The aetiology of chronic clinical or biochemical hepatic dysfunction in a group of adult Sri Lankans: experience in a tertiary referral centre

Abstract

OBJECTIVES: To evaluate the histological outcome and clinical implications of such a finding in a group of adults who were admitted for investigation of either clinical or biochemical hepatic dysfunction lasting over 3 months. DESIGN AND SETTING: 100 consecutive liver biopsies performed from 15.2.2002 to 30.9.2004 in patients with abnormal hepatic function for at least three months prior to biopsy were reviewed. The clinicopathological features of patients who showed histological evidence of chronic liver disease were analysed retrospectively by examining their case notes. RESULTS: The age range was 15 - 80 years. Male to Female ratio 2.5:1. The peek incidence (37%) of chronic liver damage was seen in 40-49 year group, while 57% was within 50-59 year group. Histology showed cirrhosis, non-alcoholic steatohepatitis (NASH), steatosis, hepatoma, and chronic active hepatitis in 54%, 14%, 8%, 5%, and 4% respectively. There was a high male preponderance for NASH (M: F=8: l) and cirrhosis (M: F=6: l). 57% of cirrhotics were alcoholics. Hepatitis C serology was negative in all, and only one was positive for hepatitis B serology. 33% of patients with NASH had Diabetes mellitus and another 33% of patients with NASH had dyslipidaemias. Diet, social class and obesity were not associated with NASH. CONCLUSIONS: NASH and hepatic steatosis are emerging as significant causes for chronic hepatic dysfunction. The aetiology of non-alcoholic cirrhosis merit in depth study.