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Microvesicular fatty liver occurs in acute fatty liver of pregnancy, Reye's syndrome, certain drug toxicities (valproic acid, the perinatal center at st. john's mercy medical center 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, the perinatal center at st. john's mercy medical center presenting as multiple space-occupying lesions of the liver. Such focal fat may appear in patients apparently at risk of developing this change the perinatal center at st. john's mercy medical center (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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