Lipoatrophic diabetes and end-stage liver disease secondary to nonalcoholic steatohepatitis with recurrence after liver transplantation

Michele S. Cauble, Richard Gilroy, Michael Floyd Sorrell, Mark E Mailliard, Debra L. Sudan, Joseph C. Anderson, James Lowell Wisecarver, Sajeev Balakrishnan, Jennifer Lynn Larsen

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background. Lipoatrophic diabetes is an insulin resistance syndrome characterized by the complete or partial lack of adipose tissue and disturbances in lipid and glucose metabolism. Nonalcoholic steatohepatitis (NASH) is a well-described change in liver pathology consisting of steatosis, hepatitis, and fibrosis that can be associated with lipoatrophic diabetes. Results. This article describes the first reported case of lipoatrophic diabetes with NASH leading to liver failure and liver transplantation. Before transplantation, the patient required 600-700 U of insulin/day. After transplantation, a dramatic decline in her insulin requirements was observed, despite corticosteroids. Eighteen months after transplantation, her glycemic control worsened, and she developed recurrent NASH on serial liver biopsies. Conclusions. NASH associated with lipoatrophic diabetes can recur after liver transplantation, and in this case, was accompanied by increased insulin requirements. These results suggest that the development of NASH itself may contribute to the insulin resistance observed in lipoatrophic diabetes.

Original languageEnglish (US)
Pages (from-to)892-895
Number of pages4
JournalTransplantation
Volume71
Issue number7
DOIs
StatePublished - Apr 15 2001

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Lipoatrophic Diabetes Mellitus
End Stage Liver Disease
Liver Transplantation
Recurrence
Transplantation
Insulin
Insulin Resistance
Liver
Liver Failure
Lipid Metabolism
Hepatitis
Adipose Tissue
Adrenal Cortex Hormones
Fibrosis
Non-alcoholic Fatty Liver Disease
Pathology
Biopsy
Glucose

ASJC Scopus subject areas

  • Transplantation

Cite this

Lipoatrophic diabetes and end-stage liver disease secondary to nonalcoholic steatohepatitis with recurrence after liver transplantation. / Cauble, Michele S.; Gilroy, Richard; Sorrell, Michael Floyd; Mailliard, Mark E; Sudan, Debra L.; Anderson, Joseph C.; Wisecarver, James Lowell; Balakrishnan, Sajeev; Larsen, Jennifer Lynn.

In: Transplantation, Vol. 71, No. 7, 15.04.2001, p. 892-895.

Research output: Contribution to journalArticle

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AU - Sudan, Debra L.

AU - Anderson, Joseph C.

AU - Wisecarver, James Lowell

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AB - Background. Lipoatrophic diabetes is an insulin resistance syndrome characterized by the complete or partial lack of adipose tissue and disturbances in lipid and glucose metabolism. Nonalcoholic steatohepatitis (NASH) is a well-described change in liver pathology consisting of steatosis, hepatitis, and fibrosis that can be associated with lipoatrophic diabetes. Results. This article describes the first reported case of lipoatrophic diabetes with NASH leading to liver failure and liver transplantation. Before transplantation, the patient required 600-700 U of insulin/day. After transplantation, a dramatic decline in her insulin requirements was observed, despite corticosteroids. Eighteen months after transplantation, her glycemic control worsened, and she developed recurrent NASH on serial liver biopsies. Conclusions. NASH associated with lipoatrophic diabetes can recur after liver transplantation, and in this case, was accompanied by increased insulin requirements. These results suggest that the development of NASH itself may contribute to the insulin resistance observed in lipoatrophic diabetes.

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