Article Text

Download PDFPDF
Werner syndrome as a possible cause of non-alcoholic steatohepatitis
  1. H Hashizume1,
  2. K Sato1,
  3. H Takagi1,
  4. D Kanda1,
  5. T Kashihara2,
  6. S Kiso3,
  7. M Mori1
  1. 1
    Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
  2. 2
    Department of Internal Medicine, Itami City Hospital, Hyogo, Japan
  3. 3
    Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
  1. Correspondence to Dr K Sato, Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa, Maebashi, Gunma 371-8511, Japan; satoken{at}


Non-alcoholic steatohepatitis (NASH) is characterised by steatosis, liver cell injuries, the presence of a mixed inflammatory lobular infiltrate, and variable degrees of fibrosis. Werner syndrome (WS) is a rare autosomal recessive disease characterised by the premature onset of multiple age-related disorders. Central obesity and insulin resistance are common symptoms of both NASH and WS. Three cases were studied to evaluate the association between WS and NASH. NASH was diagnosed by liver biopsies and imaging studies following the exclusion of alcohol consumption, viral disease or autoimmune liver disease. Liver histology was compatible with NASH in all cases. Liver dysfunction, hyperlipidaemia, insulin resistance and regional increase of intra-abdominal fat even though the body mass indices were all normal or low, were observed. Metabolic disorders due to WS may complicate and cause NASH. Hence, the observed clinical association between WS and NASH suggests that patients with WS should also be screened for NASH.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Reprint permission Data on the sibling cases has previously been published in the journal Gastroenterological Endoscopy.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; not externally peer reviewed.