Acute steatohepatitis, due to extreme metabolic dysregulation, as the first presentation of non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD) is a slowly progressive chronic disease, with a high prevalence among obese, dyslipidemic or diabetic people, commonly presented as an asymptomatic mild elevation of serum aminotransferases. We report a patient who experienced an acute form of non-alcoholic steatohepatitis, as the first manifestation of NAFLD, due to exacerbation of pre-existing metabolic disorders by an extremely unhealthy lifestyle. A 50-year old, obese, diabetic man presented with a one-week history of jaundice and malaise. Analysis revealed elevated liver enzymes, bilirubin, lipids, and glucose. Based on patient's history, physical examination, laboratory results, and imaging findings, acute non-alcoholic steatohepatitis was established as a diagnosis of exclusion. The patient was started on a low-calorie diet free of carbohydrates and fats, in combination with insulin. A dramatic improvement of clinical and laboratory parameters was observed. In the context of extreme metabolic dysregulation, induced by unhealthy diet, NAFLD may present as an acute steatohepatitis.
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Georgios
G
Kranidiotis
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Angeliki
A
Angelidi
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Emmanouel
E
Sevdalis
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Thomas-Nikolaos
TN
Telios
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Alexandra
A
Gougoutsi
1st Department of Internal Medicine, "Tzaneion" General Hospital , Piraeus, Greece.
Andreas
A
Melidonis
diabetes mellitus; non-alcoholic fatty liver disease; nonalcoholic steatohepatitis; obesity