Non-alcoholic fatty liver disease and the statins treatment.

Even if the fatty liver is an entity recognized long time ago, only recently the non-alcoholic liver disease (NAFLD) came in attention. The fact that NAFLD might progress from simple steatosis to steatohepatitis and cirrhosis showed that NAFLD is not always a benign disorder. NAFLD has many etiological factors, but the majority of cases are those in the context of metabolic syndrome, known as primary NAFLD. Statins are well known as 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitors, but this class has also pleiotropic actions non-related with HMG-CoA inhibition. Particularly, the possible anti-inflammatory and anti-fibrinogenesis qualities make statins an option in NAFLD. So, regarding the statins treatment in NAFLD, there are two aspects that are important. First of all, if statins (that are essential in the therapy for the improvement of cardiovascular risk) are safe at patients with NAFLD, given their adverse effect of increasing hepatic transaminases. Secondly, considering the strong associations between NAFLD and metabolic syndrome components, like obesity and insulin resistance, if statins could be a therapeutic option for the patients with NAFLD in the absence of dyslipidemia.

[False surgical acute abdomen with intermittent acute porphyria]. / Fals abdomen acut chirurgical în cadrul unei porfirii acute intermitente.

This article presents a case of acute intermittent porphyria admitted to the Surgery Department of C.F. Craiova Hospital between 18.08.2003-26.08.2003 then transferred to the Colentina Hospital in Bucharest for diagnosis confirmation and adequate treatment. The purpose of this paper is to bring attention on a rare metabolic inherited disease that, due to its non-specific and often noisy symptoms and limited possibilities of biochemical, enzymatic and genetic diagnosis, could generate potential serious confusions. The presentes case illustrates the fact that sometimes the acute attack may be mistaken for an acute surgical affection which requires an emergency operation with all the aggravating consequences and delay in the real diagnosis. About 1% of acute attacks of porphyria may be fatal. Only the drugs known as safe should be prescribed. Basic treatment consists in oral and intravenous glucose and hematin administration.