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Liver & GIT

3 out of 5

Which is not a cause of NASH?(PNQ)


C Gall stone
D Hepatitis C

Ans. C Gall stone

M/C cause of cryptogenic cirrhosis is NASH (Ref; Harrison, 18thpg- 2605)

Causes of NASH

1. Obesity

2. DM

3. TPN,

4. Drug (Steroid, tamoxifen, Estrogen

5. Wilson disease, genotype – 3

6. Hepatitis C

Extra Edge: Gall stone not a cause of NASH.

Liver function tests

i. AST, ALT raised, not more than 2 times of normal. (ALT > AST)

ii. Elevated alkaline phosphatase levels are seen in about 30% of case.

iii. It is important to differentiate simple fatty liver disease (NAFL), which does not require follow-up, from NASH.

iv. Elevated serum transaminases greater than twice the upper limit of normal and the presence of the metabolic syndrome (hypertriglyceridemia, hypertension, diabetes mellitus, an elevated BMI> 25 and especially truncal obesity are useful predictors of NASH.

Liver biopsy

Histologically, fat deposition is usually macrovesicular fat seen in acute fatty, Mallory bodies, neutrophil infiltration and pericellular fibrosis.