In our case, the amelioration of liver enzymes was associated with the administration of anti-RANKL antibody, suggesting that RANKL-RANK signaling pathway may be one of the potential pathogenesis for the development of NAFLD or NASH under the condition of panhypopituitarism including GH deficiency. Here, TNFRSF11A is linked to metabolic dysfunction-associated steatohepatitis.