All of the following are features of non-alcoholic steatohepatitis except: September 2005

Ans. C: Histological features are different from alcoholic steatohepatitis Non-alcoholic fatty liver disease includes simple hepatic steatosis, steatosis accompanied by minor, non-specific inflammation, and non-alcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis or NASH is a common, often "silent" liver disease. NASH is usually first suspected in a person who is found to have elevations in liver tests that are included in routine blood test panels, such as alanine aminotransferase (ALT) or aspaate aminotransferase (AST). When fuher evaluation shows no apparent reason for liver disease (such as medications, viral hepatitis, or excessive use of alcohol) and when x-rays or imaging studies of the liver show fat, NASH is suspected. The only means of proving a diagnosis of NASH and separating it from simple fatty liver is a liver biopsy. NASH is diagnosed when examination of the tissue with a microscope shows fat along with inflammation and damage to liver cells. If the tissue shows fat without inflammation and damage, simple fatty liver or NAFLD is diagnosed. NASH is characterized by steatosis and multifocal parenchymal inflammation, mainly neutrophils, Mallory bodies, hepatocyte death (both ballooning degeneration and apoptosis), and sinusoidal fibrosis. Fibrosis also occurs within poal tracts and around terminal hepatic venules. These histological features are similar to those of alcoholic steatohepatitis.