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Abstract Details
Hepatitis, Nonalcoholic Steatohepatitis
Sharma B1, John S2.
Source
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017-.
2017 Nov 21.
Author information
1
SUNY Upstate University Hospital
2
SUNY Upstate Medical University
Excerpt
Nonalcoholic, fatty liver disease (NAFLD) is defined as the ectopic accumulation of fat in the liver (hepatic steatosis) when no other causes of secondary, liver fat accumulation are present. As minor deposition of fat can occur in healthy adults, deposition of fat in at least 5% of hepatocytes is considered pathologic. Nonalcoholic steatohepatitis (NASH) is diagnosed via a liver biopsy when there is evidence of inflammatory activity and hepatocyte injury in a steatotic liver tissue. The diagnosis of NAFLD should not be made in a patient who has a history of significant alcohol consumption. The acceptable level of daily alcohol consumption is considered to be less than 20 g/day in men and 10 g/day in women. These cutoff values are not accurately defined, especially in patients with prior history of heavy alcohol use and those who are prone to NASH. NASH can progress to liver fibrosis, cirrhosis, and hepatocellular carcinoma. The term NAFLD includes the term NASH. NASH is not a diagnosis of exclusion, and it can be associated with other live conditions such as chronic hepatitis C. Thirty percent to 40% of patients with NASH develop fibrosis. NASH is classified into two types, primary NASH which is related to obesity and diabetes in the absence of excessive alcohol intake, and secondary NASH which is toxin or drug induced. This article will focus on primary NASH.