Steatohepatitis: Difference between revisions

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==Overview==
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'''Steatohepatitis''' is a type of [[liver disease]], characterized by [[inflammation]] of the [[liver]] with concurrent [[fat]] accumulation in liver ("steato", meaning fat, "[[hepatitis]]", meaning inflammation of the liver).  Classically seen in alcoholics, steatohepatitis also is frequently found in people with [[diabetes]] and [[obesity]].  When not associated with excessive [[alcohol]] intake, it's referred to as "[[non-alcoholic steatohepatitis]]", or NASH.  Steatohepatitis of either [[etiology]] may progress to [[cirrhosis]], and NASH is now believed to be a frequent cause of unexplained cirrhosis (at least in Western societies). 
 
Steatohepatitis is characterized microscopically by hepatic fat accumulation ([[steatosis]]), mixed lobular inflammation, ballooning degeneration of [[hepatocyte]]s (sometimes with identifiable [[Mallory bodies]]), [[glycogen]]ated hepatocyte nuclei, and pericellular [[fibrosis]].  The "chicken wire" pattern of the pericellular fibrosis, which affects portal areas only secondarily in later stages, is very characteristic and is identified on trichrome stains.
 
 
 
==Treatment==
 
Recent studies suggest that [[diet (nutrition)|diet]], [[exercise]], and especially [[anti-diabetic drug|antiglycemic drug]]s may alter the course of the disease. A [[randomized controlled trial]] found that "[[pioglitazone]] led to metabolic and histologic improvement in subjects with  nonalcoholic steatohepatitis".<ref name="pmid17135584">{{cite journal |author=Belfort R, Harrison SA, Brown K, ''et al'' |title=A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis |journal=N. Engl. J. Med. |volume=355 |issue=22 |pages=2297–307 |year=2006 |pmid=17135584 |doi=10.1056/NEJMoa060326}}</ref>
 
==Prognosis==
A retrospective [[cohort study]] concluded that "liver failure is the main cause of morbidity
and mortality in NASH-associated cirrhosis. The prognosis is either similar or less severe
than HCV-cirrhosis."<ref name="pmid12883486">{{cite journal |author=Hui JM, Kench JG, Chitturi S, ''et al'' |title=Long-term outcomes of cirrhosis in nonalcoholic steatohepatitis compared with hepatitis C |journal=Hepatology |volume=38 |issue=2 |pages=420–7 |year=2003 |pmid=12883486 |doi=10.1053/jhep.2003.50320}}</ref>
 
==References==
<references/>
 
==See also==
*[[fatty liver|steatosis hepatis]]
*[http://hepatitis-central.com/hcv/info/2003/aug/hepcinfo420.pdf Hepatitis C]Long-Term Outcomes of Cirrhosis in Nonalcoholic Steatohepatitis Compared With Hepatitis C
 
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[[Category:Hepatitis]]
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Latest revision as of 17:07, 5 March 2013

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