Tashfeen Adam, Noor Khan Lakhnana.
Non Alcoholic Steatohepatitis - A study of forty eight cases.
J Pak Inst Med Sci Jan ;15(1):849-82.

Non-Alcoholic Steatohepatitis is increasingly being recognized as an important cause of deranged liver function tests and abnormal liver histology. A total of 48 patients with NASH were enroled in the study .The diagnosis was based on blood biochemistry, ultrasound imaging, liver histology, absent history of alcohol use/abuse and a negative liver screen (Hepatitis B, C serological markes, Ferritin , Caeruloplasmin,a 1 antitrypsin, ANF, Anti-Smooth Muscle and Anti-Mitochondrial Antibodies). In our series, 58% of NASH patients were female. The vast majority (> 90%) were obese. The average ALT & AST levels were 87 and 71 u/l, respectively. Bilirubin and Serum Albumin were normal in all patients. 63% of patients had diabetes. Fasting lipid profile showed hypercholesterolaemia in 79% and raised triglycerides in 88%. All the ultrasounds confirmed "fatty liver", white liver histology showed changes consistent with NASH in all biopsies. It was observed that in our cases, the epidemiologc features and association with diabetes obesity, female sex and dyslipidaemia are similar to cases described in the western literature. Long term follow -up studies are required to assess its association with hepatocellular carcinoma (HCC) and liver failure, and to plan treatment strategies.

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