Wednesday, July 29, 2009

Non Alcoholic Steatohepatitis (NASH)

15 year old male obese boy came with pain in abdomen with elevated liver enzymes. He is non alcoholic, not taking any medication and tests negetive for hepatitis. MRI abdomen T1 weighted image shows diffuse fatty infilteration in the liver which is confirmed by loss of signal on ooposed phase chemical shifgt image. Findings are consistent with Non Alcoholic Steatohepatitis (NASH).

Synonyms: Hepatic fatty metamorphosis , Hepatic fatty steatosis, NASH
Nonalcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage.Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss, and weakness—once the disease is more advanced or cirrhosis develops.

We have to differentiate "Fatty liver", NASH and nonalcoholic fatty liver disease (NAFLD). Fat in their liver, but no inflammation or liver damage, a condition called “fatty liver. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver. Main causes for the NASH are elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, obesity.

USG shows diffuse increase in echotexture. CT scan will show diffuse decrease in attenuation. MRI shows intracellular fatty infilteration which is diffusely hyperintense on T1 weighted image (in phase image) and shows loss of signal on opposed phase chemical shift image. These MRI findings in patient with elevated liver enzymes suggestive of NASH. Liver biopsy and histopathology are diagnostic.

1 comment:

Christian Baluyut said...

Many people who are overweight or who have diabetes, prediabetes, or high cholesterol may also have liver damage without knowing it. Nonalcoholic steatohepatitis (NASH) is a liver disease that occurs when a buildup of fat in the liver causes irritation (inflammation) and damage that may interfere with how the liver works. Many people with NASH feel fine and do not even know they have the condition.

If you have been told that you have or may have either NASH or a fatty liver, and diet and exercise haven’t worked, you may want to consider participation in the VIA clinical research study.

What is the purpose of the VIA clinical research study?
The VIA study is evaluating whether a once-daily, oral investigational medication called volixibat, is tolerable, safe, and effective in reducing liver damage in people with NASH. The study will evaluate the effects (if any) of three different doses of volixibat in patients with NASH.

For more details please visit

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