Objective: Be familiar with NASH - Recognize and manage a patient with NASH (Non alcoholic steato-hepatitis)

The typical patient is over 40 and has diabetes, obesity and elevated ALT.

Certainly, one would already have ruled out other causes of hepatitis like the viral etiologies, SLE, auto-immune hepatitis, drug induced hepatitis, alcoholic hepatitis etc.

60% of such patients will have NASH.

Weight loss must be encouraged. In 3-6 months recheck ALT. If still elevated, proceed to biopsy. Necrosis of parenchyma may be obvious.