Causes and risk factors
Function of liver is breaking down of complex substances into simple substances. Some chemicals are difficult for liver to breakdown which affects the liver causing injury. They include exposure to toxic substances, consumption of excess alcohol, certain medications, industrial chemicals; certain herbs are also dangerous for liver.
Clinical presentation
Patient presents with features such as yellowing of the skin and eyes [jaundice], itching of skin, rash. Patient experiences pain and discomfort in the upper right portion of the abdomen. Associated symptoms include fatigue, loss of appetite, nausea and vomiting, weight loss. Additional signs and symptoms such as Hepatomegaly, spleenomegaly, encephalopathy, ascites [retention of fluid in abdominal cavity], abdominal distension, pale-colored stools, dark or tea-colored urine are also seen. Untreated or delayed diagnosis of toxic hepatitis leads to liver cirrhosis and ultimately liver failure.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. History of exposure to or consumption of toxic material which can cause toxic hepatitis will lead to the diagnosis. Hepatomegaly can be easily diagnosed on physical examination of the abdomen. Routine blood tests, Liver function test is recommended. Imaging studies such as ultrasound examination of abdomen, CT scan, MRI to view liver may be useful for further evaluation. Invasive procedures like ERCP; MRCP to check the condition of bile duct is advised. liver biopsy confirms the diagnosis.
Treatment
Stoppage of the exposure to toxic substances is the main line of treatment. Medications are given to reverse the liver damage caused by drug overdose. Supportive care and symptomatic treatment by intravenous fluid administration is given to manage the condition. Doctor will advise to choose a healthy diet, reduce alcohol intake, and quit smoking, caution in consumption of vitamin supplements or over the counter medications. Liver transplant may be needed if the patient is unresponsive to any of the above treatment.
