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Other causes include malnutrition doctors (especially the protein-deficient diet of children with kwashiorkor), inborn metabolic disorders (of glycogen, galactose, tyrosine, or homocysteine), drugs (eg, corticosteroids), or systemic illnesses with fever. Microvesicular fatty liver occurs in acute fatty liver of pregnancy, Reye's syndrome, certain doctors drug toxicities (valproic acid, tetracycline, salicylate), or inborn metabolic defects (of the urea cycle enzymes or involving mitochondria in FFA oxidation). Focal fatty change is much less common and less well recognized. These nodules of fatty liver cells are subcapsular. They are usually an incidental finding on ultrasound or CT, presenting as multiple space-occupying doctors lesions of the liver. Such focal fat may appear in patients apparently at risk of developing this change (eg, obese or alcoholic patients). Pathogenesis Triglycerides accumulate in the liver because of increased input through synthesis from FFA or decreased export as VLDL from the hepatocytes.
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