Regression of steatohepatitis-related cirrhosis

The authors document regression of cirrhosis in an obese 56-year-old man after significant weight loss by sequential liver biopsies. The patient had a known history of steatohepatitis. His initial laboratory workup 6 years earlier revealed elevated liver enzyme activities and blood triglyceride levels, and negative viral hepatitis serology screen. A liver biopsy at that time showed histological features consistent with precirrhotic stage of active steatohepatitis. A liver biopsy performed 4 years later revealed progression of the disease to cirrhosis. Following this diagnosis he went on a special strict diet and lost 49 kg. His body mass index decreased from 46 to 28 during a 2-year period and his liver enzyme activities returned to normal. A liver biopsy at this time demonstrated significant regression of the liver fibrosis and disappearance of the steatosis and necroinflammation. In conclusion, massive weight loss resulted in resolution of liver fibrosis in this obese patient with steatohepatitis-related cirrhosis.