The document summarizes various liver diseases including viruses (hepatitis A, B, C), alcohol/drugs (fatty liver disease, cirrhosis), and inherited conditions (hemochromatosis, Wilson's disease). Key details are provided on symptoms, causes, pathophysiology, and treatment options for each disease. The liver plays an important role in metabolism and is susceptible to damage from infections, toxins, and genetic disorders.
The document summarizes various liver diseases including viruses (hepatitis A, B, C), alcohol/drugs (fatty liver disease, cirrhosis), and inherited conditions (hemochromatosis, Wilson's disease). Key details are provided on symptoms, causes, pathophysiology, and treatment options for each disease. The liver plays an important role in metabolism and is susceptible to damage from infections, toxins, and genetic disorders.
The document summarizes various liver diseases including viruses (hepatitis A, B, C), alcohol/drugs (fatty liver disease, cirrhosis), and inherited conditions (hemochromatosis, Wilson's disease). Key details are provided on symptoms, causes, pathophysiology, and treatment options for each disease. The liver plays an important role in metabolism and is susceptible to damage from infections, toxins, and genetic disorders.
The document summarizes various liver diseases including viruses (hepatitis A, B, C), alcohol/drugs (fatty liver disease, cirrhosis), and inherited conditions (hemochromatosis, Wilson's disease). Key details are provided on symptoms, causes, pathophysiology, and treatment options for each disease. The liver plays an important role in metabolism and is susceptible to damage from infections, toxins, and genetic disorders.
Liver Disease • The right upper quadrant of the abdomen is dominated by the liver and its companion biliary tree and gallbladder. • Residing at the crossroads between the digestive tract and the rest of the body, the liver has the enormous task of maintaining the metabolic homeostasis. Liver Diseases: VIRUSES • Hepatitis A • Hepatitis B • Hepatitis C Hepatitis A (Description) • Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. You're most likely to get hepatitis A from contaminated food or water or from close contact with a person or object that's infected. Mild cases of hepatitis A don't require treatment. Most people who are infected recover completely with no permanent liver damage. Hepatitis A (Pathopyshiology) • HAV is a single-stranded, positive-sense, linear RNA enterovirus of the Picornaviridae family. In humans, viral replication depends on hepatocyte uptake and synthesis, and assembly occurs exclusively in the liver cells. Virus acquisition results almost exclusively from ingestion (eg, fecal-oral transmission), although isolated cases of parenteral transmission have been reported. Hepatitis A (Treatment) • There are no specific medicines to cure infection with hepatitis A. Most people require no treatment except to relieve symptoms. However, if symptoms become severe or dehydration develops, the person should seek medical care emergently. • There is a vaccine for it. If you have been exposed to someone who is infected with HAV, a treatment called immune serum globulin is available and may prevent you from becoming infected. Immune serum globulin is more likely to be effective when given within 2 weeks of exposure. Hepatitis B (Description) • Hepatitis B infection is a worldwide healthcare problem, especially in developing areas. The hepatitis B virus (HBV) is commonly transmitted via body fluids such as blood, semen, and vaginal secretions. Hepatitis B (Pathophysiology) • Hepatitis B virus (HBV) is a hepadnavirus, with the virion consisting of a 42-nm spherical, double-shelled particle composed of small spheres and rods and with an average width of 22 nm. It is an exceedingly resistant virus, capable of withstanding extreme temperatures and humidity. HBV can survive when stored for 15 years at –20°C, for 24 months at –80°C, for 6 months at room temperature, and for 7 days at 44°C. Hepatitis B (Treatment) • An injection of immunoglobulin (an antibody) given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis B. Because this treatment only provides short-term protection, you also should get the hepatitis B vaccine at the same time, if you never received it. • People diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Hepatitis