Differentiation of nonalcoholic from alcoholic steatohepatitis: are routine laboratory markers useful?

Kazemi-Shirazi, Lili; Veloso, Moema Pinheiro; Frommlet, Florian; Steindl–Munda, Petra; Wrba, Fritz; Zehetmayer, Sonja; Marsik, Claudia; Ferenci, Péter

doi:10.1007/s00508-007-0921-1

Cited by 16 publications

(17 citation statements)

References 32 publications

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“…Portal-based pathology has also been described as distinct pathological entities in paediatric subjects such as type 2 NASH without ballooning and perisinusoidal changes29 and isolated portal fibrosis seen in morbidly obese subjects 32. Our cohort included well-characterised patients with FLD from which other causes of chronic liver disease and drug-induced fatty liver disease had been excluded; hence, our findings confirm with another recent retrospective series33 that portal inflammation is a common component of histological spectrum of both AFLD and NAFLD.…”

Section: Discussionsupporting

confidence: 87%

Portal inflammation is associated with advanced histological changes in alcoholic and non-alcoholic fatty liver disease

et al. 2010

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Section: Discussionsupporting

confidence: 87%

Portal inflammation is associated with advanced histological changes in alcoholic and non-alcoholic fatty liver disease

et al. 2010

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“…In the eight economically leading nations, liver cirrhosis is the 10th commonest cause of death [1], as highlighted by the substantial increase in liver cirrhosis mortality rates in the UK. In other European countries, including Austria, overall mortality from liver disease has decreased in the past two decades [1] but non-alcoholic steatohepatitis, the liver manifestation of metabolic syndrome, is increasing in prevalence [2]. Patients with cirrhosis are susceptible to a variety of complications and their life expectancy is markedly reduced: depending on the severity of the cirrhosis, 1-year mortality ranges from 10% to 82% [3].…”

Section: Introductionmentioning

confidence: 99%

Störungen des angeborenen Immunsystems bei akuten und chronischen Lebererkrankungen

Leber

Mayrhauser

Rybczynski

et al. 2009

Wien Klin Wochenschr

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Liver cirrhosis is a common disease causing great public-health concern because of the frequent complications requiring hospital care. Acute liver failure is also prone to several complications but is rare. One of the main complications for both acute and chronic liver diseases is infection, which regularly causes decompensation of cirrhosis, possibly leading to organ failure and death. This review focuses on innate immune function in cirrhosis, acute-on-chronic liver failure and acute liver failure. The known defects of Kupffer cells, neutrophils and monocytes are discussed, together with the pathophysiological importance of gut permeability, portal hypertension and intrinsic cellular defects, and the role of endotoxin, albumin, lipoproteins and toll-like receptors. Based on these different pathomechanisms, the available information on therapeutic strategies is presented. Antibiotic and probiotic treatment, nutritional support, artificial liver support, and experimental strategies such as inhibition of toll-like receptors and use of albumin and colony-stimulating factors are highlighted.

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“…[2,6] In the present study, non-alcoholic steatohepatitis (NASH) (31.42%) was the most common cause of CLD with occurrence in 81.8% females, followed by alcoholic liver disease (ALD) (25.71%) seen only in males (100%). [8,9,10] The gender variation indicate that alcohol induced cirrhosis is predominant among males, whereas HCV, autoimmune hepatitis, primary biliary cirrhosis and NASH are predominant among females. [11] It may be due to socioeconomic factors with alcohol abuse being more common in males.…”

Section: Discussionmentioning

confidence: 99%

“…[24,25] This may be useful in assessing prognosis, or comparing biopsies in clinical trials. [8,9,24,25] The cellular oxidative-stress together with endotoxemia, act as catalyst for the progression of steatohepatitis into hepatic necrosis, fibrosis, and cirrhosis. [26] Other histological findings observed were mild to moderate interface hepatitis, portal inflammation, Mallory Denk bodies, hepatocellular and bile ductular cholestasis.…”

Section: Alcoholic Liver Disease (Ald)mentioning

confidence: 99%

“…[26] Other histological findings observed were mild to moderate interface hepatitis, portal inflammation, Mallory Denk bodies, hepatocellular and bile ductular cholestasis. [8,9,25] Portal inflammation is associated with clinical and histologic features of advanced disease. [25] Another notable feature was bile ductular proliferation and this may be due to the repeated occurence of liver injury along with necrotizing and fibrotic changes.…”

Section: Alcoholic Liver Disease (Ald)mentioning

confidence: 99%

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Study of Liver Biopsy in Chronic Liver Diseases

Kulkarni

2018

APALM

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Background: Chronic liver disease (CLD)represents liver disorders of varying causes and severity in which hepatic inflammation and necrosis continue for at least 6 months.The treatment of cause leads to regression of fibrosis and parenchymal recovery. Liver biopsy is often used to establish the diagnosis, assess the severity of disease in CLD and its role is evolving with advances in medical technology. The objective was to study the histopathological pattern of injury in patients with CLD and thereby establish a possible etiologic diagnosis in correlation with clinical, biochemical and serologic findings. Methods: Thirty five cases of CLD with histopathological features of necroinflammation/fibrosis were studied for a period of five years. Along with demographics and laboratory parameters, sections were studied for the pattern and degree of injury.Grading and staging were done using standard systems. Results: Nonalcoholic fatty liver disease (31.42%) and alcoholic liver disease (25.71%) were the most common causes followed by viral hepatitis (11.42%) and drug induced liver injury (8.58%). One case each of autoimmune hepatitis and primary biliary cirrhosis were seen. A definitive diagnosis was not possible in six patients, and only a probable etiology was considered. Conclusion: The natural history of CLD is changing and is important to establish an etiological diagnosis. Despite the advances in diagnostic techniques, liver biopsy remains a valuable tool to establish the etiology and traditional descriptive reports still hold importance for the treatment and prognosis.However, it remains challenging and should be interpreted in the setting of clinical, biochemical, serological and radiological findings.

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Differentiation of nonalcoholic from alcoholic steatohepatitis: are routine laboratory markers useful?

Abstract: Higher MCVs and AST/ALT ratios in ASH reflect the severity of underlying liver disease and do not differentiate NASH from ASH. Instead, these biomarkers might prove useful in guiding selection of patients for liver biopsy and in targeting therapy.

Cited by 16 publications

References 32 publications

Portal inflammation is associated with advanced histological changes in alcoholic and non-alcoholic fatty liver disease

Portal inflammation is associated with advanced histological changes in alcoholic and non-alcoholic fatty liver disease

Störungen des angeborenen Immunsystems bei akuten und chronischen Lebererkrankungen

Study of Liver Biopsy in Chronic Liver Diseases

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