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Nonalcoholic steatohepatitis masquerading as autoimmune hepatitis
K Tajiri1, H Takenawa, K Yamaoka
1Second Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Journal of Clinical Gastroenterology
|December 31, 1997
Summary
Nonalcoholic steatohepatitis (NASH) can mimic autoimmune hepatitis in Japanese women. These cases highlight diverse NASH pathogenesis, emphasizing the need for careful differential diagnosis.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Nonalcoholic steatohepatitis (NASH) is a growing clinical concern.
- Differentiating NASH from other liver diseases is crucial for effective management.
Observation:
- Two middle-aged Japanese women presented with clinical and laboratory findings suggestive of autoimmune hepatitis.
- Histological examination revealed definitive steatohepatitis with significant fibrosis in both patients.
Findings:
- Both patients shared specific Human Leukocyte Antigen (HLA) haplotypes (DR4 and DR2).
- These HLA types are commonly associated with autoimmune hepatitis in Japanese populations.
- Histologic findings confirmed steatohepatitis, not autoimmune hepatitis.
Implications:
- These cases underscore the potential for NASH to present atypically, mimicking autoimmune liver disease.
- The shared HLA-DR haplotypes suggest a complex interplay of genetic and environmental factors in NASH pathogenesis.
- Recognizing this diagnostic challenge is vital for accurate patient diagnosis and treatment strategies.