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Editor’s quiz: GI snapshot
Diet-refractory NASH in an elderly woman
  1. Paul Manka1,
  2. Hideo A Baba2,
  3. Heiner Wedemeyer1,3,
  4. Alisan Kahraman1
  1. 1 Department for Gastroenterology and Hepatology, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
  2. 2 Institute of Pathology and Neuropathology, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
  3. 3 Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Niedersachsen, Germany
  1. Correspondence to Dr Paul Manka, Department for Gastroenterology and Hepatology, University Hospital Essen, Essen 45122, Germany; paul.manka{at}uk-essen.de

https://doi.org/10.1136/gutjnl-2020-320740

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    Clinical presentation

    Here we report a case of a 68-year-old woman who presented to our centre for further evaluation of elevated liver function tests (LFTs). She reported a 20-year history of elevated liver enzymes. She had known dyslipidaemia (low-density lipoproteincholesterol of 232 mg/dL) and was treated with atorvastatin and ezetimibe. Diabetes and cardiovascular events were not reported. Family history was suspected as a factor as her father died due to heart attack and also had a history of elevated LFTs; her brother died due to cryptic cirrhosis. The patient underwent multiple liver biopsies in several liver centres (1996, 1999, 2003 and 2008). Histology results similarly demonstrated microvesicular fatty liver with minimal fibrosis. In line with the patient’s metabolic profile, her case was treated as non-alcoholic steatohepatitis (NASH)-related although histological …

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    Footnotes

    • Presented at The results of this study have been published as a poster presentation at the Annual Meeting 2020 of the German Association of the Study of the liver: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0039-3402157.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.