Cirrhosis causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Cirrhosis}}
{{Cirrhosis}}
{{CMG}} ; {{AE}} {{ADI}}
{{CMG}} {{AE}} {{ADI}} {{Cherry}}


==Overview==
==Overview==
There are a wide range of causes for cirrhosis, including [[alcohol abuse]], [[genetic diseases]], cardiac causes, [[toxins]], [[viruses]], and [[malnutrition]]. The consequence to the liver is the same in all cases however, with the functioning liver tissue being replaced by non-functioning scar tissue.
There are a wide range of causes for cirrhosis, including [[alcohol abuse]], [[genetic diseases]], [[Heart|cardiac]] causes, [[toxins]], [[viruses]], and [[malnutrition]]. The consequence is the same in all cases with the functional [[liver]] tissue being replaced by [[Fiber|fibrous]] [[scar]] tissue and regenerative [[Nodule (medicine)|nodules]].


== Causes ==
== Causes ==
=== Common Causes ===
=== Common causes ===
Cirrhosis has many possible causes; sometimes more than one cause is present in the same patient. In the Western World, chronic alcoholism and hepatitis C are the most common causes.
Cirrhosis has many possible causes; sometimes more than one cause is present in the same patient. In the Western World, chronic [[alcoholism]] and [[hepatitis C]] are the most common causes. [[Hepatitis B]] is more common in parts of sub-Saharan Africa and Asia.
* [[Alcoholic liver disease]]  
* [[Alcoholic liver disease]]  
* Chronic [[hepatitis C]]
* Chronic [[hepatitis C]]
Line 24: Line 24:
* [[Cystic fibrosis]]
* [[Cystic fibrosis]]
* [[Hard and soft drugs|Drug]]s or [[toxin]]s
* [[Hard and soft drugs|Drug]]s or [[toxin]]s
* Certain parasitic infections (such as [[schistosomiasis]])
* Certain [[Parasitism|parasitic]] [[Infection|infections]] (such as [[schistosomiasis]]) 


