5-Minute Clinical Consult

Cirrhosis of the Liver

Cirrhosis of the Liver was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.

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Basics

Description

A chronic disease in which liver cell injury causes inflammation, necrosis, and stellate cell activation, leading to liver failure and/or cancer.

Epidemiology

  • Predominant age: 40–50 years old
  • Predominant sex: Male > Female; but more women get cirrhosis from alcohol abuse.
  • 9th leading cause of death among all US adults

Risk Factors

Alcohol abuse; IV drug abuse; obesity; blood transfusion

Genetics
Hemochromatosis, Wilson disease, and α-1-antitrypsin deficiency in adults

General Prevention

  • Counsel patients to prevent risk factors for chronic liver disease (e.g., alcohol abuse); >80% of chronic liver disease is preventable.
  • Limit alcohol consumption to <2 drinks/d and advise weight loss for obesity:
    • Raised BMI and alcohol both are linked to liver disease, with evidence of a supra-additive interaction between the 2 (1)[A].

Etiology

  • Chronic hepatitis C (26%)
  • Alcohol abuse (21%)
  • Hepatitis C with alcohol liver disease (15%)
  • Nonalcoholic steatohepatitis/obesity (~10%)
  • Hepatitis B + hepatitis D infection (15%)
  • Other: Hemochromatosis; autoimmune hepatitis; primary biliary cirrhosis; secondary biliary cirrhosis; primary sclerosing cholangitis; Wilson disease; α-1-antitrypsin deficiency; granulomatous disease (e.g., sarcoidosis); drug-induced liver disease (e.g., methotrexate, α-methyldopa, amiodarone); venous outflow obstruction (e.g., Budd-Chiari syndrome, veno-occlusive disease); chronic right-sided heart failure; tricuspid regurgitation; and rare genetic, metabolic, and infectious causes

Commonly Associated Conditions

Diabetes, alcoholism, drug abuse, depression, obesity

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