Diabetic hepatosclerosis: True clinical entity or ghost disease?

Diabetic hepatosclerosis is a novel entity that has recently been introduced by reviewing archived liver biopsies as a non-cirrhotic form of peri-sinusoidal fibrosis with basement membrane formation. Diabetic hepatosclerosis is usually characterized by an indolent clinical course. Serum aminotransferase levels are normal or minimally elevated, but elevated alkaline phosphatase levels is usually present. Clinically relevant to DH is the co-existence of other diabetic microvascular complications in the same patient, such as ESRD on long-term dialysis or renal transplantation, retinopathy, or neuropathy. Although it seems that DH occurs in patients with type 1 more often than type 2 diabetes mellitus, the true prevalence of this entity still remains unknown. Future prospective studies should include long-term follow-up to examine the natural history and to explore treatment options for this form of hepatic micro-angiopathy disease.