ESPE Abstracts

Introduction: Childhood obesity is continuing to increase worldwide resulting in a rise in the number of individuals with complications secondary to obesity. Non-alcoholic fatty liver disease (NAFLD) is seen in both adult and paediatric populations and if not treated appropriately is potentially life-threatening, as it may progress to advanced fibrosis, cirrhosis or hepatocellular carcinoma. NAFLD has now become the most common indication for liver transplant in adults.

Case Report: We report a thirteen-year-old female who initially presented to the primary care at the age of ten years with abdominal pain. She was noted to have a high body mass index (BMI) of 28.8kg/m² (+2.97 SDS) and a weight of 69.2 kg (+4.58 SDS). Biochemistry showed deranged liver function tests and a liver ultrasound identified extensive fatty deposition in the liver. The liver biopsy confirmed advanced fibrosis (NAFLD activity score of 7/8 and a chronicity fibrosis score of 3/4). Autoimmune and infection causes were excluded. The patient was managed with lifestyle intervention, but unfortunately this was unsuccessful. She was referred to the multidisciplinary team (MDT) weight management clinic at the age of thirteen years with a weight of 110.5kg (+6.05 SDS) and BMI of 36.1kg/m² (+3.18 SDS). Following a three-month period of an intense MDT programme, which included two-weekly reviews and Liraglutide (glucagon-like peptide-1 agonist) treatment, the patient demonstrated 9.7% weight loss. Her weight at the end of three months was 99.8kg (+4.83 SDS) and BMI was 32.9kg/m² (+2.81 SDS). A repeat liver ultrasound revealed some echogenicity suggestive of fatty changes, but the hepatomegaly and inflammation had resolved. The liver function tests have fully normalised following the treatment course (Table 1).

Conclusion: We report successful resolution of steatohepatitis and 9.7% weight loss in an adolescent female with significant obesity following a 3-month course of Liraglutide treatment along with intense MDT support.