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Is drug-induced fatty liver curable?

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Practicing since : 2000
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I am male 33 years age. height =173cm,wt=72kg,lean body shape,non alcoholic.I had TB 12years before and used Isonazid and Rifamzine for treatment(9 months).
For last eight years I am having high values of liver function test results (sgpt =235,sgot=88,pt=14).Ultrasound shows mild fatty infiltration of liver.Liver biopsy shows midzonal fatty change ,no fibrosis or interphase hepatitis,no deposits of iron. No hepatitis. sgpt and sgot values are continuously high for last eight years. one consultant opinioned that it is fatty liver due to the drugs used for tb treatment. Used udiliv for 4months,enzime values came down,when it is used,but it came as earlier when it stopped. Is it completly reversible(curable)? How XXXXXXX it is? What medication shoud take. Kindly help.
Posted Mon, 23 Apr 2012 in Liver and Gall Bladder
Answered by Dr. Poorna Chandra K.S 3 hours later

Thanks for the query.

Elevated SGOT and SGPT usually indicate hepatitis and correlate with inflammation - portal or interface on the biopsy. While it is common to have normal enzymes but presence of inflammation on biopsy.

But it is unlikely that you have an elevated enzymes and no inflammation on biopsy unless - 1) there is a sampling error or 2) the elevated enzymes are because of an extrahepatic source like muscle.

However inveiw of presence of fatty change the first possibility is more likely.

Common causes of fatty liver are - alcohol, obesity + Diabeties + lipid abnormalities, certain drugs, rapid weight alterations and storeage disorders. TB drugs taken such long back are less likely to be the cause of the present problem. One has to also rule out Wilson's disease ( copper storeage disorder) as it can also present a fatty liver like picture.
Some times fatty liver can be a coincidental finding & hence one has to rule out viral hepatitis also.

I suggest you to see a gastroenterologist for evaluation and further tests.

Hope this helps you. If you have more concerns, I am available for follow ups.

Above answer was peer-reviewed by
Follow-up: Is drug-induced fatty liver curable? 13 hours later
dear doctor,
thank you for the reply. I sent my biopsy and ultrasound results to doctor@health care magic. Please go thourgh the reports.
If the fattyliver is because of medicine, In your experience is it curable by medicine? What are the normal medicines prescribed? How to detect wilsons disease?
Answered by Dr. Poorna Chandra K.S 33 hours later

Thanks for the reports.

I have gone through your Ultrasound report.

The liver in the average adult weighs on average 1500 g, and a standard core liver biopsy represents 1/50,000 of the whole organ. An ideal liver biopsy should contain atleast 4-6 portal triads to be effectively analysed.

Hence I think it was an inadequate sample and the presence of inflammation was missed.

Hope this answers your query.

Wish you a good health.

Above answer was peer-reviewed by
Follow-up: Is drug-induced fatty liver curable? 1 hour later
dear doctor,
As you said, inflamation of liver is present, Is there any symptoms ?
Is it curable by medicine?
Please reply
with best regards
Answered by Dr. Poorna Chandra K.S 9 hours later
Hello again,

Hepatitis usually manifests as fatigue, loss of appetite, (R) upper quadrant discomfort/pain & nausea.

In some cases it may be very subtle and in others accompanied by jaundice.

Treatment depends on the cause - If the cause is eradicated the inflammation will subside and earlier the treatment the better it is.

In addition to Wilson's disease ( blood test and urine test) also get yourself investigated for celiac disease (blood test and duodenal biopsy).

Specific tests and investigations can be obtained on advise of your gatroenterologist.

Above answer was peer-reviewed by
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