Development of Pediatric Nonalcoholic Fatty Liver Disease Associated with Craniopharyngioma: Insights from a Case Report and Literature Review

During the last decade, pediatric Nonalcoholic fatty liver disease (NAFLD) has emerged as the main cause of chronic liver disease in children. NAFLD is a multicluster disease which ranges from simple steatosis to non-alcoholic steatohepatitis NASH. Recently it has become the main cause of chronic liver disease in children and has emerged to be predicted by many specific risk factors, such as obesity and sedentary lifestyle, on predisposing genetic settings. Increasing prevalence is thought to result from a combination of several environmental and genetic factors. The natural history of pediatric NAFLD is lacking, and the etiopathogenesis is not fully understood. It has been reported that children with craniopharyngioma can have features of metabolic syndrome and other comorbidities. A case of an 11-year-old child was reported who was diagnosed with craniopharyngioma. After the surgery of his brain tumor and hormone replacement therapy, he was diagnosed as having NAFLD. The presence of a craniopharyngioma, and/or treatment-related damage to centers in the hypothalamus that regulate energy balance often results in severe obesity and abnormal eating behaviors. This may be exacerbated by hormonal deficits from coexistent hypopituitarism. This case is used to highlight the main pathophysiologic processes resulting in the development of NAFLD in children following treatment of craniopharyngioma. The focus is on the endocrine disturbances that can link the two entities.