Drugs and steatohepatitis.

摘要: In addition to the usual associations with insulin resistance, type 2 diabetes, central obesity, and hypertriglyceridemia, nonalcoholic steatohepatitis (NASH) has been associated several drugs toxins. However, drug-induced liver disease is a relatively uncommon cause of steatohepatitis. The term preferred when association appears result from direct toxic effect drug on liver. For some agents implicated as causing cirrhosis or fatty disorders, may be coincidental because NASH common component resistance (or metabolic) syndrome. other instances, corticosteroids, tamoxifen, estrogens precipitate in predisposed persons by exacerbating methotrexate worsen hepatic fibrosis NASH. Drug-induced prolonged therapy (more than 6 months) possibly accumulation, which case perhexiline maleate favored genetic polymorphism CYP2D6 that leads slow oxidation. mechanism involve mitochondrial injury, causes steatosis impaired beta-oxidation acids, generation reactive oxygen species ATP depletion. Thus, provide clues injurious events more metabolic forms A clinical feature types progression after discontinuation causative agent. It follows early recognition hepatotoxicity crucial prevent development severer improve outcome.