Key Points 1 Primary biliary cholangitis (PBC, formerly known as primary biliary cirrhosis) is a chronic cholestatic liver disease that typically affects middle-aged women. Its pathogenesis includes a combination of environmental and genetic factors. 2 Genetic studies suggest that the…
Key Points 1 Hepatic encephalopathy (HE) occurs only in the setting of significant liver disease. Any neuropsychiatric symptom or sign in a patient with severe liver dysfunction should be considered HE until proven otherwise. 2 HE may be covert or…
Key Points 1 The term hepatorenal syndrome (HRS) refers to kidney failure in patients with decompensated cirrhosis. 2 HRS is characterized by a rapid decline of kidney function and is associated with a poor prognosis and high resource utilization. 3…
Key Points 1 Cirrhosis accounts for 85% of the cases of ascites in the United States; the development of ascites is associated with a 50% 2-year survival rate. 2 Abdominal paracentesis with ascitic fluid analysis is a safe and cost-effective…
Key Points 1 Patients with cirrhosis with clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] >10 mm Hg) develop esophageal varices at a rate of 8% per year. This threshold is also required for development of other complications of…
Key Points 1 The major causes of cirrhosis include chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), and hemochromatosis. 2 Etiologic classification of cirrhosis is more clinically relevant than morphologic classification (micronodular, macronodular, mixed), because morphologic…
Key Points 1 The 10 most frequent causes of acute drug-induced liver injury (DILI) in the prospective Drug-Induced Liver Injury Network (DILIN) are amoxicillin-clavulanic acid (amox-clav), isoniazid (INH), nitrofurantoin, sulfamethoxazole-trimethoprim (SMX-TMP), minocycline, cefazolin, azithromycin, ciprofloxacin, levofloxacin, and diclofenac. These 10…
Key Points 1 Hepatic steatosis, the accumulation of triglyceride droplets in hepatocytes, is found in one third to one half of all adults in the United States and is an important cause of elevated serum aminotransferase levels (typically <250 U/L).…
Key Points 1 Alcoholic liver disease (ALD) remains one of the most prevalent forms of liver disease in the United States. Worldwide, numerous epidemiologic studies have confirmed a correlation between per capita alcohol consumption and liver-related deaths. 2 The risk…
Key Points 1 Criteria for the diagnosis of autoimmune hepatitis have been codified with development of two diagnostic scoring systems that can support clinical judgment in the diagnosis of difficult cases. 2 Presentations range from acute severe (fulminant) to asymptomatic…