A Case Study on A Patient with Non-Alcoholic Fatty Liver Disease (NAFLD) by Using Ultrasound

Baik Tai-Hyeun; Tai-Hyeun, Baik

doi:10.13048/jkm.16014

JKM > Volume 37(1); 2016 > Article

Tai-Hyeun: A Case Study on A Patient with Non-Alcoholic Fatty Liver Disease (NAFLD) by Using Ultrasound

Case Report

The Journal of Korean Oriental Medicine 2016; 37(1): 151-157.

Published online: March 31, 2016

DOI: https://doi.org/10.13048/jkm.16014

A Case Study on A Patient with Non-Alcoholic Fatty Liver Disease (NAFLD) by Using Ultrasound

Baik Tai-Hyeun^*

Dept. of Internal Medicine, College of Korean Medicine, Sangji University

Correspondence to: 백태현, 강원도 원주시 우산동 283번지, 상지대학교 부속한방병원 내과학교실, Tel: +82-33-741-9207, E-mail: white@sangji.ac.kr

Received February 23, 2016 Revised March 14, 2016 Accepted March 21, 2016

Abstract

Objectives:

The purpose of this study is to report the clinical effect of Shihosogan-tang extract on NAFLD through ultrasound.

Methods:

The patient was treated with Shihosogan-tang extract. We observed the changes in symptoms and ultrasound imaging on a patient with NAFLD.

Results:

After treatment, the symptoms of the patient with NAFLD were decreased and ultrasound imaging were improved from moderate to mild grade.

Conclusion:

The patient of NAFLD was improved in symptoms and ultrasound imaging.

Keywords: Non-alcoholic fatty liver disease, NAFLD, Roaccutane, Isotretinoin, Sonography, Shihosogan-tang

Fig. 1.

Ultrasonography findings of liver at 2015.6.4.

(A): US image shows moderate obscuration of diaphragm and hepatic vessels due to fatty infiltration

(B): The echo-texture of the liver is brighter than the right kidney due to fatty liver

Fig. 2.

Ultrasonography findings of liver at 2015.9.4.

(A): The obscuration of diaphragm and hepatic vessels is lesser than Fig.1 (A)

(B): The difference in echogenicity between the liver and right kidney is lesser than Fig.1 (B)

Fig. 3.

Ultrasonography findings of liver at 2015.12.22.

(A): US image shows slight obscuration of diaphragm and hepatic vessels

(B): The difference in echogenicity between the liver and right kidney is lesser than Fig.1 (B)

Table 1.

The improvement of clinical symptoms

Date	2015.6.4.	2015.7.2.	2015.9.4.	2015.11.4.	2015.12.21.

Symptom
疲勞	+++	+++	++	++	+
上熱感	++	++	+	+	±
易怒	+++	+++	++	+	±
偏頭痛	++	++	++	+	+
消化不良	+++	++	++	+	±

Symptom Grade : +++ severe, ++ moderate, + mild, ± trace

Table 2.

Classification of Fatty Liver by Scararige

구 분	판 정 기 준
輕症 (mild)	우측 신실질의 에코(echo)보다 간실질의 에코가 약간 증가된 상태로 간내 혈관들이나 횡격막이 잘 보이는 경우
中等度 (moderate)	우측 신실질의 에코보다 간실질의 에코가 중간 정도 증가된 상태로 간내 혈관들이나 횡격막이 약간 불분명하게 보이는 경우
重症 (severe)	우측 신실질의 에코보다 간실질의 에코가 심하 게 증가된 상태로 간내 혈관들이나 횡격막이 거 의 보이지 않는 경우

참고문헌

1.. Sim CS. Abdominal Ultrasound. Seoul. Yeo Mun Gak;(2002). p. 268

2.. Liver System Association of Internal Medicine. Liver System of Internal Medicine. 5th ed. Seoul. Nado;(2013). 38:p. 321-5.

3.. Angulo, P. Nonalcoholic fatty liver disease. N Engl J Med, (2002). 346, 1221-31.

