Description

Toxic hepatitis is an inflammation of the liver in reaction to certain substances to which it is exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements.

In some cases, toxic hepatitis develops within hours or days of exposure to a toxin. In other cases, it may take months of regular use before signs and symptoms appear.

The symptoms of toxic hepatitis often disappear when the exposure to the toxin stops. But the toxic hepatitis can cause permanent damage to the liver, leading to irreversible scarring of liver tissue (cirrhosis), and in some cases of liver failure, which can be deadly.

Symptoms

Mild forms of toxic hepatitis may not cause any symptoms and can be detected only by blood tests. When the signs and symptoms of toxic hepatitis occur, they may include:

  • Yellowing of the skin and the whites of the eyes (jaundice)
  • Itching
  • Abdominal pain in the upper right portion of the abdomen
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Eruption
  • Fever
  • Weight loss
  • Dark or tea-colored urine

When to see a doctor

See your doctor right away if you have signs or symptoms that worry you.

Overdose of some drugs, such as acetaminophen (Tylenol, others), can lead to liver failure. Seek medical attention right away if you think that an adult or a child has taken an overdose of paracetamol. The signs and symptoms of a possible overdose of paracetamol are:

  • Loss of appetite
  • Nausea and vomiting
  • Upper abdominal pain
  • Comma

If you suspect an overdose of paracetamol, immediately call 911, your local emergency services, or the poison help line. There are two ways you can get help from Poison Control in the united states (U. S: in-line www.poison.org or by calling us at 800-222-1222 . Both options are free, confidential and available 24 hours a day. Do not wait for symptoms to occur. An overdose of acetaminophen can be fatal, but it can be successfully treated if dealt with from the beginning after the ingestion.

Causes

Toxic hepatitis occurs when the liver develops inflammation due to exposure to a toxic substance. Toxic hepatitis can also develop when you take too much of a prescription or over-the-counter medication.

The liver normally removes and breaks down the most drugs and chemicals from your bloodstream. Break down toxins creates by-products that can damage the liver. Although the liver has a great capacity for regeneration, the constant exposure to toxic substances that can cause serious, sometimes irreversible damage.

Toxic hepatitis can be caused by:

  • The consumption of Alcohol. Excessive consumption of alcohol over many years can lead to alcoholic hepatitis — inflammation of the liver due to alcohol, which can lead to liver failure.
  • Over-the-counter pain medications. - Counter pain medications such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage the liver, especially if taken frequently or combined with alcohol.
  • The prescription of drugs. Some medications are linked to severe liver injury include statin drugs to treat high cholesterol, the combination drug amoxicillin-clavulanate (Augmentin), phenytoin (Dilantin, Phenytek), azathioprine (Azasan, Imuran), niacin (Niaspan), ketoconazole, some antiviral drugs and anabolic steroids. There are many others.
  • Herbs and supplements. Some herbs are considered to be dangerous to the liver include aloe vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra. There are many others. Children may develop liver damage if you make the mistake of taking vitamin supplements for sweets and to take large doses.
  • Industrial chemicals. The chemicals that you may be exposed to on the job can cause liver injury. Common chemicals that can cause damage to the liver include dry cleaning solvent carbon tetrachloride, a substance called vinyl chloride (used to make plastics), the herbicide paraquat and a group of industrial chemicals called polychlorinated biphenyls.

Risk factors

Factors that may increase your risk of toxic hepatitis include:

  • Taking over-the-counter pain relievers or prescription of certain medications. Taking a medication or over-the-counter to relieve the pain that carries a risk of damage to the liver, increases the risk of toxic hepatitis. This is especially true if you are taking multiple medications, or take more than the recommended dose of the medication.
  • Having a liver disease. Have serious liver problems such as cirrhosis or non-alcoholic fatty liver makes them more susceptible to the effects of toxins.
  • Have hepatitis. Chronic infection with the hepatitis viruses (hepatitis B, hepatitis C, or one of the other — very rare — hepatitis virus can persist in the body) makes your liver more vulnerable.
  • Aging. As you age, your liver breaks down harmful substances more slowly. This means that the toxins and their by-products stay in your body for a longer time.
  • The consumption of alcohol. Drinking alcohol while you are taking medications, or certain herbal supplements increases the risk of toxicity.
  • The fact of being a woman. Because women seem to metabolize certain toxins more slowly than men, their livers are exposed to higher concentrations in the blood of harmful substances for a longer time. This increases the risk of toxic hepatitis.
  • Have certain genetic mutations. Inherit certain genetic mutations that affect the production and action of liver enzymes that break down the toxins can make you more susceptible to the toxic hepatitis.
  • Working with industrial toxins. Working with certain industrial chemicals puts you at risk of toxic hepatitis.

Complications

The inflammation associated with toxic hepatitis can lead to liver damage and the formation of scars. Over time, this type of scarring, called cirrhosis makes it difficult for the liver to do its job. Finally cirrhosis leads to liver failure. The only treatment for chronic liver failure is to replace the liver with a healthy one from a donor (liver transplant).

