Liver Cirrhosis – Definition & Pathology

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Cirrhosis represents a late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules. It is generally considered to be irreversible in its advanced stages, at which point the only treatment option may be liver transplantation. However, reversal of cirrhosis (in its earlier stages) has been documented in several forms of liver disease following treatment of the underlying cause. Patients with cirrhosis are susceptible to a variety of complications, and their life expectancy is markedly reduced.
Etiologies and Classification — There are numerous causes of liver disease that can result in cirrhosis, either by causing chronic hepatic inflammation or cholestasis. The most common causes of cirrhosis in the United States are hepatitis C, alcoholic liver disease, and nonalcoholic liver disease, which together accounted for approximately 80 percent of patients on the liver transplantation waitlist between 2004 and 2013 .

In developed countries, common causes of cirrhosis include:
— Chronic viral hepatitis (hepatitis B, C)
— Alcoholic liver disease
— Hemochromatosis
— Nonalcoholic fatty liver disease

Less common causes include:
— Autoimmune hepatitis
— Primary and secondary biliary cirrhosis
— Primary sclerosing cholangitis
— Medications (eg, methotrexate, isoniazid)
— Wilson disease
— Alpha-1 antitrypsin deficiency
— Celiac disease
— Idiopathic adulthood ductopenia
— Granulomatous liver disease
— Idiopathic portal fibrosis
— Polycystic liver disease
— Infection (eg, brucellosis, syphilis, echinococcosis, schistosomiasis)
— Right-sided heart failure
— Hereditary hemorrhagic telangiectasia
— Veno-occlusive disease

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