BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the main cause of chronic liver disease. Several studies have suggested a protective role of coffee in chronic liver disease, but their results remain controversial. AIM: The purpose of the study was to investigate the association between coffee consumption and the prevalence and severity of NAFLD in a non-diabetic and non-alcoholic population. METHODS: This study involved 157 participants. Cases were defined by the presence of steatosis on liver ultrasound, the severity of which was assessed by the Bright Liver Steatosis Score. Controls were defined by the absence of steatosis on liver ultrasound. All patients with cytolysis and/or cholestasis had an etiological investigation (serologic testing for Hepatitis B virus and hepatitis C virus infection, and autoimmune investigation). All participants underwent liver ultrasound, clinical assessment (blood pressure, waist circumference, and body mass index (BMI)), and biological assessment (Complete Blood Count, lipid profile test, liver function tests, and Fasting Blood Glucose [FBG]). Dietary assessment was conducted using a food frequency questionnaire, coffee consumption was dichotomized into present or absent and then categorized according to the number of cups consumed per day. RESULTS: The study included 94 NAFLD and 63 controls, the two groups were comparable in demographic characteristics. The means of systolic blood pressure, BMI, waist circumference, Aspartate Transaminase, Alanine Transaminase (ALT), Gamma-Glutamyl transferase (GGT), alkaline phosphatase, and FBG were significantly higher in the NAFLD group. The study of the association between coffee consumption and NAFLD showed a significant decrease in the risk of its occurrence (Odds Ratios [OR] = 0.39) and its severity (OR = 0.32) in coffee consumers, mainly in those consuming 3 or more cups. In multivariate analysis, the following factors were associated with increased prevalence of NAFLD: Metabolic syndrome, high mean levels of alkaline phosphatase, GGT, ALT, FBG, BMI, and waist circumference. However, Green tea consumption was not associated with either prevalence or severity of NAFLD (OR = 1.02, p = 0.82). CONCLUSION: Coffee consumption is inversely associated with the prevalence and severity of NAFLD. Further prospective studies are needed to establish a cause-effect relationship between coffee and NAFLD.

IgG4-related disease (IgG4-RD) is an emerging immune-mediated disease that can involve any organ. The involvement of the pancreas and biliary tract is the most common and well-studied in the literature. It is characterized by a non-specific presentation, mimicking a malignant process. The goal was to look at the different clinical and paraclinical aspects of this disease, as well as the challenges that come from its management. It was made up of three observations of patients with IgG4-RD involving the biliary tract and pancreas. The first observation concerned intrahepatic biliary cholangitis that was accompanied by portomesenteric thrombosis, which was discovered by cholestatic jaundice on the 15th day after an appendectomy, and the patient improved under corticosteroids and anticoagulants. The second observation concerned an acute revelation of the disease. It was an acute attack of chronic pancreatitis of IgG4-RD. The main symptoms were pancreatic pain and exocrine pancreatic insufficiency, and corticosteroid therapy allowed remission. The third observation was related to autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis, revealed by jaundice with cholestasis. The patient acquired corticosteroid resistance and an adverse progression to decompensated cirrhosis, and liver transplantation was indicated. The clinical presentation of IgG4-RD is heterogeneous, as evidenced by our three clinical observations. There are still significant gaps in our understanding, particularly in terms of pathogenesis and factors that influence therapy response. Further observational and interventional research is needed to better manage this disease.

Le kyste hydatique est une zoonose qui touche fréquemment le foie, qui sévit à l´état endémique dans plusieurs pays comme le Maroc. L´hydatidose hépatique peut se compliquer d´une angiocholite dont le traitement de choix est actuellement la cholangio-pancréatographie rétrograde endoscopique avec sphinctérotomie. Nous rapportons deux cas cliniques d´angiocholite sur kyste hydatique hépatique fistulisé dans la voie biliaire principale qui ont été traités par voie endoscopique avec une évolution favorable. Le diagnostic précoce et la prise en charge adéquate permettent l´amélioration du pronostic de ces patients.