Volume 132, Issue 3, Pages 938-943 (March 2007) Growth Hormone Reverses Nonalcoholic Steatohepatitis in a Patient With Adult Growth Hormone Deficiency  Yutaka Takahashi, Keiji Iida, Kentaro Takahashi, Shiro Yoshioka, Hidenori Fukuoka, Ryoko Takeno, Mari Imanaka, Hitoshi Nishizawa, Michiko Takahashi, Yasushi Seo, Yoshitake Hayashi, Takuma Kondo, Yasuhiko Okimura, Hidesuke Kaji, Riko Kitazawa, Sohei Kitazawa, Kazuo Chihara  Gastroenterology  Volume 132, Issue 3, Pages 938-943 (March 2007) DOI: 10.1053/j.gastro.2006.12.024 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Pretreatment liver biopsy samples (A–D) and posttreatment liver biopsy samples (E–H). Before treatment, typical NASH characteristics were observed. These include marked steatosis (33.5%) with an inflammatory infiltrate and hepatocyte ballooning (H&E staining; original magnification, A and E ×100; B and F ×400) and perisinusoidal and pericellular fibrosis in acinar zone 3 demonstrated by Masson trichrome staining (original magnification, C and G ×100; F and H ×400). In contrast, steatosis was reduced to 7.2% after treatment, inflammatory infiltrate and hepatocyte ballooning disappeared, and fibrosis showed a marked decrease. Gastroenterology 2007 132, 938-943DOI: (10.1053/j.gastro.2006.12.024) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Clinical course during GH-replacement therapy. The daily dose of rhGH was increased gradually. During the treatment, liver dysfunction improved to the normal range. Inflammation and oxidative stress markers such as serum levels of hsCRP and TNF-α, and urine levels of 8OHdG were substantially decreased. Gastroenterology 2007 132, 938-943DOI: (10.1053/j.gastro.2006.12.024) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 An oxidative stress marker, 8OHdG staining, demonstrated that, in pretreatment liver, most of the hepatocytes were positive for the oxidative stress marker (A); however, after treatment, 8OHdG-stained hepatocytes were drastically reduced (B). (C) A negative control. In normal liver, most of the hepatocytes were negative for 8OHdG staining. (D) A positive control. In NASH liver, most of the hepatocytes were positive for 8OHdG staining. Gastroenterology 2007 132, 938-943DOI: (10.1053/j.gastro.2006.12.024) Copyright © 2007 AGA Institute Terms and Conditions