NONALCOHOLIC STEATOHEPATITIS - 10 YEARS EXPERIENCE AT THE INSTITUTO-NACIONAL-DE-LA-NUTRICION-SALVADOR-ZUBIRAN

AIM. To describe the characteristics of nonalcoholic steatohepatitis (NASH) at the Instituto Nacional de la Nutricion Salvador Zubiran. Material and methods. We reviewed all liver biopsy reports from january 1982 to December 1991. From patient records we obtained the following data: clinical, biochemical, imaging studies and we reviewed the histological material. We correlated clinical, biochemical and histological data. Results. From 2963 biopsies reviewed we obtained 16 cases with NASH. We found a 7:1 female/male ratio. Median age was 30 years and six patients were obese. Eleven patients had concomitant disease (diabetes in seven) and nine were using drugs. All had been studied for biochemical abnormalities and were asymptomatic. Ten patients had hepatomegaly and six splenomegaly. Ultrasound suggested the diagnosis in 50% of the cases. All had steatosis, inflammatory infiltrate, necrosis; fibrosis and Mallory bodies at different stages. One case had cirrhosis on initial biopsy and two developed cirrhosis on follow-up (one and eight years later). We did not find any correlation between clinical, biochemical or imaging characteristics and histological findings. When we compared these findings between obese and non obese patients and primary and secondary NASH we did not find any differences between groups. Conclusions. NASH is infrequent in our institution. The underlying pathogenesis seems to be multifactorial. There is no biochemical-histological correlation. Cirrhosis can develop in some cases.