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Alcoholism is one possible cause, but fat deposition may also develop from a reaction to medication or from a viral infection. Hepatocellular necrosis and bile stasis may also occur. Nonalcoholic fatty liver disease, therefore, is simply fat deposition in the liver that homocystinuria is not caused by chronic ingestion of alcohol. The terms NAFLD and NASH are often used interchangeably. However, NASH properly refers to that subset of patients with NAFLD who have evidence of inflammation on liver biopsy. The spectrum of NAFLD homocystinuria is similar to that of alcoholic liver disease. At one extreme is fatty liver occurring without inflammation; at the other is cirrhosis. Nonalcoholic steatohepatitis is an intermediate disease state between these two extremes. 2. What is the difference between macrovesicular and microvesicular fat deposition in the liver? Macrovesicular fat is deposited in large vacuoles in hepatocytes; such accumulation pushes the nucleus toward the wall of the cell.
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