Cirrhosis
Basics
Basics
Basics
Description
Description
- Progressive process of inflammation, cellular injury and necrosis, diffuse fibrosis, and formation of regenerative nodules
- Loss of lobular and vascular architecture
- Irreversible in advanced stages
- Intrahepatic portal hypertension owing to increased resistance at the sinusoid, compression of the central veins, and anastomosis between the arterial and portal systems
Etiology
Etiology
- Chronic viral hepatitis C (most common cause in the U.S.)
- Chronic alcohol abuse (second most common cause in the U.S.)
- Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
- Other: Chronic hepatitis B and/or D
- Metabolic:
- Hereditary hemochromatosis
- Wilson disease
- Porphyria
- Drugs:
- Acetaminophen
- Methotrexate
- Amiodarone
- Methyldopa
- Hepatic congestion:
- Right-sided heart failure
- Pericarditis
- Budd–Chiari syndrome (hepatic venous outflow obstruction)
- Infiltrative/autoimmune:
- Sarcoidosis
- Amyloidosis
- Primary biliary cholangitis (PBC) or secondary (sclerosing cholangitis)
- Hepatocellular carcinoma, diffusely infiltrating
- Infections:
- Brucellosis
- Echinococcosis
- Tertiary syphilis
- Schistosomiasis
Pediatric Considerations
- Congenital: Arteriohepatic dysplasia, biliary atresia
- Cystic fibrosis, α1-antitrypsin deficiency
- Metabolic
- Fructosemia, tyrosinemia, galactosemia, glycogen storage diseases
- Infectious
- Congenital hepatitis B
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