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Cirrhosis of the Liver

Cirrhosis of the Liver is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

A chronic hepatocellular disease with inflammation, necrosis, and fibrosis potentially leading to liver failure and/or cancer

Epidemiology

  • 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

Genetics
Hemochromatosis, Wilson disease, and α1-antitrypsin deficiency in adults are associated with cirrhosis.

Risk Factors

Alcohol abuse, intravenous drug abuse, obesity, blood transfusion

General Prevention

  • 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

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Citation

Stephens, Mark B., et al., editors. "Cirrhosis of the Liver." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116134/all/Cirrhosis_of_the_Liver.
Cirrhosis of the Liver. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116134/all/Cirrhosis_of_the_Liver. Accessed March 22, 2019.
Cirrhosis of the Liver. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116134/all/Cirrhosis_of_the_Liver
Cirrhosis of the Liver [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 22]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116134/all/Cirrhosis_of_the_Liver.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cirrhosis of the Liver ID - 116134 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116134/all/Cirrhosis_of_the_Liver PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -