Cirrhosis of the Liver
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A chronic hepatocellular disease with inflammation, necrosis, and fibrosis potentially leading to liver failure and/or cancer
- Predominant age: 40 to 50 years old
- Predominant sex: male > female; more women get cirrhosis from alcohol abuse.
- Ninth leading cause of death among U.S. adults
Etiology and Pathophysiology
- Chronic hepatitis C (26%)
- Alcohol abuse (21%)
- Hepatitis C with alcoholic liver disease (15%)
- Nonalcoholic steatohepatitis (NASH)/obesity (~10%)
- Hepatitis B plus hepatitis D infection (15%)
- Other: hemochromatosis, autoimmune hepatitis, primary biliary cirrhosis, secondary biliary cirrhosis, primary sclerosing cholangitis, Wilson disease, α1-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
Hemochromatosis, Wilson disease, and α1-antitrypsin deficiency in adults are associated with cirrhosis.
Alcohol abuse, intravenous drug abuse, obesity, blood transfusion
- Mitigate risk factors (e.g., alcohol abuse); >80% of chronic liver disease is preventable.
- Limit alcohol consumption and advise weight loss in overweight or obese patients.
- Elevated BMI and alcohol have an additive effect on liver disease (1).
Commonly Associated Conditions
Diabetes, alcoholism, drug abuse, depression, obesity