4.. Kim SY. The Association of Nonalcoholic Fatty Liver Disease with Metabolic Syndrome [dissertation]. Seoul: Ewha Womans Univ;2006.

5.. Caturelli, E, Squillatne, MM, Andriulli, A, & Rapaccini, GL. Hypoechoic lesions in the ‘bright liver’ : A reliable indicator of fatty change. A prospective study. J Gastroenterol Hepatol, (1992). 7, 469-72.

6.. Joseph, AE, Saverymuttu, SH, al Sam, S, Cook, MG, & Maxwell, JD. Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol, (1991). 43(1), 26-31.

7.. Hong MU, Hong H. Practical Chinise Medicine of Digestive Disease. 1st ed. Tianjin. Tianjin Science & Technology Translation & Publishing CO;(1994). p. 235

8.. Scatarige, JC, Scott, WW, Donovan, PJ, Siegelman, SS, & Sanders, RC. Fatty infiltration of the liver: ultrasonographic and computerized tomographic correlation. J Ultrasound Med, (1984). 3, 9-14.

9.. Kim, HK, Gwon, YO, Kim, JY, Gwak, KS, Choi, RH, & Jeong, JM, et al. Comparatives Studty of Serum Transaminase Level and Liver Biopsy Finding in Fatty Liver. Journal of Korean Medical Association, (1988). 31(1), 79-84.

10.. Kim, SH, Kang, DH, Lee, SH, & Yun, CH. Causes of Fatty Liver Diagnosed by Abdominal Ultrasonography. Korean J Fam Med, (1995). 16(11), 785-794.

11.. Cho, KH, Hong, MH, Yu, HD, Lee, TH, Cho, AK, & Park, YK, et al. Clinical Significance of Fatty Liver diagnosed by Abdominal Ultrasonography. Korean J Fam Med, (1993). 14(11), 734-742.

12.. Im, CS, & Kim, SS. Risk Factors Associated with Metabolic Syndrome in Ultrasonographic Fatty Liver. Korean J Obes, (2008). 17(3), 124-131.

13.. Hultcrantz, R, & Gabrielsson, N. Patients with persistent elevation of aminotransferases: investigation with ultrasonography, radionuclide imaging and liver biopsy. J Intern Med, (1993). 233, 7-12.

14.. Fishbein, MH, Gardner, KG, Potter, CJ, Schmalbrock, P, & Smith, MA. Introduction of fast MR imaging in the assessment of hepatic steatosis. Magn Reson Imaging, (1997). 15, 287-93.

15.. Mclane, J. Analysis of common side effects of isotretinoin. J Am Acad Dermatol, (2001). 45, S188-94.

16.. Rodondi, N1, Darioli, R, Ramelet, AA, Hohl, D, Lenain, V, & Perdrix, J, et al. “High risk for hyperlipidemia and the metabolic syndrome after an episode of hypertriglyceridemia during 13-cis retinoic acid therapy for acne: a pharmacogenetic study.”. Ann Intern Med, 136, (2002). 582-9.

17.. McCarter, TL, & Chen, YK. “Marked hyperlipidemia and pancreatitis associated with isotretinoin therapy.”. Am J Gastroenterol, (1992). 87, 1855-8.

18.. Wysowski, DK, Pitts, M, & Beitz, J. “An analysis of reports of depression and suicide in patients treated with isotretinoin.”. J Am Acad Dermatol, (2001). 45, 515-9.

19.. Ryu, KJ, Kim, JH, Han, C, Park, JH, & Kwon, SR. A Case Report of Panic Disorder with Functional Gastrointestinal Disturbance. J of Oriental Neuropsychiatry, (2009). 20(2), 187-196.

20.. Oh, KC. A Clinical report on Panic Disorder with Nausea treated by Shihosogantang-gami. J of the Korea Institute of Oriental Medical Diagnostics, (2012). 16(3), 59-68.

21.. Lee, SR, & Ryu, HY. Effects of Ondamtang, Samulansintang and Shihosogansan Water Extract on the Obesity and Stress. J of Oriental Neuropsychiatry, (1992). 3(1), 25-45.