title: Histological Remission during Corticosteroid Therapy of Overlapping Nonalcoholic Steatohepatitis and Autoimmune Hepatitis: Case Report and Literature Review.
abstract: Concurrence of nonalcoholic steatohepatitis (NASH) with autoimmune hepatitis (AIH) is a rare condition that is challenging to diagnosis, due to the relatively high prevalence of autoantibodies in NASH. It is also difficult to determine the most effective treatment as corticosteroids are likely to worsen NASH despite being effective in the treatment of AIH. In this case report, we present a female diagnosed with NASH-AIH overlap with accompanying diabetes mellitus, who successfully achieved normalization of serum alanine aminotransferase levels following prednisolone therapy and weight loss. A follow-up liver biopsy performed 40 months after the initial diagnosis showed only minimal inflammatory infiltrates in the portal area without any NASH histology. Resolution of NASH, in conjunction with a reduction in hepatic fibrosis, might suggest that prednisolone itself does not aggravate steatohepatitis, but rather prevents disease progression. Appropriate immunosuppressive treatment may therefore be an important component of the optimum therapy for NASH-AIH overlap.
authors: Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan.
authors: Shinichiroh
authors: S
authors: Fukuda
authors: Atsumasa
authors: A
authors: Komori
authors: Masahiro
authors: M
authors: Itoh
authors: Yumi
authors: Y
authors: Mihara
authors: Satoru
authors: S
authors: Hashimoto
authors: Sung Kwan
authors: SK
authors: Bae
authors: Shinya
authors: S
authors: Nagaoka
authors: Seigo
authors: S
authors: Abiru
authors: Hiroshi
authors: H
authors: Yatsuhashi
authors: Hiromi
authors: H
authors: Ishibashi