Inflammation of the liver

definition

Inflammation of the liver (hepatitis) is a reaction of the immune system and vascular connective tissue to internal and external damage in the liver.

Causes and Symptoms

There are several causes of liver inflammation:

• Viruses

• bacteria

• Autoimmune reaction: Through the own immune system (immune system)

• Drugs or toxins

A further distinction is made between acute liver inflammations that last less than two months and show a rapid course. If the acute inflammation does not heal, it can develop into chronic liver inflammation if the inflammation lasts for more than 6 months. The chronic inflammation has a gradual course and uncharacteristic symptoms, which can lead to long-term effects that can lead to death.

The symptoms of inflammation of the liver specifically differ depending on the type and cause of the inflammation. In general, symptoms such as malaise, fatigue, loss of appetite, nausea, fatigue and fever occur. In some cases jaundice occurs (Jaundice), in which the skin and eyes turn yellow and the urine turns dark.

Viral causes

The causative agents of viral liver inflammation are called Hepatitis designated. All of them cause liver inflammation, but they do not belong to the same virus family.

Acute hepatitis

The causative agents of Hepatitis A and E. trigger acute inflammation and become with the stool (fecal) excreted and via the mouth (orally) recorded. This transmission path is therefore referred to as fecal-oral.

The Hepatitis A (Liver inflammation A) is supported by the Hepatitis A virus transmitted and is as Travel hepatitis known because it is through contaminated water or raw foodsuch as oysters or lettuce transferred (low standard of hygiene). The first symptoms of acute hepatitis appear 3-5 weeks on and it can become a mild jaundice come. The course of hepatitis A is age-dependent and usually lasts about 5 weeks on. When traveling to areas where hepatitis A (Tropics and subtropics) is common, you should get vaccinated.

Also the Hepatitis E. (Hepatitis E virus) is travel hepatitis (Consumption of risk products such as lettuce, ice cubes, tap water), but can also be done in Germany through the Consumption of undercooked meat (Wild boar, offal) be transmitted. Risk areas are the Indian subcontinent, Africa, Southeast Asia and the Caribbeanif you stay in rather modest accommodations on the trip.
The first symptoms appear after 2-8 weeks that disappear on their own. The infection can get more severe with age and has a mortality rate of 1-4%. Especially at Pregnant women a hepatitis E infection can be particularly severe. Currently is in Germany no vaccine Approved against heptatitis E.

Chronic hepatitis pathogens

The causative agents of chronic liver inflammation include Hepatitis B., C. and D viruses, which mostly come via the bloodstream (parenteral) get into the body. The following symptoms occur with chronic liver inflammation: Accumulation of water in the abdomen (Ascites), Jaundice (Jaundice), Rash on the palm of the hand (Palmar erythema) and it comes to Remodeling of the liver tissue.

In Germany there are 400,000 peoplewho carry the hepatitis B virus. The viral disease is still widespread worldwide and occurs mainly in Africa, Southeast Asia and South America often on. Hepatitis B is mainly transmitted via Sexual contact, but can also be done via the saliva or that Breastfeeding pass from mother to child.
Another transmission route is via that blood - for example by sharing a needle (Needle sharing) in drug abuse of heroin.

The incubation period of the disease is between 45 - 180 days and ends, if it is chronic, in 30-90% of cases 5 years after infection fatal. However, this disease can be caused by a Interferon therapy or the application of Nucleoside analogs be treated. Prophylactic one should vaccinate leave to prevent infection.
The vaccination against hepatitis B also indirectly protects against the hepatitis D virus, which is usually transmitted via needle sharing. Hepatitis C is also very common worldwide and is also mainly transmitted via intravenous drug use. Sexual transmission plays a rather subordinate role.

There are also some viruses that cause generalized infections, but can also affect the liver. This includes that HI virus (HIV), the Epstein-Barr Virus (Pfeiffer's glandular fever), the Varicella zoster virus (chickenpox, Shingles) and the Cytomegalovirus (severely flu-like symptoms). In addition, viruses can also trigger hepatitis, which is otherwise common for mumps, rubella or various febrile illnesses are responsible.

Bacterial causes

Some bacteria can also lead to liver inflammation, such as the causative agent of the tuberculosis or the syphilis. There are also some Fungal or parasitic diseasescausing inflammation of the liver.

Other causes

Liver inflammation can also result from Damage with toxic substances occur, such as excessive alcohol consumption over a long period of time.
But certain drugs also damage the liver, for example pain relievers Diclofenac or Paracetamol.

„Physical“Forms of liver inflammation occur Bruised liver on and are called post-traumatic hepatitis designated. But also a previous one radiotherapy can cause liver inflammation.

Other triggers for liver inflammation may also be localized outside the liver. So can Inflammation from the biliary tract rise to the liver and cause inflammation there as well. There are also congenital causes of liver inflammation, some of which Iron or copper storage diseases counting.

Diagnosis of inflammation of the liver

The liver inflammation is determined by the doctor using blood tests, which also determine the cause of the disease (Viruses, bacteria, metabolic disease) can determine.
The blood test can also be used to determine how advanced the inflammation of the liver is.

More information can be found here: Bilirubin

If a blood test is not clear enough, the next step is an ultrasound to make a diagnosis. Since the ultrasound has no side effects, this is a very used diagnostic method.

Read more on the topic: Ultrasound of the abdomen
An MRI of the liver is also available as a further examination option.Like ultrasound, liver MRI does not in itself have any side effects if there are no contraindications.
In contrast to ultrasound, further valuable information can be obtained through MRI.
The disadvantage is the effort and cost of the examination, in some cases contrast media is used for the examination, which can cause side effects.
Read more on the topic: MRI of the liver
If the inflammation is chronic, a tissue sample is taken from the liver (liver biopsy) to assess the causes and the quality / condition of the liver tissue.

For more information, please also read our page Liver values.

You might also be interested in this topic: Ferritin

Consequences of inflammation of the liver

Inflammation of the liver causes this in the long term Death of liver tissue (necrosis). Since the liver has a high regenerative capacity, new cells can form after the inflammation has subsided and one carries after an acute illness no damage from that.

Is there a chronic inflammation the liver can no longer produce enough new cells and the The organ's efficiency decreases. It is increased connective tissue formed in the liver and it will form nodethat are irreversible. The resulting clinical picture is called Cirrhosis of the liver. Especially infections with Hepatitis B or C. can also Cancers lead in the liver.

Therapy and prophylaxis

A vaccination against hepatitis viruses to prevent infections and special precautions help in areas with poor hygiene standards to avoid liver inflammation. Furthermore, one should only consume alcohol in moderation.

If symptoms of liver inflammation occur, it is essential a doctor should be consulted. How the liver inflammation is treated depends on the cause.