Steatohepatitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Steatohepatitis
Micrograph of steatohepatitis.
Synonyms	Fatty liver hepatitis
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, abdominal pain, jaundice
Complications	Cirrhosis, liver cancer, liver failure
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Alcoholic liver disease, non-alcoholic fatty liver disease
Risks	Obesity, type 2 diabetes, hyperlipidemia, metabolic syndrome
Diagnosis	Liver biopsy, blood tests, imaging studies
Differential diagnosis	Viral hepatitis, autoimmune hepatitis, hemochromatosis
Prevention	N/A
Treatment	Lifestyle changes, weight loss, medications
Medication	Vitamin E, pioglitazone, metformin
Prognosis	Variable, depends on severity and treatment
Frequency	Common, especially in individuals with risk factors
Deaths	N/A

Steatohepatitis is a type of liver disease characterized by inflammation of the liver with concurrent accumulation of fat in the liver cells, a condition known as steatosis. It is a progressive form of non-alcoholic fatty liver disease (NAFLD) and can lead to more severe liver damage, including cirrhosis and liver cancer.

Pathophysiology

Steatohepatitis occurs when there is an excessive accumulation of fat in the liver, leading to inflammation and damage to liver cells. The exact mechanism is not fully understood, but it is believed to involve a "two-hit" hypothesis. The first "hit" is the accumulation of fat in the liver, and the second "hit" involves oxidative stress, mitochondrial dysfunction, and inflammatory cytokines that lead to liver cell injury and fibrosis.

Causes

Steatohepatitis can be caused by a variety of factors, including:

• Obesity
• Type 2 diabetes
• Metabolic syndrome
• Hyperlipidemia
• Alcohol consumption (in the case of alcoholic steatohepatitis)
• Certain medications and toxins

Symptoms

Many individuals with steatohepatitis are asymptomatic, especially in the early stages. When symptoms do occur, they may include:

• Fatigue
• Abdominal pain, particularly in the upper right quadrant
• Hepatomegaly (enlarged liver)
• Jaundice (in advanced cases)

Diagnosis

The diagnosis of steatohepatitis is typically made through a combination of:

• Blood tests showing elevated liver enzymes
• Imaging studies such as ultrasound, CT scan, or MRI
• Liver biopsy to confirm inflammation and fat accumulation

Treatment

Treatment of steatohepatitis focuses on addressing the underlying causes and may include:

• Lifestyle modifications such as weight loss and exercise
• Control of blood sugar and lipid levels
• Avoidance of alcohol
• Medications to reduce liver inflammation and fibrosis

Prognosis

The prognosis of steatohepatitis varies depending on the severity of the disease and the presence of other risk factors. Early intervention and lifestyle changes can significantly improve outcomes and prevent progression to cirrhosis or liver cancer.

See also

• Non-alcoholic fatty liver disease
• Cirrhosis
• Liver cancer
• Hepatitis