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac cirrhosis]], [[Right sided cardiac failure]], [[Constrictive pericarditis]], [[Cor Pulmonale]], [[Tricuspid insufficiency]]
| style="width:75%" bgcolor="Beige" ; border="1" | [[Cardiac cirrhosis]], [[Right sided cardiac failure]], [[Constrictive pericarditis]], [[Cor Pulmonale]], [[Tricuspid insufficiency]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Aflatoxin]]
| bgcolor="Beige" | [[Aflatoxin]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| [[Keratitis-ichthyosis-deafness syndrome]], [[Addison-Gull syndrome ]], [[Reynolds syndrome ]], [[Tricho-hepato-enteric syndrome ]]
| bgcolor="Beige" | [[Keratitis-ichthyosis-deafness syndrome]], [[Addison-Gull syndrome ]] , [[Reynolds syndrome ]] , [[Tricho-hepato-enteric syndrome ]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amiodarone]], [[Ethanol]], [[interferon alfacon-1]], [[Isoniazid]], [[Methotrexate]], [[Methyldopa]], [[Sulfasalazine]]
| bgcolor="Beige" | [[Amiodarone]], [[Ethanol]], [[interferon alfacon-1]], [[Isoniazid]], [[Methotrexate]], [[Methyldopa]], [[Sulfasalazine]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Addison-Gull syndrome ]], [[Alpha 1-antitrypsin deficiency ]], [[Alström syndrome]], [[Autoimmune cholangiopathy]], [[Autoimmune hepatitis]], [[Bearn-Kunkel syndrome ]], [[Bile duct]] [[stricture]], [[Biliary atresia]], [[Budd-Chiari Syndrome]], [[Caroli disease]], [[Cerebrohepatorenal syndrome]], [[Ceroid storage disease]], [[Cholestasis-oedema syndrome, Norwegian type]], [[Cruveilhier-Baumgarten syndrome]], [[Congenital hepatic fibrosis]], [[Cystic fibrosis]], [[Granulomatous cirrhosis]], [[Hemochromatosis]], [[Hepatic vein thrombosis]], [[Hereditary fructose intolerance]], [[Indian familial childhood cirrhosis]], [[Non-alcoholic steatohepatitis ]], [[Primary biliary cirrhosis]], [[Primary sclerosing cholangitis]], [[Reynolds syndrome ]], [[Tricho-hepato-enteric syndrome ]], [[Wilson disease]]
| bgcolor="Beige" | [[Addison-Gull syndrome ]] , [[Alpha 1-antitrypsin deficiency ]] , [[Alström syndrome]], [[Autoimmune cholangiopathy]], [[Autoimmune hepatitis]], [[Bearn-Kunkel syndrome ]] , [[Bile duct]] [[stricture]], [[Biliary atresia]], [[Budd-Chiari Syndrome]], [[Caroli disease]], [[Cerebrohepatorenal syndrome]], [[Ceroid storage disease]], [[Cholestasis-oedema syndrome, Norwegian type]], [[Cruveilhier-Baumgarten syndrome]], [[Congenital hepatic fibrosis]], [[Cystic fibrosis]], [[Granulomatous cirrhosis]], [[Hemochromatosis]], [[Hepatic vein thrombosis]], [[Hereditary fructose intolerance]], [[Indian familial childhood cirrhosis]], [[Non-alcoholic steatohepatitis ]] , [[Primary biliary cirrhosis]], [[Primary sclerosing cholangitis]], [[Reynolds syndrome ]] , [[Tricho-hepato-enteric syndrome ]] , [[Wilson disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"|  [[Abetalipoproteinemia]], [[Alagille syndrome]], [[Alpers disease]], [[Alpha 1-antitrypsin deficiency ]], [[Alström syndrome]], [[Berardinelli lipodystrophy syndrome]], [[Carbohydrate deficient glycoprotein syndrome type 1a]], [[Carbohydrate-deficient glycoprotein syndrome type 1b]], [[Caroli disease]], [[Ceroid storage disease ]], [[Cholestasis-oedema syndrome, Norwegian type]], [[Congenital hepatic fibrosis]], [[Cystic fibrosis]], [[Fanconi disease]], [[Fructose-1-phosphate aldolase deficiency]], [[Galactosemia]], [[Glycogen storage disease type IV]], [[Haemosiderosis]], [[Hemochromatosis]], [[Hereditary fructose intolerance]], [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]], [[Polycystic kidney disease, autosomal recessive]], [[Porphyria cutanea tarda type 2 (familial)]], [[Sickle cell disease]], [[Tyrosinaemia type 1]], [[Wilson disease]]
| bgcolor="Beige" |  [[Abetalipoproteinemia]], [[Alagille syndrome]], [[Alpers disease]], [[Alpha 1-antitrypsin deficiency ]] , [[Alström syndrome]], [[Berardinelli lipodystrophy syndrome]], [[Carbohydrate deficient glycoprotein syndrome type 1a]], [[Carbohydrate-deficient glycoprotein syndrome type 1b]], [[Caroli disease]], [[Ceroid storage disease ]] , [[Cholestasis-oedema syndrome, Norwegian type]], [[Congenital hepatic fibrosis]], [[Cystic fibrosis]], [[Fanconi disease]], [[Fructose-1-phosphate aldolase deficiency]], [[Galactosemia]], [[Glycogen storage disease type IV]], [[Haemosiderosis]], [[Hemochromatosis]], [[Hereditary fructose intolerance]], [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]], [[Polycystic kidney disease, autosomal recessive]], [[Porphyria cutanea tarda type 2 (familial)]], [[Sickle cell disease]], [[Tyrosinaemia type 1]], [[Wilson disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"|  [[Budd-Chiari Syndrome]], [[Erythropoietic  protoporphyria]], [[Fanconi disease]], [[Haemosiderosis]], [[Hepatic vein thrombosis]], [[Porphyria cutanea tarda type 2 (familial)]], [[Sickle cell disease]], [[Thalassemia]], [[Tyrosinaemia type 1]]
