Hepatic Steatosis

The  following information, collected from a variety of medical sources, sheds light on hepatic steatosis.  Also known as “fatty liver” disease, this is one of the 15 health conditions covered by the VA for Camp Lejeune victims.

Some fat in your liver is normal. But if it makes up more than 5%-10% of the organ’s weight, you may have fatty liver disease.   

From the Review of VA Clinical Guidance for the Care of Health Conditions Identified by the Camp Lejeune Legislation (by the IOM):

Hepatic steatosis is not a disease rather it is a common pathological finding in medical conditions that affect the liver.  In western countries, it affects up to one third of the population and up to 75% in some subgroups such as obese patients.  Hepatic steatosis or simple fatty liver can be caused by a variety of conditions including alcohol abuse, overweight or obesity, Type 2 Diabetes, metabolic syndrome, medication use and hepatitis.

Generally hepatic steatosis or fatty liver resolves by treating the underlying condition.  In evaluating whether a Camp Lejeune Veteran or family member has hepatic steatosis related to Camp Lejeune, the clinician should consider whether it is more likely than not that the patient has fatty liver disease from a known etiology.  The most common causes of hepatic steatosis include obesity and alcohol abuse.  If a patient’s clinical course is consistent with a known cause of hepatic steatosis, their treatment for hepatic steatosis should not be covered by the law.  Camp Lejeune Veterans and family members with hepatic steatosis of unclear or unknown etiology should be covered by the Camp Lejeune law.  Moreover, if a patient’s clinical course of hepatic steatosis is atypical or progresses faster than expected, then exacerbation by TCE, PCE or other organic solvents in the contaminated water should be considered.

From an online medical dictionary:

Diagnosis
During a physical examination, a doctor might notice that the liver is enlarged and tender when the abdomen is palpated (examined with the tips of the fingers while the patient lies flat). Blood tests or a liver biopsy can be used to confirm fatty liver. In pregnant women, the fatty liver condition is usually associated with another serious complication, pre-eclampsia or eclampsia. In this condition, the mother has seriously high blood pressure, swelling, and possibly, seizures. Laboratory abnormalities include elevations of the SGOT (serum glutamic-oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase). In many cases the alkaline phosphatase will be significantly elevated due to cholestasis produced by the fatty infiltration.

Treatment
Treatment involves correcting the condition that caused fatty liver and providing supportive care.

Prognosis
Fatty liver is usually reversible if recognized and treated. There may be some long-term tendency toward other types of liver problems depending on how long and how severe the fatty liver condition was. In pregnant women with the condition, the situation can be life threatening for both the mother and the infant. Left untreated, there is a high risk of death for both the mother and baby. Severe liver damage that may require a liver transplant can occur in the mother if the condition is not recognized early.