Alcoholic steatohepatitis (fatty liver disease, fatty liver)

Fat accumulation in the liver that occurs in various situations independent of alcohol consumption, such as obesity, malnutrition, prolonged intravenous nutrition, diabetes mellitus, abnormal blood fats (cholesterol or high triglycerides) and some medications.
Until the 1980s, it was believed that all with liver fat accumulation and signs of inflammation (hepatitis) was caused by alcohol consumption. This kind of change is so common in users of alcohol even though the patient denied consuming alcohol was still considered as if lying
In 1980, Ludwig and colleagues described with the name steatohepatitis nonalcoholic (nonalcoholoic steatohepatitis, NASH) a syndrome of obese and diabetic women who denied the use of alcohol, but had very similar changes in the liver of the alcoholic hepatitis, with enlargement of the liver, changes in laboratory tests and biopsies macrovesículas fat (steatosis hence the name, which comes from fat) in hepatocytes, necrosis (cell death), focal inflammation and lesions called corpuscles Mallory (findings hitherto considered characteristic of alcoholic hepatitis).

Call Nonalcoholic fatty liver disease (NAFLD or NAFLD, the English "nonalcoholic fatty liver disease") fat accumulation in the liver (steatosis) not related to alcohol use. The steatohepatitis non-alcoholic (NAFLD or NASH, the English "nonalcoholic steatohepatitis") is a NAFLD where the presence of steatosis is related to inflammation of the liver (hepatitis). Thus, hepatic steatosis ("fatty liver") and NASH are different presentations of NAFLD, the first of which can progress to the second. Cirrhosis of unknown cause (cryptogenic) where there is steatosis, but no signs of active NASH, NAFLD is also rated.
Treatment
It is recommended dietary restriction and the use of certain medications that help reduce the deposit of these metals.
Symptoms
Hepatic steatosis does not cause symptoms. Usually the diagnosis is made accidentally by imaging studies such as ultrasound or CT scans requested for other reasons.

Some patients with NAFLD complains of fatigue and heaviness in the right upper quadrant of the abdomen. There is no evidence, however, that these symptoms are related to the accumulation of fat in the liver. There are patients with advanced grade steatosis do not exhibit any symptoms.

What differentiates fat accumulation benign hepatic steatosis fat accumulation of harmful steatohepatitis hepatitis is the presence of inflammation in the liver. Both frameworks do not usually cause symptoms. Clinically it is impossible to distinguish them.

Importantly, through imaging also is not always possible to differentiate cases of steatosis, especially in advanced stage of steatohepatitis. The ultrasound, for example, can well be seen fat, but lacks sufficient sensitivity to confirm or rule out the presence of inflammation in the liver.

Imaging studies also fail to distinguish steatohepatitis from other causes of hepatitis. Therefore, a medical history, physical examination and laboratory tests are essential for patient assessment. A good medical evaluation can identify the cause of liver damage.

Laboratory tests used to assess the degree of liver injury by so called liver enzymes and other markers of liver disease, such as gamma. In hepatic steatosis, liver enzymes are normal, while in steatohepatitis no increase thereof.