RESUMO
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Assuntos
Humanos , Masculino , Feminino , Colestase/complicações , Colestase/patologia , Colestase , Abdome/patologia , Abdome , Síndrome de Mirizzi , Coledocolitíase/patologia , Coledocolitíase , Colangite Esclerosante/complicações , Colangite Esclerosante , Ductos Biliares Intra-Hepáticos/patologia , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/patologia , Colangiocarcinoma , AdenocarcinomaRESUMO
BACKGROUND: The progressive character of the hepatic lesions in nonalcoholic steatohepatitis (NASH) has not been well established. In the present study, the clinical and histological course of this condition was evaluated at medium term. METHODS: Then patients (6 females and 4 males) with NASH, in a non-cirrhotic stage at the time of diagnosis, were followed up during 58 +/- 7 months (range 24 to 88 months). RESULTS: Nine patients were obese, but a significant reduction of body weight was found at the end of the study (p = 0.0072). Other clinical, physical or laboratory changes were not found, although in two cases hepatic biochemical tests were within normal limits when the follow-up biopsy was performed. Changes in the characteristic hepatic features were also absent, although fat infiltrates disappeared in three cases. Six patients had increased fibrosis and a progression of the hepatic architectural distortion; four reached the stage of cirrhosis. The evolution of the hepatic lesion correlated with the interval between diagnostic and follow-up biopsies (r = 0.69; p less than 0.05) and with the reduction in body weight (r = 0.64; p less than 0.05). CONCLUSIONS: In most cases, NASH results in a progressive hepatic distortion with can end in cirrhosis, although the change is slow and silent.
