ORIGINAL ARTICLE

Non-alcoholic steatohepatitis: a common cause of progressive chronic liver injury?

C D J Evans¹, K A Oien², R N M MacSween² and P R Mills¹

¹ Department of Gastroenterology, Western Infirmary, Glasgow G11 6NT, UK
² Department of Pathology, Western Infirmary

Correspondence to:
Correspondence to:
Dr P Mills, Floor 8, Gartnavel General Hospital, Glasgow G12 0YN, UK;
p.r.mills{at}clinmed.gla.ac.uk

Aim: To investigate the natural history of patients with non-alcoholic steatohepatitis by means of a prospective histological study.

Methods: One thousand five hundred and seventy one patients underwent liver biopsy at the Western Infirmary in Glasgow during the 10 year period 1985 to 1994. All biopsies were reported by a single pathologist: 62 were confirmed as having non-alcoholic steatohepatitis and prospective follow up was conducted in 1999. Repeat liver biopsy was carried out where appropriate to assess disease progression.

Results: Initial biopsy scores for the 62 patients (20 men; mean age at biopsy, 52 years) showed a mean of 1.85, 1.39, and 0.5 for necroinflammation, fibrosis, and iron stores, respectively. Forty six were traceable and invited for review, and 26 attended (six men; mean age at initial biopsy, 49.9 years) at a mean of 8.7 years after the initial liver biopsy. No patients had symptoms or signs of chronic liver disease. Four patients had normal liver function tests, one had cirrhosis; the remaining 21 were invited to have a repeat biopsy. Seven patients agreed, a mean 8.2 years after the initial biopsy, and repeat biopsy scores showed no significant difference over this time period, with mean scores of 1.71 (initial score, 2.14), 1.43 (initial score, 0.71), and 0.14 (initial score, 0) for necroinflammation, fibrosis, and iron stores, respectively.

Conclusion: In this series of patients with non-alcoholic steatohepatitis, with a mean clinical follow up of 8.7 years, and a histological follow up of 8.2 years, there was no evidence of progressive chronic liver injury.

Keywords: non-alcoholic steatohepatitis; natural history; liver biopsy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Lall, C. G., Aisen, A. M., Bansal, N., Sandrasegaran, K. (2008). Nonalcoholic Fatty Liver Disease. Am. J. Roentgenol. 190: 993-1002 [Abstract] [Full Text]