Nonalcoholic fatty liver disease (NAFLD) is mostly diagnosed in overweight and obese people. However, severe forms of NAFLD can also be detected in rare genetic diseases such as lipodystrophy or in patients with HIV, putting them at a high risk for developing liver failure, diabetes and cardiovascular diseases. Norbert Stefan and colleagues have now detected a yet unknown cause of NAFLD in lean people. They report a case of a woman who received immune checkpoint blockade therapy for skin cancer, which may have triggered inflammation of her subcutaneous fat, resulting in a dramatic loss of fat mass and severe NAFLD.
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