alexa Case of Nonalcoholic Steatohepatitis Occurring in Combination with Sleep Apnea Syndrome, Who Showed Improvement of Liver Function by Continuous Positive Airway Pressure | Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Case of Nonalcoholic Steatohepatitis Occurring in Combination with Sleep Apnea Syndrome, Who Showed Improvement of Liver Function by Continuous Positive Airway Pressure

Shigefuku R1#, Takahashi H1,4*#, Ikeda H1, Matsunaga K1, Koike J2, Maeyama S3, Matsumoto N1, Okuse C1, Itoh F1 and Suzuki M1
1Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, 2-16-1, Sugao, Miyamae, Kawasaki 216-8511, Japan
2Department of Pathology, St. Marianna University, School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki 216-8511, Japan
3Shiodome Medical Examination Clinic, 1-17-10, Hamamatsu-cho, Minato, Tokyo 105-0013, Japan
4Sapporo Shorakabadai Hospital, 18-7-26, Tsukisamu-Higashi Nijou, Toyohira, Sapporo 062-0052, Japan
#Equally contributed to this work
Corresponding Author : Hideaki Takahashi
Department of Internal Medicine
Division of Gastroenterology and Hepatology
St. Marianna University, 2-16-1
Sugao, Miyamae, Kawasaki 216-8511, Japan
Tel: +81-44-977-8111
Fax: +81- 44-976-5805
E-mail: [email protected]
Received May 10, 2013; Accepted October 22, 2013; Published October 24, 2013
Citation: Shigefuku R, Takahashi H, Ikeda H, Matsunaga K, Koike J, et al. (2013) Case of Nonalcoholic Steatohepatitis Occurring in Combination with Sleep Apnea Syndrome, Who Showed Improvement of Liver Function by Continuous Positive Airway Pressure. J Clin Case Rep 3:307. doi:10.4172/2165-7920.1000307
Copyright: © 2013 Shigefuku R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We present a case of Nonalcoholic Steatohepatitis (NASH) occurring in combination with sleep apnea syndrome (SAS) in a 35-year-old man whose liver function improved on introduction of continuous positive airway pressure (CPAP). The patient had been steadily gaining body weight since the age of 20, and liver dysfunction had been frequently highlighted during regular health checks. He had a history of snoring, nasal obstruction, and lethargy and was admitted to our hospital for evaluation and diagnosis of these symptoms. Following Polysomnography (PSG), he was diagnosed with SAS on the basis of an apnea and hypopnea index (AHI) score of 34.7/hour. Following CPAP treatment, his symptoms gradually improved and his AHI score reduced to 3.8/hour. However, despite CPAP contributed to the improvement of Alanine Aminotransferase (ALT) and aspartate aminotransferase (AST) these levels remained elevated, and he showed sustained liver dysfunction. Therefore, we were consulted for evaluation and diagnosis of the sustained liver dysfunction. On admission, his body mass index (BMI) was 34.5 kg/m2 and abdominal Ultrasonography (US) and Computed Tomography (CT) indicated the presence of severe fatty liver. A liver biopsy was performed and the patient was diagnosed with NASH, grade 1/stage 2 and steatosis grade 3.

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