C (Description) • Hepatitis C is an infection caused by the hepatitis C virus (HCV) that attacks the liver and leads to inflammation. Hepatitis C (Pathophysiology) • Hepatitis C virus (HCV) is a spherical, enveloped, single-stranded RNA virus belonging to the family Flaviviridae, genus Flavivirus. Lauer and Walker reported that HCV is closely related to hepatitis G, dengue, and yellow fever viruses. • The natural targets of HCV are hepatocytes and, possibly, B lymphocytes. Viral clearance is associated with the development and persistence of strong virus-specific responses by cytotoxic T lymphocytes and helper T cells. • In most infected people, viremia persists and is accompanied by variable degrees of hepatic inflammation and fibrosis. Findings from studies suggest that at least 50% of hepatocytes may be infected with HCV in patients with chronic hepatitis C. Hepatitis C (Treatment) • Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. Liver Diseases: ALCOHOL & DRUGS • Fatty Liver Disease • Cirrhosis Fatty Liver Disease (Description) • Fatty liver is also known as hepatic steatosis. It happens when fat builds up in the liver. Having small amounts of fat in your liver is normal, but too much can become a health problem. Fatty Liver Disease (Pathophysiology) Potential pathophysiologic mechanisms for fatty liver include the following: • Decreased mitochondrial fatty acid beta- oxidation • Increased endogenous fatty acid synthesis or enhanced delivery of fatty acids to the liver • Deficient incorporation or export of triglycerides as very low-density lipoprotein (VLDL) Fatty Liver Disease (Treatment) • The first line of treatment is usually weight loss through a combination of a healthy diet and exercise. • Vitamin E • Coffee Cirrhosis (Description) • Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. Cirrhosis (Classification) • Biliary cirrhosis • Post necrotic cirrhosis • Alcoholic cirrhosis Bilary Cirrhosis • It is due to an intra hepatic block that obstructs the excretion of bile or it may occur secondary to obstruction of the bile ducts. • The obstruction in one area of biliary passage • results in bile stasis; that causes injury and scarring • around the hepatocytes with evidence of fibrosis. Post Necrotic Cirrhosis • It follows massive liver necrosis and involves the destruction of lobules and even lobes of the liver. • It may occur after hepatitis or after exposure to hepato-toxins such as certain drugs. Alcoholic Cirrhosis • The most common cause of cirrhosis is excessive alcohol consumption • At least 75% of alcohol related deaths are attributed to cirrhosis. Cirrhosis (Treatment) • Stop drinking • Weight Loss Liver Diseases: INHERITANCE • Hemochromatosis • Wilson Disease Hemochromatosis (Description) • Hereditary hemochromatosis causes your body to absorb too much iron from the food you eat. Excess iron is stored in your organs, especially your liver, heart and pancreas. Too much iron can lead to life-threatening conditions, such as liver disease, heart problems and diabetes. Hemachromatosis (Phatophysiology) • Inappropriately decreased expression of the iron- regulatory hormone hepcidin. Hepcidin serves to decrease the export of iron from reticuloendothelial cells and absorptive enterocytes. Thus, HH patients demonstrate increased iron release from these cell types, elevated circulating iron, and iron deposition in vulnerable tissues. Hemachromatosis (Treatment) • Removing blood from your body. Wilson Disease (Description) • Wilson disease is a rare genetic disorder characterized by excess copper stored in various body tissues, particularly the liver, brain, and corneas of the eyes. The disease is progressive and, if left untreated, it may cause liver (hepatic) disease, central nervous system dysfunction, and death. Wilson Disease (Pathophysiology) • Wilson disease is an autosomal recessive inherited disorder of copper metabolism resulting in pathological accumulation of copper in many organs and tissues. • ATP7B is the gene product of the Wilson disease gene located on chromosome 13 and resides in hepatocytes in the trans-Golgi network, transporting copper into the secretory pathway for incorporation into apoceruloplasmin and excretion into the bile. Mutations of the gene result in impaired trafficking of copper in and through the hepatocytes. Wilson Disease (Treatment) • Liver Transplant