NASH



NASH


Matthew M. Yeh, MD, PhD









Low-power view of a liver biopsy in a child with steatohepatitis reveals chronic portal inflammation image. Macrosteatosis is noted within the hepatic lobules image, and bridging fibrosis is evident.






A chronic portal inflammation image with expansion into zone 1 image is illustrated here. The lobular inflammatory cells are situated among steatotic hepatocytes.


TERMINOLOGY




ETIOLOGY/PATHOGENESIS


Mechanism



  • Abnormal accumulation of lipids in hepatocytes provides source of oxidative stress


  • Leads to injury/inflammation


  • Subsequent activation of TGF-β and hepatic stellate cells results in liver fibrosis


Associated Conditions



  • Diabetes, obesity, hyperlipidemia, dyslipidemia, drugs, malabsorption, malnutrition


CLINICAL ISSUES


Presentation



  • Hepatomegaly


  • Metabolic syndrome



    • Central (visceral) obesity


    • Type 2 diabetes


    • Dyslipidemia (hypertriglyceridemia and low HDL)


    • Systemic hypertension


Laboratory Tests



  • Elevated transaminases



Prognosis



  • May lead to liver fibrosis, cirrhosis, and hepatocellular carcinoma


MICROSCOPIC PATHOLOGY


Histologic Features

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on NASH
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