Acute steatohepatitis, due to extreme metabolic dysregulation, as the first presentation of non-alcoholic fatty liver disease

  • Georgios Kranidiotis | gekranid@hotmail.com 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.
  • Angeliki Angelidi 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.
  • Emmanouel Sevdalis 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.
  • Thomas-Nikolaos Telios 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.
  • Alexandra Gougoutsi 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.
  • Andreas Melidonis 1st Department of Internal Medicine, “Tzaneion” General Hospital, Piraeus, Greece.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a slowly progressive chronic disease, with a high prevalence among obese, dyslipidemic or diabetic people, commonly presented as an asymptomatic mild elevation of serum aminotransferases. We report a patient who experienced an acute form of non-alcoholic steatohepatitis, as the first manifestation of NAFLD, due to exacerbation of pre-existing metabolic disorders by an extremely unhealthy lifestyle. A 50-year old, obese, diabetic man presented with a one-week history of jaundice and malaise. Analysis revealed elevated liver enzymes, bilirubin, lipids, and glucose. Based on patient’s history, physical examination, laboratory results, and imaging findings, acute non-alcoholic steatohepatitis was established as a diagnosis of exclusion. The patient was started on a low-calorie diet free of carbohydrates and fats, in combination with insulin. A dramatic improvement of clinical and laboratory parameters was observed. In the context of extreme metabolic dysregulation, induced by unhealthy diet, NAFLD may present as an acute steatohepatitis.

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Published
2013-05-20
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Section
Case Reports
Keywords:
non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, obesity, diabetes mellitus.
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How to Cite
Kranidiotis, G., Angelidi, A., Sevdalis, E., Telios, T.-N., Gougoutsi, A., & Melidonis, A. (2013). Acute steatohepatitis, due to extreme metabolic dysregulation, as the first presentation of non-alcoholic fatty liver disease. Clinics and Practice, 3(2), e17. https://doi.org/10.4081/cp.2013.e17