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STEATOSIS (FATTY LIVER) |
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genetic and/or metabolic: |
diabetes mellitus1 obesity1 dysbetalipoproteinemia1 lipodystrophy1 cholesterol ester storage disease3 Weber-Christian disease1 Wolman’s disease3 pregnancy2 (acute fatty liver of
pregnancy) |
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nutritional: |
starvation1 protein-calorie malnutrition1 total parenteral nutrition1 rapid weight loss1 bowel bypass surgery1 (done for morbid obesity) |
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chronic illness: |
inflammatory bowel disease1 HIV/AIDS1 small bowel bacterial overgrowth1 |
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drugs: |
Reye’s syndrome (aspirin2) steroids1 amiodarone3 methotrexate1 synthetic oestrogens1 tamoxifen1 tetracycline2 antivirals2 (didanosine, zidovudine, etc) ?calcium-channel blockers1 ?sodium valproate2 other drugs |
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toxins: |
alcohol1 cocaine2 phosphorus2 petrochemicals1,2 organic solvents certain poisonous mushrooms1 Bacillus
cereus toxin2 (food poisoning) |
(1) these cause predominantly a macrovesicular steatosis (due to imbalance in hepatic synthesis and export of lipids)
(2) these cause predominantly microvesicular steatosis (due to defects in mitochondrial function)
(3) these cause hepatic phospholipidosis (accumulation of phospholipids in lysosomes)
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