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Henares, Coslada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, H.U. Henares, Coslada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, H.U. Henares, Coslada, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dolor abdominal: manifestación clínica inicial de esteatohepatitis no alcohólica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1486 "Ancho" => 2507 "Tamanyo" => 550247 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Image of the tomography and liver biopsy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 56-year-old woman who was not overweight and did not drink alcohol and who had a medical history of tobacco use and hypertension was admitted for investigation of abdominal pain that had been ongoing for two months. She had a previous endoscopic and ultrasound study that was normal.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The examination and tests performed only detected significant hepatomegaly, which measured 26 cm and reached the iliac crest with displacement of the bowel loops.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The results of the liver disease study were anodyne. Likewise, she presented with a general blood test with glucose 118 mg/dL, total cholesterol 212 mg/dL, and triglycerides 264 mg/dL.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Given how notable the hepatomegaly was, it was decided to perform a liver biopsy. The histopathological study reported a tissue cast with marked steatosis that was predominantly macrovacuolar and with little liver parenchyma conserved. It had an inflammatory component and focal ballooning degeneration (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">With a diagnosis of nonalcoholic steatohepatitis (NASH), treatment was started with vitamin E, omega-3 fatty acids, statins, pioglitazone, and analgesics. She continues in follow-up.</p><p id="par0030" class="elsevierStylePara elsevierViewall">This is a particularly noteworthy case for the reported symptoms that led to the diagnosis, the speed of onset, and the absence of classic risk factors for this disease. In addition, the marked steatosis merits mention, with an almost complete replacement of the liver parenchyma and signs of activity.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-12-27" "fechaAceptado" => "2020-01-10" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sanz-Baena S, Díaz-Menéndez A, Quintana-Valcarcel P. Dolor abdominal: manifestación clínica inicial de esteatohepatitis no alcohólica. Rev Clin Esp. 2022;222:114–115.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1486 "Ancho" => 2507 "Tamanyo" => 550247 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Image of the tomography and liver biopsy.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022200000002/v1_202202020644/S2254887421001259/v1_202202020644/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022200000002/v1_202202020644/S2254887421001259/v1_202202020644/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887421001259?idApp=WRCEE" ]
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