Alcoholic liver fibrosis
Last reviewed: 23.04.2024
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Alcoholic liver fibrosis develops in 10% of patients with chronic alcoholism. The main pathogenetic factor of alcoholic liver fibrosis is the ability of ethanol to stimulate the proliferation of connective tissue. A characteristic histological feature is an increased proliferation of fibrous tissue around the central veins of the hepatic lobules (perivennular fibrosis). In many patients, pericellular fibrosis also develops-the proliferation of connective tissue strands from the central zone of the hepatic lobule in the form of a mesh in the parenchyma along the sinusoids and hepatic beams.
Characteristic clinical and laboratory manifestations of alcoholic liver fibrosis:
- subjective symptoms - general weakness, dyspeptic phenomena (poor appetite, occasional nausea, belching, bitterness in the mouth), pain in the right subcostal area - moderate but prolonged;
- minor or moderate hepatomegaly;
- indicators of functional liver samples were not changed or changed insignificantly - serum aminotransferase activity was increased, - y-glutamyltranspeptidase;
- characteristic increase in blood levels of proline and hydroxyproline - markers of intense fibrosis, as well as increased excretion of hydroxyproline in the urine.
A reliable diagnosis of alcoholic liver fibrosis can be made only with the help of histological examination of liver biopsy specimens. Particularly characteristic is the combination of centrolobular perivennular fibrosis with fatty liver dystrophy. In a later phase, there is pericellular fibrosis - the spread of fibrosis from the centrolobular zone to the parenchyma along the sinusoids and hepatocytes.
Alcoholic liver fibrosis can be considered as a manifestation of liver cirrhosis. With continued use of alcohol, fibrosis is transformed into cirrhosis of the liver.
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