Diabetic hepatosclerosis: another diabetes microvascular complication?

Diabetic Medicine : a Journal of the British Diabetic Association
R J KingH J Bodansky

Abstract

Liver disease in diabetes is common and is frequently the result of hepatic steatosis. Diabetic hepatosclerosis is a relatively recent description of sinusoidal fibrosis, without steatosis, observed in liver biopsies of people with diabetes presenting with cholestasis. Its association with other microvascular complications suggests it is a form of hepatic diabetic microangiopathy. We report the case of a 50-year-old woman with longstanding Type 1 diabetes, complicated by nephropathy resulting in cadaveric renal transplant, retinopathy, gastroparesis and neuropathy with slowly healing ulceration to her right foot. She was noted to have deranged liver function tests: alanine aminotransferase, 162 IU/l; bilirubin, 44 IU/l; alkaline phosphatase, 5279 IU/l (isoenzymes; bone 1029 IU/l, liver 4250 IU/l); γ-glutamyl transferase, 662 IU/l. A non-invasive liver screen did not reveal the cause of the cholestasis. A liver biopsy demonstrated sinusoidal fibrosis without evidence of steatosis and thus a diagnosis of diabetic hepatosclerosis was made. Comparison with a biopsy performed 11 years previously at a different trust due to elevated alkaline phosphatase levels revealed slow progression of the sinusoidal fibrosis. This case describes ...Continue Reading

References

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Citations

Nov 18, 2018·Endocrine, Metabolic & Immune Disorders Drug Targets·Abd Elkhalek HamedShorouk Moussa
Mar 3, 2020·Immunopharmacology and Immunotoxicology·Souty M Z SharkawiRamadan A M Hemeida
Aug 3, 2020·European Journal of Gastroenterology & Hepatology·Rita de Sousa Gameiro, Filipe G Nery
Sep 10, 2020·Journal of Clinical Medicine·Sazlyna Mohd Sazlly LimFekade Bruck Sime
Feb 26, 2019·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·Theodora StratigouGeorge Ioannidis
May 4, 2021·Digestive Diseases and Sciences·Chau ToPaul J Thuluvath
Jun 13, 2017·Diabetes & Metabolic Syndrome·Natalia G VallianouGeorge Ioannidis

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