Cirrhosis cryptogenic

Cholestatic disorder Alcohol-related cirrhosis Autoimmune cirrhosis Cryptogenic cirrhosis Haemochromatosis Alpha-l-antitrypsin deficiency Wilson s disease Primary biliary cirrhosis ... 

The main indications for liver transplantation include chronic hepatitis C, alcoholic liver disease, nonalcoholic fatty liver disease, and cryptogenic cirrhosis. 

Causes of cirrhosis can usually be identified by the patient s history combined with serological and histological investigation. Alcoholic liver disease and hepatitis C and B are the most common causes of cirrhosis. The association of excessive alcohol consumption with liver disease has been recognised for centuries. After the identification of the hepatitis C vims and of non-alcoholic steatohepatitis in obese patients with diabetes, the diagnosis of cirrhosis without an apparent cause (cryptogenic cirrhosis) is rarely made. Genetic causes of cirrhosis include haemochromatosis and Wilson s disease. 

Patient 2 Patient Information Name/DoB/unit number Colin Day, 43 years old Diagnosis (lype/cause) (if known) Cryptogenic cirrhosis Relevant biochemical tests ... 

Liver biopsy - established cryptogenic cirrhosis (inactive). No cholestasis... 

Cryptogenic cirrhosis Chronic viral hepatitis Non-alcoholic steatohepatitis (NASH)... 

In acute viral hepatitis C, the HCV RNA usually clears from the serum once the infection is over — although the anti-HCV test remains positive for a long time after this. However, the combination of increased GPT and a positive anti-HCV test of the first generation nearly always points to infectious HCV. Subsequent to the EIA test, 95% of the positive sera demonstrated cRNA by PCR, so that infectivity could be confirmed. Eor this reason, neither anti-HCV-positive blood donors nor blood units can be released for transfusion. As a check for hepatitis B-negative patients with liver cell carcinoma, the EIA test displayed positivity in 83% of cases. In patients with aetiologically unresolved cirrhosis, the EIA test was positive in 62% of cases, i. e. a large number of the cryptogenic chronic cases of hepatitis and cirrhosis were probably caused by HCV infection. 

From present knowledge, it can be assumed that numerous cases of cryptogenic chronic hepatitis or cryptogenic cirrhosis are attributable to the presence of NASH in terms of aetiopathogenesis. 

Clark, J.M., Diehl, A.M. Nonalcoholic fatty liver disease. An underrecognized cause of cryptogenic cirrhosis. J. Amer. Med. Ass. 2003 289 3000-3004... 

At the end of the morphological development of chronic hepatitis, aetiologically defined cirrhosis occurs in a certain percentage of cases. In this connection, no primary cirrhosis exists (as with the exclusively historical term primary biliary cirrhosis). Even though cryptogenic cirrhosis may be in evidence, the term primary is not acceptable because cirrhosis is not a primary occurrence ... 

Ayata, G., Gordon, FJ)., Lewis, D., Pomfret, E., PomposeUl, J.J., Jenkins, R.L., Khettry, U. Cryptogenic cirrhosis Clinicopathologic findings at and after liver transplantation. Human Path. 2002 33 1098-1104... 

Caldwell, S.H., Oelsner, D.H., lezzoni, J.C., Hespenheide, E.E., Battle, E.H., Driscoll, C.J. Cryptogenic cirrhosis clinical characterization and risk factors for underlying disease. Hepatology 1999 29 664-669... 

Poonawala, A., Nair, S.P., Thuluvath, P.J. Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis A case-control study. Hepatology 2000 32 689 - 692... 

Ratzin, V., Bonyhay, L., di Martino, V., Charlotte, F., Cavallaro, L., Say h-Tainturier, M.H., Giral, R, Grimaldi, A., Opolon, R, Poynard, T. Survival, liver failure, and hepatocellular carcinoma in obesity-related cryptogenic cirrhosis. Hepatology 2002 35 1485-1493... 

Alcoholic cirrhosis Autoimmune hepatitis Cryptogenic cirrhosis HBV and HDV HCV... 

Hodges J, MiUward-Sadler G, Barbatis C, Wright R, Heterozygous MZ alpha 1-antitrypsin deficiency in adults with chronic active hepatitis and cryptogenic cirrhosis. N Engl J Med 1981 304 557-60. 

Includes alcoholic and cryptogenic cirrhosis, acute viral and active chronic hepatitis. 

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