Re: NASH/AIH combo

Posted By shelby on May 25, 1999 at 16:12:54
I have a very general question.  Can you have a combination of Autoimmune Hepatitis and NASH?  If so, can you tell by the biopsy.  My biopsy said cirrhosis with moderate active inflammation and mild fatty changes.  I also have a positive ANA.
Can NASH alone cause cirrhosis?  All other hepatitis tests were negative like A,B,C etc.  The ANA test by the way is the only autoimmune test that was off according to the doctors. ANA 1:320.
I don't drink or smoke.
Thanks for any information in advance.
Shelby
Do you consider NASH a serious disorder?

[HFHSM.D.-D.M.]

Posted By HFHSM.D.-D.M. on May 28, 1999 at 15:49:02

Dear shelby:
I was intrigued by your questions.  It sounds like you have an interesting set of clinical and biopsy findings.  let me try to make a few helpful comments.
NASH does not typically cause cirrhosis but it can cause cirrhosis.  We do consider it a serious condition and we try to get our patients with NASH to lower their cholesterol, control their diabetes and lose weight to the degree that those things are appropriate.  
However, you do have a positive ANA and the possibility of autoimmune hepatitis has to be considered.  This condition is somewhat more likely to cause cirrhosis.  
The critical thing is that there should be more information available from the biopsy than you are giving me.  The two conditions have different appearances and different sort of inflammation.  I would like to think the biopsy can give you a little more direction than you currently have.  You might ask that the biopsy slides be read by individuals with a lot of experience with liver disease (either pathologists or hepatologists).
The distinction between NASH and autoimmune hepatitis is critical because autoimmune hepatitis is often treated with steroids which can typically make NASH worse.  It sounds like you have cirrhosis, which means your liver disease is serious and sorting out the cause will be important.  
I hope this information is helpful to you. Again feel free to let us know of additional questions or information.  You can always contact us directly at Henry Ford at [phone].  If you are in the Detroit area, we would always welcome to come see us.  We have a very active group of liver specialists and see many patients with autoimmune hepatitis.  We also have a very active liver transplant program.  
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  











Follow Ups:


NASH/AIH combo sherrie 6/18/1999
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Re: NASH/AIH combo HFHSM.D.-D.M. 7/11/1999
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