Nodular regenerative hyperplasia of the liver. Report of two cases associated with autoimmune disease

Nodular regenerative hyperplasia of the liver (N.R.H.) is an uncommon clinicopathological entity characterized by diffuse regenerative hepatocytic nodules without fibrosis. Grossly the lesion is often mistaken for cirrhosis. The etiology and pathogenesis are unknown. We report two new cases of N.R.H. diagnosed by liver biopsy. Peritoneoscopically the liver showed a nodular surface resembling micronodular cirrhosis. Both patients showed some clinical and immunological features of autoimmune disease, and in both cases N.R.H. was associated with chronic active hepatitis. We discuss the pathological differential diagnosis of N.R.H., its relation to other associated diseases and review the hypotheses for the pathogenesis of this condition.

[Metabolic regulation of nutrition]

The mechanisms regulating nutrient metabolism and their adaptation and compensation during stress conditions are discussed. The stress conditions considered are fasting and refeeding, pregnancy, growth and development, and malnutrition.