2012-9-27 Characteristic of cirrhosis CIRRHOSIS AND ITS COMPLICATIONS Dr Jinsheng Guo Zhong Shan Hospital, Fu Dan University architecture Etiologies of Cirrhosis Factors that contribute to the risk of developing cirrhosis Regular(moderate)alcohol consumption Drug and chemicals e.g- PBC, AlH No Alcoholic Liver Cirrhosis older age, obesity, insulin resistance or type 2 diabetes pattis lipidemia(all Cryptogenic Genetic impact(single nucleotide polymorphisms DIsorders and brugs It Can cause DiSorders and brugs inat can cause panic ting hepatic blood flo g chronic hepatitis B or CI sitic (eg, echinococcosis) occlusive disease d antineoplastic agents2012-9-27 1 CIRRHOSIS AND ITS COMPLICATIONS Dr. Jinsheng Guo Zhong Shan Hospital, Fu Dan University Characteristic of Cirrhosis Normal Liver Cirrhotic Liver A chronic, progressive, diffuse liver disease Fibrosis and disorganization of the lobular and vascular architecture histologically Chronic hepatitis with fibrosis 10-50 yrs Liver Cirrhosis Nonalcoholic steatohepatitis （NASH） Alcoholic Steatohepatitis (ASH) Long term, 80g/d, 10yr Drug and chemicals DILI Autoimmune e.g., PBC, AIH Biliary Schistosomiasis Chronic viral hepatitis HBV, HCV Etiologies of Cirrhosis Cryptogenic Inherited Circulation disturbance veno-occlusive disease, Budd-Chiari syndrome, constrictive pericarditis Wilson’s diseases hemochromatosis Factors that contribute to the risk of developing cirrhosis Regular (moderate) alcohol consumption age older than 50 years male gender older age, obesity, insulin resistance or type 2 diabetes hypertension, and hyperlipidaemia (all features of the metabolic syndrome) >= factors Genetic impact (single nucleotide polymorphisms) Disorders and Drugs That Can Cause Hepatic Fibrosis  Infections Viral (e.g., chronic hepatitis B or C) Bacterial (eg, brucellosis) Parasitic (eg, echinococcosis)  Drugs and chemicals Alcohol Amiodarone Chlorpromazine Isoniazid Methotrexate Methyldopa Oxyphenisatin Arsenicals Oral contraceptives (Buddi-Chiari) Pyrrolidizine alkaloids and antineoplastic agents  Disorders affecting hepatic blood flow Budd-Chiari syndrome Heart failure Hepatic veno-occlusive disease Portal vein thrombosis (venoocclusive disease)  Mechanical obstruction Biliary obstruction (chronic)  Metabolic abnormality Nonalcoholic fatty liver disease  Autoimmune Primary biliary cirrhosis Autoimmune hepatitis Primary sclerosing cholangitis Disorders and Drugs That Can Cause Hepatic Fibrosis