Key Points 1 The clinical presentation, prognosis, and management of several liver disorders can be different in older adults than in younger persons. 2 Hepatic blood flow, liver size, and hepatic regenerative capacity decrease with age; these changes result in…
Key Points 1 The liver is physiologically immature during the perinatal period, and significant maturational changes in hepatic metabolic processes occur in early life. These metabolic processes affect the presentation of and reaction to viral and toxin exposures. 2 Inherited…
Key Points 1 Abnormal liver biochemical test levels are associated with many different systemic diseases. These abnormalities are generally incidental, but in some systemic diseases the liver may be severely compromised ( Table 24.1 ). TABLE 24.1 The Liver in…
Key Points 1 Liver diseases in pregnancy include those that occur exclusively in pregnancy and those that occur coincidentally in pregnancy or are present at the time of pregnancy. 2 Normal physiologic changes in pregnancy may alter the normal range…
Key Points 1 Liver involvement (cardiac hepatopathy) in either forward or backward heart failure is frequent, the extent of which depends on the severity of the heart failure. 2 Backward heart failure causes congestion of the liver with hepatomegaly with…
Key Points 1 Hepatic vein occlusion, or Budd-Chiari syndrome (BCS), is an uncommon disorder characterized by hepatomegaly, ascites, and abdominal pain. The disorder most often occurs in patients with an underlying thrombotic diathesis including polycythemia vera, factor V Leiden mutation,…
Key Points 1 Alpha-1 antitrypsin deficiency (α-1 ATD) is the most common metabolic liver disease in childhood. The diagnosis should be considered in all adults and children with chronic hepatitis or cirrhosis of unknown origin. α-1 ATD is associated with…
Key Points 1 Wilson disease (WD) is an autosomal recessive disorder of copper metabolism caused by disease-specific defects in the ATP7B gene that encodes a copper-transporting P-type adenosine triphosphatase (ATPase) expressed primarily in the trans-Golgi network of hepatocytes. 2 Loss…
Key Points 1 Hereditary hemochromatosis (HH) is an inherited disorder characterized by iron-mediated tissue injury reflecting impaired regulation of intestinal iron absorption. 2 Classic HH is most commonly associated with autosomal recessive inheritance of mutations in the HFE gene that…
Key Points 1 Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease that frequently occurs in association with inflammatory bowel disease (IBD), usually ulcerative colitis. 2 The diagnosis of PSC is based on clinical, biochemical, and, most importantly, cholangiographic findings…