Non-alcoholic steatohepatitis NASH

• Facts:
  Impaired resistance of fat cells to insulin
  Causes accumulation of fat (steatosis) in the liver
  Progresses to steatohepatitis and fibrosis
  
• History / PE:
  Hepatomegaly
  
• Diagnosis:
  Mild elevation of aminotransferases and alk phos
  Percutaneous liver biopsy (hepatic fibrosis)
  
• Treatment:
  Control comorbid conditions
  Ursodeoxycholic acid (mild help)
• Differential Diagnosis:
  Alcoholic hepatitis (drinker)
• Risk Factors:
  Obesity, DM, hyperlipidemia
  Total parenteral nutrition
  Meds (eg. steroids, amiodarone , diltiazem, tamoxifen , HAART)
  Endocrinopathies (eg. Cushing's)