Early on when taking these drugs (hormones), you can simplistically think of the medication as "supplementing" your body's own production of corticosteroids. With time, your body realizes you are getting all of the corticosteroids you need in pill or intravenous form, and your body sends a message to stop producing your own natural corticosteroids. If these drugs are suddenly stopped, you not only are not getting the prescription, but it can take a significant amount of time before your body realizes that it needs to make its own corticosteroids again.
SS among patients who received corticosteroids (35%) was significantly higher than in patients who did not receive corticosteroids (23%; P = ) (Fig. 1 ). However, there were no significant differences in SS between steroid groups in any particular diagnosis subgroup, including those with AI-ALF (32% versus 20%, respectively, P = ). In addition, reassignment of etiology based on a histological diagnosis of AI-ALF also yielded no difference (26% in those who received corticosteroids and 21% in those who did not ( P = ).
One of the difficulties in diagnosing NASH as the cause of severe scaring or cirrhosis is that as the scaring progresses to cirrhosis, the fat disappears. This results in a condition that is referred to as cryptogenic cirrhosis , cirrhosis in which there is no clear cause. (Specifically, in cryptogenic cirrhosis the two most common causes of cirrhosis - alcohol and viral hepatitis - are not involved.) Cryptogenic cirrhosis has puzzled physicians for many years as to its cause. However, it now appears that half of cryptogenic cirrhosis occurs in patients with obesity and/or diabetes and probably is due to NASH.