HEPATIC STEATOSIS: AN AETIOHISTOPATHOLOGICAL STUDY

BACKGROUND Fatty liver disease, i.e. hepatic steatosis defined as hepatic lipid accumulation greater than 5-10% of liver weight. 1-3 has become a common health problem in both developed and developing countries. Morphologically fatty liver is of two types: microvesicular and macrovesicular. Macrovesicular steatosis is a chronic condition associated with various risk factors like alcoholism, diabetes mellitus, obesity, etc. The aim of present study was to analyse various aetiological factors associated with macrovesicular hepatic steatosis and find its correlation with the grade of steatosis. METHODOLOGY This retrospective and prospective study was conducted in histopathology laboratory of a tertiary health care centre in Mangalore, Karnataka, from 2009 to 2014; 120 cases of liver biopsies and autopsy liver tissue of adults (>= 18 years) showing histologically confirmed macrovesicular steatosis in >10% hepatocytes were analysed for aetiology and grade of steatosis. RESULT Hepatic steatosis was observed mainly in middle aged (31-50 years) males. ALD and non-alcoholic steatohepatitis (NASH) were most common causes followed by infections like TB, HCV, HBV, HIV and other causes like CPC (Chronic Passive Congestion) liver and drugs. Spearmen's correlation coefficient was used to analyse correlation between aetiology and grade of steatosis. ALD and NASH were most common causes for severe steatosis. ALD and NASH were also common causes for mild-to-moderate grade of steatosis. Mainly moderate-to-severe steatosis was found in association with TB, HCV, HBV, HIV. CPC cases predominantly showed moderate steatosis. The correlation between aetiology and grade of steatosis was found to be statistically significant. Drug induced steatosis was mostly severe grade, but the number of cases were too less to consider it statistically significant. CONCLUSION Various causes like ALD, NASH, TB, HCV, HBV and HIV infections, CPC and rarely drugs should be considered in cases of macrovesicular hepatic steatosis and histopathological sections of liver tissue should be studied extensively to rule out higher grades of steatosis.