Diabetic hepatosclerosis: A novel entity or a rare form of nonalcoholic fatty liver disease?

✍ Scribed by Michael Mendoza; Zobair Younossi

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 61 KB
• Volume: 44
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.21349

✦ Synopsis

Objective: This study sought to characterize a noncirrhotic form of hepatic sinusoidal fibrosis in patients with long-standing diabetes mellitus (DM) who underwent liver biopsy. The authors suggest that diabetic hepatosclerosis is distinct from other hepatic manifestations of DM. Methods: Clinical records, detailed light microscopy results, and immunohistochemical preparations of twelve diabetic patients presenting with characteristic histologic findings were reviewed. Liver biopsy slides were evaluated for the degree of perisinusoidal, perivenular, and portal fibrosis, along with other histologic findings. When available, unstained biopsy sections were used for additional immunohistochemical analyses. Medical records were examined for relevant clinical data. Patients were chosen from Saint Louis University School of Medicine and the Armed Forces Institute of Pathology. Results: All patients presented with a long-standing history of DM and most had evidence of microvascular complications resulting in end-organ damage. Alkaline phosphatase elevation was common. Immunohistochemical staining of liver biopsies showed basement membrane components in a perisinusoidal distribution. Hematoxylin-eosin and trichrome staining of the biopsies revealed dense perisinusoidal fibrosis while lacking other features commonly seen in non-alcoholic steatohepatitis (NASH). Conclusions: These findings suggest a form of diabetic microangiopathy affecting the liver, described as diabetic hepatosclerosis. Further investigation must be done to understand the pathogenesis and clinical significance of this novel entity.