| bgcolor="Beige" |  [[Budd-Chiari Syndrome]], [[Erythropoietic  protoporphyria]], [[Fanconi disease]], [[Haemosiderosis]], [[Hepatic vein thrombosis]], [[Porphyria cutanea tarda type 2 (familial)]], [[Sickle cell disease]], [[Thalassemia]], [[Tyrosinaemia type 1]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Bile duct]] [[stricture]], [[Graft versus host disease]], [[Parenteral nutrition]]
| bgcolor="Beige" | [[Bile duct]] [[stricture]], [[Graft versus host disease]], [[Parenteral nutrition]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Fasciola hepatica]], [[Hepatitis B]], [[Hepatitis C]], [[Schistosoma haematobium]], [[Schistosoma japonicum]], [[Schistosoma mansoni]], [[Visceral leishmaniasis]]
| bgcolor="Beige" | [[Fasciola hepatica]], [[Hepatitis B]], [[Hepatitis C]], [[Schistosoma haematobium]], [[Schistosoma japonicum]], [[Schistosoma mansoni]], [[Visceral leishmaniasis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Alpers disease]], [[Cerebrohepatorenal syndrome]], [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]]
| bgcolor="Beige" | [[Alpers disease]], [[Cerebrohepatorenal syndrome]], [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|  [[Abetalipoproteinemia]], [[Carbohydrate deficient glycoprotein syndrome type 1a]], [[Carbohydrate-deficient glycoprotein syndrome type 1b]], [[Ceroid storage disease ]], [[Cholesterol ester storage disease]], [[Fructose-1-phosphate aldolase deficiency]], [[Galactosemia]], [[Glycogen storage disease type IV]], [[Hypervitaminosis A]], [[Parenteral nutrition]]
| bgcolor="Beige" |  [[Abetalipoproteinemia]], [[Carbohydrate deficient glycoprotein syndrome type 1a]], [[Carbohydrate-deficient glycoprotein syndrome type 1b]], [[Ceroid storage disease ]] , [[Cholesterol ester storage disease]], [[Fructose-1-phosphate aldolase deficiency]], [[Galactosemia]], [[Glycogen storage disease type IV]], [[Hypervitaminosis A]], [[Parenteral nutrition]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]]
| bgcolor="Beige" | [[Keratitis-ichthyosis-deafness syndrome, autosomal recessive]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Acetaminophen overdose]]
| bgcolor="Beige" | [[Acetaminophen overdose]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Cerebrohepatorenal syndrome]], [[Fanconi disease]], [[Polycystic kidney disease, autosomal recessive]]
| bgcolor="Beige" | [[Cerebrohepatorenal syndrome]], [[Fanconi disease]], [[Polycystic kidney disease, autosomal recessive]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|  [[Autoimmune cholangiopathy]], [[Autoimmune hepatitis]], [[Graft versus host disease]], [[Primary biliary cirrhosis]], [[Primary sclerosing cholangitis]], [[Reynolds syndrome ]], [[Sarcoidosis]]
| bgcolor="Beige" |  [[Autoimmune cholangiopathy]], [[Autoimmune hepatitis]], [[Graft versus host disease]], [[Primary biliary cirrhosis]], [[Primary sclerosing cholangitis]], [[Reynolds syndrome ]] , [[Sarcoidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Alcoholic liver disease ]]
| bgcolor="Beige" | [[Alcoholic liver disease ]]
|-
|-
|}
|}
Line 175: Line 175:
*[[Fanconi disease]] <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2165837/</ref>
*[[Fanconi disease]] <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2165837/</ref>
*[[Fasciola hepatica]]
*[[Fasciola hepatica]]
*[[Fructose-1-phosphate aldolase deficiency]] <ref> http://ghr.nlm.nih.gov/condition/hereditary-fructose-intolerance</ref>
*[[Fructose-1-phosphate aldolase deficiency]] <ref>http://ghr.nlm.nih.gov/condition/hereditary-fructose-intolerance</ref>
*[[Galactosemia]]
*[[Galactosemia]]
*[[Glycogen storage disease type IV]]
*[[Glycogen storage disease type IV]]
Line 198: Line 198:
*[[Primary biliary cirrhosis]]
*[[Primary biliary cirrhosis]]
*[[Primary sclerosing cholangitis]]
*[[Primary sclerosing cholangitis]]
*[[Reynolds syndrome ]] <ref> http://rarediseases.info.nih.gov/GARD/Condition/4697/Reynolds_syndrome.aspx</ref>
*[[Reynolds syndrome ]] <ref>http://rarediseases.info.nih.gov/GARD/Condition/4697/Reynolds_syndrome.aspx</ref>
*[[Right sided cardiac failure]]
*[[Right sided cardiac failure]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
Line 215: Line 215:
{|
{|


