Comment:
Fatty liver disease can be caused by many different autosomal recessive diseases. One includes Wilson’s disease, a condition which leads to abnormal copper accumulation in multiple organs. Cirrhosis is common in up to 30% of cases, as well as steatosis and steatohepatitis. Cystic fibrosis is another example, where steatosis is common and liver disease occurs in 0.1-3.6% of patients. Furthermore, alpha-1-antitrypsin deficiency and lysosomal acid lipase deficiency have been linked to steatosis accumulation, although have little research into their pathogenesis. Drug-induced steatosis/steatohepatitis can also occur, and this study discusses this in the context of amiodarone, methotrexate and tamoxifen. Furthermore, the hepatitis C virus shows cirrhosis in 20% of its cases, although in this case, steatosis is usually mild. Finally, celiac disease can also relate to steatosis/steatohepatitis, thought to be due to the alterations in gut permeability and the gut-liver axis.
This review by Allende DS & Kleiner DE aimed to summarise the alternative, less common possible aetiologies of fatty liver disease.
Key learnings
Steatosis and steatohepatitis are very common liver injuries, seen in many different conditions with many different causes. Clinicians should therefore be careful in terms of diagnosis and management NAFLD, as different conditions can, in a sense, mimic this condition.
