Nonalcoholic steatohepatitis: epidemiologic and pathologic study of 9 cases

Non alcohol steatohepatitis is an acquired chronic hepatopathy frequently of metabolic origin. Histopathologically, it is characterised by a steatosis associated with necrotic inflammatory lesions mimicking alcohol hepatitis. This disease is complicated by cirrhosis in 15 at 30% of cases and by hepatocellular carcinoma in 13% of cases. The aim of our study was to evaluate the clinico-epidemiological features of this disease and the histopathological degree of hepatic failure. 9 cases of non alcohol steatohepatitis are diagnosed in our hospital in 3 years between 2001 to 2004. The clinical features of patients were determined. The aspect and extent of steatosis was noted and the degree of the necrotical activity was evaluated by the Lee score. We observed strong women prevalence with a sex-ratio of 0.125 and a high frequency between 40 and 60 years. Obesity and diabetes are the most common metabolic disorders encountered in our series. In opposition to published cases, a hepatomegaly and signs of portal hypertension are the most frequent clinical lesions noted in our study. Histopathological evaluation of Lee score finds a mild to moderate activity and fibrosis in nearly all our cases. One case of cirrhosis is noted.