Journal of the Formosan Medical Association
Volume 107, Issue 10 , Pages 816-821, October 2008

Disease Progression in a Patient with Nonalcoholic Steatohepatitis

  • Ping-Huei Tseng

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Chun-Jen Liu

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Jia-Horng Kao

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Chia-Tung Shun

      Affiliations

    • Department of Forensic Medicine and Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Pei-Jer Chen

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Ding-Shinn Chen

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ding-Shinn Chen, Hepatitis Research Center, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 9 May 2007; received in revised form 27 June 2007; accepted 7 August 2007.

Article Outline

Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD). The prevalence and clinical significance of NAFLD/NASH have been increasingly recognized in Western countries but much less known in Asian countries, including Taiwan. Here, we report the case of a 43-year-old man who had abnormal liver tests for 18 years. Retrospective evaluation of his initial clinical, laboratory and histologic findings indicated that the hepatic disorder was compatible with the diagnosis of NASH. Although his liver biochemical tests improved after taking lipid-lowering agents, a liver biopsy 17 years later demonstrated histologic progression of intralobular necroinflammation and perivenular fibrosis. These facts suggest that NASH, albeit mild and slowly progressive, indeed exists in Taiwan. After the control of chronic hepatitis B and C and westernization of the lifestyle in Taiwan, an increasing burden of NAFLD/NASH is anticipated and active prophylactic measures should be implemented.

Key Words:  metabolic syndrome , nonalcoholic fatty liver disease , nonalcoholic steatohepatitis

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References 

  1. Matteoni CA , Younossi ZM , Gramlich T , et al.   Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity . Gastroenterology . 1999;116:1413–1419
  2. Ludwig J , Viaggiano TR , McGill DB , et al.   Nonalcoholic steatohepatitis: Mayo Clinic experience with an hitherto unnamed disease . Mayo Clin Proc . 1980;55:434–438
  3. Angulo P . Nonalcoholic fatty liver disease . N Engl J Med . 2002;16:1221–1231
  4. Bellentani S , Saccoccio G , Masatti F , et al.   Prevalence of and risk factors for hepatic steatosis in Northern Italy . Ann Intern Med . 2000;132:112–117
  5. Marchesini G , Bugianesi E , Forlani G , et al.   Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome . Hepatology . 2003;37:917–923
  6. Clark JM , Brancati FL , Diehl AM . Nonalcoholic fatty liver disease . Gastroenterology . 2002;122:1649–1657
  7. Neuschwander-Tetri BA , Caldwell SH . Nonalcoholic steato-hepatitis: summary of an AASLD single topic conference . Hepatology . 2003;37:1202–1219
  8. Brunt EM , Janney CG , Di Bisceglie AM , et al.   Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions . Am J Gastroenterol . 1999;94:2467–2474
  9. Marchesini G , Brizi M , Bianchi G , et al.   Nonalcoholic fatty liver disease: a feature of the metabolic syndrome . Diabetes . 2001;50:1844–1850
  10. Farrell GC , Larter CZ . Nonalcoholic fatty liver disease: from steatosis to cirrhosis . Hepatology . 2006;43:S99–112
  11. Pei D , Kuo SW , Wu DA , et al.   The relationships between insulin resistance and components of metabolic syndrome in Taiwanese Asians . Int J Clin Pract . 2005;59:1408–1416
  12. Saadeh S , Younossi ZM , Remer EM , et al.   The utility of radiological imaging in nonalcoholic fatty liver disease . Gastroenterology . 2002;123:745–750
  13. Yang PM , Hung GT , Lin JT , et al.   Ultrasonography in the diagnosis of benign diffuse parenchymal liver diseases: a prospective study . J Formos Med Assoc . 1988;87:966–977
  14. Dixon JB , Bhathal PS , Hughs NR , et al.   Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss . Hepatology . 2004;39:1647–1654
  15. Day CP . Natural history of NAFLD: remarkably benign in the absence of cirrhosis . Gastroenterology . 2005;129:375–378
  16. Adams LA , Lymp JF , St Sauver J , et al.   The natural history of nonalcoholic fatty liver disease: a population-based cohort study . Gastroenterology . 2005;129:113–121
  17. Dam-Larsen S , Franzmann M , Andersen IB , et al.   Long term prognosis of fatty liver: risk of chronic liver disease and death . Gut . 2004;53:750–755
  18. Adams LA , Sanderson S , Lindor KD , et al.   The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies . J Hepatol . 2005;42:132–138
  19. Wong VW , Chan HL , Hui AY , et al.   Clinical and histological features of non-alcoholic fatty liver disease in Hong Kong Chinese . Aliment Pharmacol Ther . 2004;20:45–49
  20. Hui AY , Wong VW , Chan HL , et al.   Histological progression of non-alcoholic fatty liver disease in Chinese patients . Aliment Pharmacol Ther . 2005;21:407–413
  21. Lai SW , Tan CK , Ng KC . Epidemiology of fatty liver in a hospital-based study in Taiwan . South Med J . 2002;11:1288–1292
  22. Liew PL , Lee WJ , Lee YC , et al.   Hepatic histopathology of morbid obesity: concurrence of other forms of chronic liver disease . Obes Surg . 2006;16:1584–1593
  23. Liu CJ , Chen PJ , Jeng YM , et al.   Serum adiponectin correlates with viral characteristics but not histologic features in patients with chronic hepatitis C . J Hepatol . 2005;43:235–242
  24. Liu CJ , Jeng YM , Chen PJ , et al.   Influence of metabolic syndrome, viral genotype and antiviral therapy on super-imposed fatty liver disease in chronic hepatitis C . Antivir Ther . 2005;10:405–415

PII: S0929-6646(08)60196-5

doi:10.1016/S0929-6646(08)60196-5

Journal of the Formosan Medical Association
Volume 107, Issue 10 , Pages 816-821, October 2008

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