Educational Forum-Drugs and non-alcoholic steatohepatitis

Health complications associated with obesity include diabetes, hypertension, hyperlipidemia, cardiovascular disease, and associated co-morbidities including non-alcoholic steatohepatitis (NASH). Additionally, NASH has been associated with several drugs. Though steatohepatitis is a rare form of drug induced liver disease, it has generated great interest in the recent past. Oral hypoglycemic agents, lipid lowering agents, antihypertensives, and antiobesity medication underlie a significant proportion of well-recognized hepatotoxicity. While some medications have predictable toxicity, many more are associated with idiosyncratic reactions. The toxic mechanism appears to involve mitochondrial injury, impaired β-oxidation, generation of reactive oxygen species and ATP depletion. If a drug is suspected, it is probably prudent to stop this medication.