NONALCOHOLIC STEATOHEPATITIS - CLINICOPATHOLOGICAL COMPARISON WITH ALCOHOLIC HEPATITIS IN AMBULATORY AND HOSPITALIZED-PATIENTS

This study reports a clinicopathological analysis of 105 patients whos e liver histology showed a pattern of alcohol-like steatohepatitis. Th ere were 32 nonalcoholic, 21 asymptomatic ambulatory, and 52 hospitali zed alcoholic hepatitis patients. Female sex, obesity, and diabetes pr edominated in nonalcoholics, Clinical and laboratory presentation were similar in nonalcoholics and ambulatory alcoholics, but different fro m the hospitalized alcoholics. Histology showed an increasing degree o f severity of hepatocellular damage, Mallory bodies, neutrophil and mo nonuclear infiltration, and pericellular and portal fibrosis from the nonalcoholics to the hospitalized alcoholics, with ambulatory alcoholi cs displaying an intermediate degree of severity. Steatosis and glycog enated nuclei were prevalent in the obese, diabetic nonalcoholics, of whom 47% had significant fibrosis and 8% cirrhosis, the latter present in 38% and 89% of ambulatory and hospitalized alcoholic hepatitis (P = 0.0001), respectively, In asymptomatic subjects with suspected liver disease, a liver biopsy is the only way of establishing the type and severity of liver lesions.