, and the complications that occur due to cirrhosis make many patients suffer and even lose their families, as medical professionals, we have been calling for a healthy life and for disease prevention before it happens.