Hepatitis is a generic term for inflammation of the liver.  This can be the result of an infection (e.g. hepatitis A, EBV), an autoimmune process, or due to insulin resistance (a component of the metabolic syndrome).

The differential diagnosis of elevated liver enzymes in an adolescent male is broad and includes infectious hepatitis, autoimmune hepatitis, and non-alcoholic steatohepatitis. The strong family history of diabetes and the dark, velvety discoloration on the neck and flexure creases (aka: acanthosis nigricans) are highly suggestive of insulin resistance, a pre-diabetic condition that can result in end-organ damage (e.g. to the liver).

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