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Alcoholic liver fibrosis
Last reviewed: 07.07.2025
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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 sign is increased proliferation of fibrous tissue around the central veins of the liver lobules (perivenular fibrosis). Many patients also develop pericellular fibrosis - the spread of connective tissue strands from the central zone of the liver lobule in the form of a mesh into the parenchyma along the sinusoids and hepatic beams.
Characteristic clinical and laboratory manifestations of alcoholic liver fibrosis:
- subjective symptoms - general weakness, dyspeptic symptoms (poor appetite, periodic nausea, belching, bitterness in the mouth), pain in the right hypochondrium - moderate but long-lasting;
- mild to moderate hepatomegaly;
- liver function test results are unchanged or change slightly - serum activity of aminotransferases and γ-glutamyl transpeptidase is increased;
- characterized by an increase in the content of proline and hydroxyproline in the blood - markers of intensive fibrosis formation, as well as an increase in the excretion of hydroxyproline in the urine.
A reliable diagnosis of alcoholic liver fibrosis can only be made by histological examination of liver biopsies. Particularly characteristic is the combination of centrilobular perivenular fibrosis with fatty liver degeneration. In a later phase, pericellular fibrosis appears - the spread of fibrosis from the centrilobular zone into the parenchyma along the sinusoids and hepatocytes.
Alcoholic liver fibrosis can be considered as a precursor to liver cirrhosis. With continued alcohol consumption, fibrosis transforms into liver cirrhosis.
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