![]() ![]() There may also be a genetic predisposition to cirrhosis which may explain the variable rates of its development in people with similar risk factors (such as alcohol abuse or hepatitis C infection).Hepatitis B is the most common cause in parts of Asia and in sub-Saharan Africa.Alcoholic liver disease and hepatitis C are the most common causes in developed countries.Mortality in women increased by almost half (46% in Scotland and 44% in England and Wales). The same report showed that between 1987-1991, and 1997-2001, cirrhosis mortality in men in Scotland more than doubled (104% increase) and in England and Wales rose by over two thirds (69%). An analysis in the Lancet showed that between 19, total recorded alcohol consumption in Britain doubled.There is concern that there are growing levels of dangerous alcohol consumption in the UK which may lead to increased numbers of people with cirrhosis.The number of people living with both alcoholic cirrhosis and non-alcohol-related cirrhosis seems to be rising. There are an estimated 30,000 people living with cirrhosis in the UK and at least 7,000 new cases being diagnosed each year. ![]() It is difficult to estimate the exact prevalence of cirrhosis, as previously undiagnosed cirrhosis is often found at post-mortem.Infections including congenital and tertiary syphilis and schistosomiasis.Congestive heart failure or tricuspid regurgitation (although this is rarely seen now due to improved management).Drugs and toxins including methotrexate, amiodarone and isoniazid.Venous outflow obstruction in Budd-Chiari syndrome or veno-occlusive disease.Sarcoidosis or other granulomatous disease.Inherited metabolic disorders - eg, tyrosinaemia, Wilson's disease, porphyria, alpha-1-antitrypsin deficiency, glycogen storage diseases.Biliary obstruction (may be due to biliary atresia/neonatal hepatitis, congenital biliary cysts or cystic fibrosis).Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) - up to 10% of patients with NASH can develop cirrhosis.Hepatitis C infection (up to 20% can develop cirrhosis).For example, chronic hepatitis C infection can take up to 40 years to progress to cirrhosis in some people. The cirrhotic process can take from weeks to many years to develop, depending on the underlying cause and other factors, including patient response to the disease process. Causes of cirrhosisĪ number of chronic liver diseases can lead to cirrhosis. Damage to liver cells (hepatocytes) causes impaired liver function and the liver becomes less able to synthesise important substances such as clotting factors and is also less able to detoxify other substances (see also the separate Liver Failure article). Portal hypertension can lead to oesophageal varices as well as hypoperfusion of the kidneys, water and salt retention and increased cardiac output. The fibrosis causes distortion of the hepatic vasculature and can lead to an increased intrahepatic resistance and portal hypertension. However, there is often a poor correlation between the histological findings and the clinical picture. Around 80-90% of the liver parenchyma needs to be destroyed before there are clinical signs of liver failure. The progression to cirrhosis is very variable and may occur over weeks or many years. Cirrhosis represents the final histological pathway for a wide variety of liver diseases. See also the separate Primary Biliary Cirrhosis article.Ĭirrhosis is a diffuse hepatic process characterised by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. ![]()
0 Comments
Leave a Reply. |