Nonalcoholic steatohepatitis: An expanded clinical entity

Bacon, Bruce R.; Farahvash, M J; Janney, Christine G.; Neuschwander‐Tetri, Brent A.

doi:10.1016/0016-5085(94)90235-6

Cited by 1,017 publications

(741 citation statements)

References 21 publications

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“…Of 199 reported cases of NASH recently cited, 36% had histologic evidence of cirrhosis or significant fibrosis. 7 Nonalcoholic steatohepatitis with cirrhosis after transplantation for the same has not, to our knowledge, been reported. Steatohepatitis without cirrhosis that recurred after transplantation was described in a liver transplanted in 1990 for cirrhosis after jejunoileal bypass.…”

Section: Discussionmentioning

confidence: 83%

Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation

1997

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Nonalcoholic steatohepatitis (NASH) may progress to cirrhosis and lead to liver failure. Histologically, NASH is often indistinguishable from liver disease caused by alcohol use; the cause of NASH remains unknown. A subgroup of patients with NASH eventually develops fibrosis and/or cirrhosis, and in many cases, transplantation is performed for end-stage liver disease attributed to steatohepatitis in patients who do not consume alcohol. The patient described received a transplant for end-stage liver disease secondary to NASH with cirrhosis. Postoperatively she did well, with a bout of mild rejection treated successfully at week 9 with prompt normalization of liver tests. Weight and glycemic control were optimized, and steroid therapy was minimized as safely as possible. Repeat liver biopsy at week 66, however, for persistent mild elevation of alkaline phosphatase and gamma-glutamyltransferase surprisingly revealed the ''recurrence'' of NASH. Subsequent biopsy revealed NASH with cirrhosis by week 76 after transplantation. Subsequent biopsy at week 87 has confirmed cirrhosis. The patient does not consume alcohol. It is believed to be the first reporting of such a case.

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Section: Discussionmentioning

confidence: 83%

Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation

1997

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“…It is plausible that iron overload in the liver damages hepatocytes, which in turn would result in elevated transaminases and GGT. Although we did not have access to liver ultrasound or biopsy in our study, a correlation between ferritin level and non-alcoholic fatty liver disease or non-alcoholic steatohepatitis, which is associated with elevated ALT, has been described by others in both obese [28] and mainly non-obese [29] individuals. An association between raised hepatic iron concentration and severity of fibrosis in non-alcoholic steatohepatitis has also been reported [30].…”

Section: Discussionmentioning

confidence: 86%

Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study

et al. 2007

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Aims/hypothesis The aim of this study was to examine the association between baseline body iron stores and new-onset diabetes. Subjects and methods We studied the association between baseline serum ferritin concentration and type 2 diabetes in 360 clinically incident diabetes cases and 758 controls nested within the EPIC (European Prospective Investigation of Cancer)-Norfolk Cohort Study. Serum ferritin levels were categorised into five groups: sex-specific quartiles of the normal range of ferritin and a group with clinically raised ferritin below levels indicative of haemochromatosis. Results Baseline serum ferritin was higher among cases than control participants (geometric mean: men 96.6 vs 67.8 ng/ml, respectively, p<0.001; women 45.9 vs 34.8 ng/ ml, respectively, p=0.005). In analyses adjusted for known risk factors (age, BMI, sex, family history, physical activity, smoking habit) and dietary factors measured by 7-day food diary, the risk of diabetes was markedly elevated in participants with clinically raised ferritin compared with the lowest quartile (odds ratio [OR] 7.4, 95% CI 3.5-15.4). Further adjustment for potential confounding by inflammation (C-reactive protein, IL-6 and fibrinogen) had no material impact on the observed association, while adjustment for hepatic enzymes (alanine aminotransferase and γ glutamyl transferase) and adiponectin attenuated the magnitude of association, but it remained statistically significant (OR 3.2 [1.3-7.6]). Conclusions/interpretation Serum ferritin is an important and independent predictor of the development of diabetes. This finding may have important implications for understanding the aetiology of diabetes.

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“…Nonalcoholic steatohepatitis has been reported to affect 2-3% of the world's population, making it probably the most common liver disorder today [126]. Of these patients with NASH, 23% progress to liver cirrhosis in 10-15 years [127].…”

Section: Nash and Hccmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Nonalcoholic steatohepatitis: An expanded clinical entity

Cited by 1,017 publications

References 21 publications

Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation

Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation

Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

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