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Differential Diagnosis''' || '''Useful Findings'''
| '''Differential Diagnosis''' || '''Useful Findings'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Alcoholic cirrhosis''' || '''History EtOH, AST/ALT > 2'''
| '''Alcoholic cirrhosis''' || '''History EtOH, AST/ALT > 2'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Chronic Hepatits C Virus (HCV)''' || '''HCV AB'''
| '''Chronic Hepatits C Virus (HCV)''' || '''HCV AB'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Primary Biliary Cirrhosis (PBC)''' || '''Elevated alk phos, AMA+'''
| '''Primary Biliary Cirrhosis (PBC)''' || '''Elevated alk phos, AMA+'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Primary sclerosing cholangitis''' || '''History inflammatory bowel disease (IBD), ANA or ASMA or P-ANCA+'''
| '''Primary sclerosing cholangitis''' || '''History inflammatory bowel disease (IBD), ANA or ASMA or P-ANCA+'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Autoimmune hepatitis''' || '''Hypergammaglobulinemia, ANA/ASMA +'''
| '''Autoimmune hepatitis''' || '''Hypergammaglobulinemia, ANA/ASMA +'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Chronic Hepatitis B Virus''' || '''HBsAg+, HBeAg may be +'''
| '''Chronic Hepatitis B Virus''' || '''HBsAg+, HBeAg may be +'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Hemochromatosis''' || '''Family history+, Fe/TIBC and ferritin elevated'''
| '''Hemochromatosis''' || '''Family history+, Fe/TIBC and ferritin elevated'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Wilson’s disease''' || '''Family history+, young age, low ceruloplasmin'''
| '''Wilson’s disease''' || '''Family history+, young age, low ceruloplasmin'''


