Most patients with metabolic-dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) are asymptomatic in early stages; findings are often incidental on health check-ups. Key features relate to metabolic disturbance and hepatic fat accumulation: Splenomegaly, thrombocytopenia: congestive hypersplenism Fatigue: commonest, linked to hepatocyte energy impairment Right upper-quadrant dull pain or discomfort: from stretched Glisson capsule Loss of appetite/early satiety: reduced gastric accommodation with post-prandial fullness Weight gain or central obesity: background of metabolic syndrome Skin pruritus: retained bile acids irritating peripheral nerves Spider naevi, palmar erythema: decreased oestrogen clearance → peripheral vasodilatation Ascites, leg oedema: combined hypoalbuminaemia and portal hypertension (advanced stage)... Learn more