aetiology
Last reviewed 11/2023
- alcoholic liver disease
- viral hepatitis - types B, C and delta
- metabolic:
- haemochromatosis - primary and secondary
- Wilson's disease
- alpha-1 anti-trypsin deficiency
- type IV glycogenosis }
- galactosaemia } very rare
- congenital tyrosinosis }
- primary biliary cirrhosis; secondary biliary cirrhosis
- "lupoid" hepatitis / autoimmune chronic active hepatitis
- hepatic venous outflow obstruction:
- venoocclusive disease
- Budd Chiari syndrome
- "cardiac cirrhosis" from constrictive pericarditis
- toxins/ drugs e.g. methrotrexate, amiodarone, bush tea
- intestinal bypass
- indian childhood cirrhosis - India, SE Asia, Middle East
- cryptogenic - heterogenous group of unknown origin
Notes:
- the most common causes are alcohol, 60-80%; viral hepatitis, 10-20%; biliary cirrhosis, 5-10%; haemochromatosis, 5%
- the frequency of cryptogenic cirrhosis is variable - in the UK, it accounts for about 30% of cases but in other countries such as France and the urban parts of the USA, it is less prevalent and alcohol more so
- in granulomatous lesions such as brucellosis, sarcoidosis and tuberculosis, fibrosis is not followed by nodular regrowth i.e. not cirrhosis
- syphilis causes cirrhosis in neonates but not adults
- schistosomiasis causes fibrosis but not cirrhosis
hereditary haemochromatosis (HH)
alpha -1 - antitrypsin deficiency
autoimmune chronic active hepatitis