|-style="background:silver; color:black"
|- style="background:silver; color:black"


| '''Alpha-1-antitrypsin (AAT) deficiency''' || '''Family history+, young age, low serum AAT'''
| '''Alpha-1-antitrypsin (AAT) deficiency''' || '''Family history+, young age, low serum AAT'''
Line 258: Line 258:


==References==
==References==
{{reflist|2}}
{{reflist|2}}


{{WH}}
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Disease]]


{{WS}}
{{WS}}
{{WH}}

Latest revision as of 20:40, 26 December 2017

Cirrhosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Sudarshana Datta, MD [3]

Overview

There are a wide range of causes for cirrhosis, including alcohol abuse, genetic diseases, cardiac causes, toxins, viruses, and malnutrition. The consequence is the same in all cases with the functional liver tissue being replaced by fibrous scar tissue and regenerative nodules.

Causes

Common causes

Cirrhosis has many possible causes; sometimes more than one cause is present in the same patient. In the Western World, chronic alcoholism and hepatitis C are the most common causes. Hepatitis B is more common in parts of sub-Saharan Africa and Asia.

Causes by Organ System

Cardiovascular Cardiac cirrhosis, Right sided cardiac failure, Constrictive pericarditis, Cor Pulmonale, Tricuspid insufficiency
Chemical / poisoning Aflatoxin
Dermatologic Keratitis-ichthyosis-deafness syndrome, Addison-Gull syndrome , Reynolds syndrome , Tricho-hepato-enteric syndrome
Drug Side Effect Amiodarone, Ethanol, interferon alfacon-1, Isoniazid, Methotrexate, Methyldopa, Sulfasalazine
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Addison-Gull syndrome , Alpha 1-antitrypsin deficiency , Alström syndrome, Autoimmune cholangiopathy, Autoimmune hepatitis, Bearn-Kunkel syndrome , Bile duct stricture, Biliary atresia, Budd-Chiari Syndrome, Caroli disease, Cerebrohepatorenal syndrome, Ceroid storage disease, Cholestasis-oedema syndrome, Norwegian type, Cruveilhier-Baumgarten syndrome, Congenital hepatic fibrosis, Cystic fibrosis, Granulomatous cirrhosis, Hemochromatosis, Hepatic vein thrombosis, Hereditary fructose intolerance, Indian familial childhood cirrhosis, Non-alcoholic steatohepatitis , Primary biliary cirrhosis, Primary sclerosing cholangitis, Reynolds syndrome , Tricho-hepato-enteric syndrome , Wilson disease
Genetic Abetalipoproteinemia, Alagille syndrome, Alpers disease, Alpha 1-antitrypsin deficiency , Alström syndrome, Berardinelli lipodystrophy syndrome, Carbohydrate deficient glycoprotein syndrome type 1a, Carbohydrate-deficient glycoprotein syndrome type 1b, Caroli disease, Ceroid storage disease , Cholestasis-oedema syndrome, Norwegian type, Congenital hepatic fibrosis, Cystic fibrosis, Fanconi disease, Fructose-1-phosphate aldolase deficiency, Galactosemia, Glycogen storage disease type IV, Haemosiderosis, Hemochromatosis, Hereditary fructose intolerance, Keratitis-ichthyosis-deafness syndrome, autosomal recessive, Polycystic kidney disease, autosomal recessive, Porphyria cutanea tarda type 2 (familial), Sickle cell disease, Tyrosinaemia type 1, Wilson disease
Hematologic Budd-Chiari Syndrome, Erythropoietic protoporphyria, Fanconi disease, Haemosiderosis, Hepatic vein thrombosis, Porphyria cutanea tarda type 2 (familial), Sickle cell disease, Thalassemia, Tyrosinaemia type 1
Iatrogenic Bile duct stricture, Graft versus host disease, Parenteral nutrition
Infectious Disease Fasciola hepatica, Hepatitis B, Hepatitis C, Schistosoma haematobium, Schistosoma japonicum, Schistosoma mansoni, Visceral leishmaniasis
Musculoskeletal / Ortho No underlying causes
Neurologic Alpers disease, Cerebrohepatorenal syndrome, Keratitis-ichthyosis-deafness syndrome, autosomal recessive
Nutritional / Metabolic Abetalipoproteinemia, Carbohydrate deficient glycoprotein syndrome type 1a, Carbohydrate-deficient glycoprotein syndrome type 1b, Ceroid storage disease , Cholesterol ester storage disease, Fructose-1-phosphate aldolase deficiency, Galactosemia, Glycogen storage disease type IV, Hypervitaminosis A, Parenteral nutrition
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic Keratitis-ichthyosis-deafness syndrome, autosomal recessive
Overdose / Toxicity Acetaminophen overdose
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte Cerebrohepatorenal syndrome, Fanconi disease, Polycystic kidney disease, autosomal recessive
Rheum / Immune / Allergy Autoimmune cholangiopathy, Autoimmune hepatitis, Graft versus host disease, Primary biliary cirrhosis, Primary sclerosing cholangitis, Reynolds syndrome , Sarcoidosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcoholic liver disease

Causes in Alphabetical Order [1] [2]

Differentiating Different Causes of Cirrhosis

Differential Diagnosis Useful Findings
Alcoholic cirrhosis History EtOH, AST/ALT > 2
Chronic Hepatits C Virus (HCV) HCV AB
Primary Biliary Cirrhosis (PBC) Elevated alk phos, AMA+
Primary sclerosing cholangitis History inflammatory bowel disease (IBD), ANA or ASMA or P-ANCA+
Autoimmune hepatitis Hypergammaglobulinemia, ANA/ASMA +
Chronic Hepatitis B Virus HBsAg+, HBeAg may be +
Hemochromatosis Family history+, Fe/TIBC and ferritin elevated
Wilson’s disease Family history+, young age, low ceruloplasmin
Alpha-1-antitrypsin (AAT) deficiency Family history+, young age, low serum AAT

References

  1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  3. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1813854/#reference-sec
  4. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2165837/
  5. ↑ http://ghr.nlm.nih.gov/condition/hereditary-fructose-intolerance
  6. ↑ http://rarediseases.info.nih.gov/GARD/Condition/4697/Reynolds_syndrome.aspx
  7. ↑ http://www.checkorphan.org/disease/tricho-hepato-enteric-syndrome

Template:WS Template:WH

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