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Cirrhosis in adults: Etiologies, clinical manifestations, and diagnosis

Authors
Eric Goldberg, MD
Sanjiv Chopra, MD, MACP
Section Editor
Bruce A Runyon, MD
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF

INTRODUCTION

Cirrhosis represents a late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules. It is generally considered to be irreversible in its advanced stages, at which point the only treatment option may be liver transplantation. However, reversal of cirrhosis (in its earlier stages) has been documented in several forms of liver disease following treatment of the underlying cause. Patients with cirrhosis are susceptible to a variety of complications, and their life expectancy is markedly reduced. (See "Cirrhosis in adults: Overview of complications, general management, and prognosis", section on 'Prognosis'.)

This topic will review the etiologies, clinical manifestations, and diagnosis of cirrhosis. An overview of the complications, prognosis, and general management of cirrhosis is discussed separately. (See "Cirrhosis in adults: Overview of complications, general management, and prognosis".)

ETIOLOGIES AND CLASSIFICATION

There are numerous causes of liver disease that can result in cirrhosis, either by causing chronic hepatic inflammation or cholestasis. The most common causes of cirrhosis in the United States are hepatitis C, alcoholic liver disease, and nonalcoholic liver disease, which together accounted for approximately 80 percent of patients on the liver transplantation waitlist between 2004 and 2013 [1].

In developed countries, common causes of cirrhosis include [2]:

Chronic viral hepatitis (hepatitis B, C)

                               

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Literature review current through: Nov 2016. | This topic last updated: Mon Aug 15 00:00:00 GMT 2016.
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