Prevention

Because it is not possible to know how it will react to a particular drug, toxic hepatitis, can't always be prevented. But you can reduce your risk for liver problems if you:

  • Limit of medicines. Taken with prescription and over the counter medications only when absolutely necessary. To investigate nondrug options for common problems, such as high blood pressure, high cholesterol, and arthritis pain.
  • Take medications as directed. Follow the instructions exactly for any medication that you take. Do not exceed the recommended amount, even if your symptoms do not seem to improve. Due to the effects of over-the-counter pain relievers sometimes disappears quickly, and is easy to take too much.
  • Be cautious with the use of herbs and supplements. Do not assume that a natural product that does not cause harm. Discuss the benefits and risks with your doctor before taking herbs and supplements. The National Institutes of Health maintains the LiverTox website, where you can search medications and supplements to see if it is linked to liver damage.
  • Do not mix alcohol and drugs. Alcohol and drugs are a bad combination. If you are taking acetaminophen, do not drink alcohol. Ask your doctor or pharmacist about the interaction between alcohol and other prescription and nonprescription medications you use.
  • Take precautions with chemicals. If you work or the use of hazardous chemicals, take all necessary precautions to protect themselves from exposure. If it comes in contact with a harmful substance, please follow the guidelines in your place of work, or call your local office of emergency services or your local poison control center for help.
  • Keep medicines and chemicals away from children. Keep all medications and vitamin supplements away from children and in containers with child-proof so that children do not ingest.

Diagnosis

Tests and procedures used to diagnose toxic hepatitis include:

  • Physical exam. It is likely that your doctor will perform a physical exam and take a medical history. Be sure to bring with you to your appointment of all the medications you are taking, including nonprescription medicines and herbs, in their original containers. Tell your doctor if you are working with industrial chemicals, or may have been exposed to pesticides, herbicides, or other environmental toxins.
  • Blood tests. Your doctor may order blood tests to look for high levels of certain liver enzymes. These levels of enzymes can show how well your liver is working.
  • Imaging tests. Your doctor may recommend an imaging test, to create an image of your liver by ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI). Additional imaging tests may include magnetic elastography and transient elastography.
  • The liver biopsy. A liver biopsy can help to confirm the diagnosis of toxic hepatitis and to help exclude other causes. During a liver biopsy, a needle is used to remove a small sample of tissue from the liver. The sample is examined under a microscope.

Treatment

Doctors will work to determine what is the cause of its damage in the liver. Sometimes it is clear what is the cause of your symptoms, and other times it requires more detective work to locate a cause. In most cases, the suspension of the exposure to the toxin that causes inflammation of the liver is going to reduce the signs and symptoms that you experience.

Treatments for toxic hepatitis may include:

  • Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medications to help relieve nausea and vomiting. Your doctor will also perform a follow-up of liver damage.
  • Medication to reverse the liver damage caused by acetaminophen. If the liver damage was caused by an overdose of acetaminophen, you will receive a chemical called acetylcysteine immediately. The afternoon of this medication is to be administered, the greater is the possibility of limiting the damage in the liver. It is most effective if administered within 16 hours of the overdose of paracetamol.
  • The emergency care. For people who overdose in a toxic medication, emergency care is essential. People who overdose on certain other medicines, acetaminophen may benefit from treatments to remove the offending medication in the body or reduce its toxic effect.
  • Liver transplant.When the function of your liver is severely damaged, a liver transplant may be the only option for some people. A liver transplant is an operation to remove the diseased liver and replace it with a healthy liver from a donor. Most of the livers used in liver transplants come from deceased donors. In some cases, the liver can come from living donors who donate part of their liver.

Liver transplant. When the function of your liver is severely damaged, a liver transplant may be the only option for some people. A liver transplant is an operation to remove the diseased liver and replace it with a healthy liver from a donor.

Most of the livers used in liver transplants come from deceased donors. In some cases, the liver can come from living donors who donate part of their liver.

Preparing for your appointment

Make an appointment with your family doctor or a general practitioner if you have signs or symptoms that worry you. If you are planning to have a liver problem, such as toxic hepatitis, it is likely to be referred to a liver specialist (hepatologist).

Because appointments can be brief, and because there's often a lot to cover, it is a good idea to be well prepared. Here's some information to help you to be prepared and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Have a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their doctor.

For the toxic hepatitis, some basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • There are other possible causes of your symptoms or condition?
  • Could one of the medications that I am taking will be responsible for the damage to my liver?
  • Is my liver damaged?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. These terms and conditions or their treatment affect the outcome of the toxic hepatitis? How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask questions during your appointment at any time.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may allow more time to cover the points you want to address. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • What prescription medications and over-the-counter medications you are taking, and have you started any new medications recently?
  • Do not take paracetamol?
  • Do you take herbal or nutritional supplements?
  • How much alcohol do you drink and how often?
  • Have you noticed yellow color in the white part of your eyes?
  • It has the color of the urine seemed to be more dark?
  • Does anyone in your family has a history of liver disease?
Symptoms and treatment for Toxic hepatitis