Rapidly advancing knowledge in the field of liver disease has led to accurate diagnosis of and effective therapy for many diseases that once caused considerable morbidity and death. The awareness of an increasing number of treatable forms of chronic liver disease over the past two decades has spawned a more rigorous approach to evaluating patients presenting with elevated serum liver enzymes or hepatomegaly. (See also the article by Moseley.) Clinical syndromes such as chronic active hepatitis, which once accounted for large numbers of patients with chronic liver injury, have now been better defined by the identification of specific causes, such as hepatitis C viral infection and autoimmune hepatitis. It is perhaps because of the currently rigorous diagnostic approach to patients with chronic liver disease, coupled with the ability to categorize diseases more precisely, that newer syndromes with characteristic features have become definable. One such syndrome is nonalcoholic steatohepatitis (NASH).

The diagnosis of NASH is based on liver biopsy findings, which are much like those seen in alcoholic hepatitis, including the presence of steatosis, mixed inflammatory cell infiltration of the lobules, Mallory's hyalin, and perisinusoidal fibrosis or cirrhosis.<sup>57 Ludwig J., Viggiano T.R., McGill D.B. , et al. Nonalcoholic steatohepatitis Mayo Clin Proc 1980 ;  55 : 434

Cliquez ici pour aller à la section Références</sup> Because NASH can cause life-threatening liver disease, it is a syndrome that should be included as a diagnostic possibility in patients without other identifiable causes of liver enzyme abnormalities or chronic liver disease. The clinical characteristics of NASH, the known risk factors for developing NASH, its natural history and pathogenesis, and current treatment recommendations are discussed in this article.