A case of non-alcoholic steatohepatitis due to malnutrition.

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  • YAMAGUCHI Kai
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • OKUSE Chiaki
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • SUZUKI Yoshihiro
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • KOBAYASHI Yutaro
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • OSADA Tatsuro
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • TOMOE Masai
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • TOYAMA Hiroki
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • HAYASHI Takeshi
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • YOSHIDA Hideki
    The Second Department of Internal Medicine, St. Marianna University School of Medicine
  • TAKAHASHI Yasuhito
    The Second Department of Pathology, St. Marianna University School of Medicine
  • MAEYAMA Shiro
    The Second Department of Pathology, St. Marianna University School of Medicine
  • UCHIKOSHI Toshiyuki
    The Second Department of Pathology, St. Marianna University School of Medicine
  • IINO Shiro
    The Institute of Medical Science, St. Marianna University School of Medicine

Bibliographic Information

Other Title
  • 栄養障害が原因と思われたｎｏｎ‐ａｌｃｏｈｏｌｉｃ　ｓｔｅａｔｏｈｅｐａｔｉｔｉｓの１例

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症例は23歳, 女性. 飲酒歴, 輸血歴および鍼灸治療歴はない. 常用薬剤なし. 感冒様症状に伴う食欲不振, 腹部不快感および2週間で約4kgの体重減少を主訴に近医を受診した. 生化学検査でtransaminaseの上昇を認め急性肝炎が疑われ当科紹介, 入院となった. 入院時現症では標準体重の-32%のるいそうを認め, 入院時検査所見では総蛋白, コリンエステラーゼの低下及びtransaminaseの上昇が認められた. しかし肝炎ウイルスマーカーはすべて陰性で, 抗核抗体および抗ミトコンドリア抗体も検出されず免疫グロブリンはいずれも正常ないし軽度低下を呈した. 腹部超音波およびCTでは著明な脂肪肝を認めた. 肝生検像では肝実質にacuteyellow collapsed cellを含む巣状壊死を散見し, 大脂肪滴沈着をzone 2～3に小葉の1/2以上に認め飲酒歴がないことからnon-alcoholic steatohepatitisと診断した. 本例は肥満, 耐糖能異常を伴わず, 薬剤服用歴もなく経過より急激な栄養障害による飢餓状態が原因と考えられた

Journal

  • Kanzo

    Kanzo 39 (1), 18-22, 1998

    The Japan Society of Hepatology

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