Liver Disorders
Liver Diseases
AutoImmune Hepatitis
Autoimmune hepatitis refers to chronic and progressive inflammation of the liver from an unknown cause. The proposed mechanism for the development of autoimmune hepatitis is thought to be the interplay of genetic predisposition, an environmental trigger, and failure of the native immune system resulting in chronic inflammation of hepatocytes and subsequent fibrosis of the liver. There are two known types of autoimmune hepatitis. Type 1 is distinguished by the presence of anti-smooth muscle antibodies (ASMA) with or without anti-nuclear antibodies (ANA). Type 2 autoimmune hepatitis presents with positive anti-liver/anti-kidney microsome (anti-LMK) type 1 antibodies or anti-liver cytosol (anti-LC) type 1 antibodies. This activity reviews the pathophysiology, causes, presentation, and diagnosis of autoimmune hepatitis and highlights the role of the interprofessional team in its management.
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Cirrhosis
Cirrhosis is a chronic diffuse liver disease characterized by fibrosis and regenerative nodules causing distortion of normal hepatic architecture.
It represents the end stage of many chronic liver injuries and leads to portal hypertension and hepatic insufficiency.
The liver becomes structurally irregular and functionally impaired.
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It represents the end stage of many chronic liver injuries and leads to portal hypertension and hepatic insufficiency.
The liver becomes structurally irregular and functionally impaired.
Primary Biliary Cholangitis
Primary biliary cholangitis (PBC), formerly termed primary biliary cirrhosis, is an autoimmune disorder that gradually destroys intrahepatic bile ducts, resulting in periportal inflammation and cholestasis. Prolonged hepatic cholestasis subsequently causes cirrhosis and portal hypertension.
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Primary Sclerosing Cholangitis
Primary sclerosing cholangitis (PSC) is a chronic, progressive cholestatic liver disease characterized by inflammation
and fibrosis of the intrahepatic and extrahepatic bile ducts, resulting in multifocal strictures and eventual biliary
cirrhosis. This condition is strongly associated with inflammatory bowel disease, particularly ulcerative colitis, and
carries substantial risks of cholangiocarcinoma, gallbladder cancer, colorectal cancer, portal hypertension, and
cirrhosis. This course outlines the presentation of PSC, ranging from asymptomatic in approximately half of patients
with cholestatic liver enzyme abnormalities only detected incidentally to symptoms such as fatigue, right upper
quadrant pain, and pruritus.
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and fibrosis of the intrahepatic and extrahepatic bile ducts, resulting in multifocal strictures and eventual biliary
cirrhosis. This condition is strongly associated with inflammatory bowel disease, particularly ulcerative colitis, and
carries substantial risks of cholangiocarcinoma, gallbladder cancer, colorectal cancer, portal hypertension, and
cirrhosis. This course outlines the presentation of PSC, ranging from asymptomatic in approximately half of patients
with cholestatic liver enzyme abnormalities only detected incidentally to symptoms such as fatigue, right upper
quadrant pain, and pruritus.
Wilson Disease
Wilson disease, also known as hepatolenticular degeneration, is a rare autosomal recessive disorder caused by gene mutations, leading to abnormal copper accumulation in the liver, brain, cornea, and other organs. Wilson disease primarily presents with hepatic and neuropsychiatric symptoms, including jaundice, liver failure, tremors, mood changes, and movement disorders.
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Hapatitis B
Hepatitis B is an acute or chronic viral liver disease caused by HBV. Chronic infection may remain inactive or progress to chronic hepatitis, cirrhosis, liver failure, and hepatocellular carcinoma.
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Hepatitis A
• Hepatitis A is an acute viral liver infection caused by hepatitis A virus (HAV), usually transmitted by the fecal–oral route through contaminated food, water, or close contact.
• It is usually self-limited and does not cause chronic hepatitis.
• Clinical expression ranges from silent/subclinical infection to acute icteric hepatitis; prolonged cholestatic or relapsing forms may occur in a minority of patients.
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• It is usually self-limited and does not cause chronic hepatitis.
• Clinical expression ranges from silent/subclinical infection to acute icteric hepatitis; prolonged cholestatic or relapsing forms may occur in a minority of patients.