The liver is an organ in vertebrates, including humans, that plays an important role in metabolism and performs a number of functions in the body – detoxification, glycogen storage and plasma protein synthesis. It also synthesizes bile, which is important for digestion.
The liver is an organ in vertebrates, including humans, that plays an important role in metabolism and performs a number of functions in the body – detoxification, glycogen storage and plasma protein synthesis. It also synthesizes bile, which is important for digestion. Medical terms related to the liver often begin with hepato-, which comes from the Greek word for liver.
The liver is the largest (after the skin), morphologically and functionally most complex human organ. His weight is about 2.5% of his total body weight. It is located in the right upper abdomen, behind the hind ribs and under the lungs.
More than 400 vital functions of the liver can be listed. The main ones are:
- Forms blood by the 7th month of pregnancy;
- Participates in the conversion of food into ingredients that the body uses for its basic needs. Produces and stores proteins, fats, reserve carbohydrates, iron and vitamins;
- Through the bile formed in it, it participates in the assimilation of fats in the intestines, some vitamins (vitamins A, D, E, K), as well as the immunosuppressants that transplant recipients take;
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Some proteins synthesized in the liver play a central role in blood clotting processes;
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It plays a central role in the disposal and emission of metabolic waste products and drugs, which in some cases are toxic to humans;
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Participates in the fight against infections and in particular those whose entrance is the intestine;
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The only organ in the human body that has the ability to self-regenerate.
Table of Contents
Liver disease – Hepatitis
Hepatitis is a Latin word that means inflammation of the liver, in which its cells are destroyed. According to the World Health Organization, this is one of the most common diseases in the world. Depending on the duration of its course, hepatitis is mainly divided into two groups:
- acute – lasts less than six months.
- chronic – lasts more than six months.
What is acute hepatitis? Acute hepatitis is characterized by violent inflammatory processes in the liver. It usually has severe symptoms, the most common being: pain in the liver (right hypochondrium), jaundice, dark urine, white stools, severe fatigue, nausea, vomiting and others. In most cases, with appropriate treatment, acute hepatitis can be completely cured in 1 to 6 months.
The main causes of acute hepatitis are:
- Hepatitis viruses – hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E.
- Infectious mononucleosis virus, cytomegalovirus and others.
- Alcohol poisoning
- Severe bacterial infections: brucellosis, leptospirosis, etc.
- Some parasites: canine tapeworm (echinococcus), liver methyl, amoeba and others.
- Poisonous mushrooms: white fly agaric, green fly agaric, and aothers.
What is chronic hepatitis?
When the inflammation of the liver persists for more than 6 months, hepatitis becomes chronic. Characteristic of chronic hepatitis is the alternation of periods of attenuation and activation of inflammatory processes. If this process is not interrupted, it leads to severe and difficult to treat complications of chronic hepatitis. The main causes of chronic hepatitis are:
- Hepatitis virus infection – hepatitis B, hepatitis C, hepatitis D viruses
- Chronic alcohol abuse
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Medications
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Autoimmune hepatitis
- Congenital metabolic disorders – relatively rare diseases – Wilson’s disease and others.
Jaundice Jaundice is a symptom / yellowing of the skin, sclera and visible mucous membranes /, characteristic of diseases of the liver and bile ducts. This symptom is due to an increase in the amount (concentration) of bilirubin in the blood and its deposition in the skin, sclera and mucous membranes. Elevated levels of bilirubin in the blood are a consequence of a number of disease states.
There is a so-called hemolytic jaundice, which occurs during hemolysis. In diseases of the liver with damage to liver cells or blockage of bile flow in the intrahepatic bile ducts occurs so. liver / hepatic, parenchymal / jaundice. In case of complete obstruction / cessation, blockage, stopping / of the outflow of bile through the extrahepatic bile ducts, the so-called posthepatic / posthepatic / jaundice.
Toxic hepatitis
Toxic hepatitis is an inflammatory damage to the liver caused by substances with toxic effects on liver cells / etc. hepatotoxic substances. These substances are various chemical compounds containing phosphorus, carbon tetrachloride, carbon tetrachloride, lead, zinc, arsenic, chlorine and others.
The development of toxic hepatitis is favored by temporary factors: previous liver disease, chronic alcoholism, malnutrition, diseases of the pancreas, stomach and intestines of an inflammatory nature.
Drug-induced hepatitis
Drug-induced hepatitis is a drug-induced liver damage. Many drugs have direct or indirect hepatotoxic effects.
Liver cirrhosis
Cirrhosis of the liver is a chronic progressive disease of the liver. Men get sick more often than women / in a ratio of 3.6: 1 /. Most often, liver cirrhosis develops between the ages of 30 and 60 years. Liver cirrhosis is the most severe consequence of chronic active hepatitis and other chronic liver diseases associated with permanent damage, loss of liver cells and their replacement by defective tissue (connective tissue). Cirrhosis combines three main disease processes: necrosis of liver cells, regeneration of liver cells with nodular restoration of liver structure, growth of connective tissue in the liver.
These three processes develop progressively to varying degrees. They disrupt the normal structure of the liver and its blood supply, as well as its vital functions. This disease can be caused by many factors, but most often it is due to alcohol and viral hepatitis. In fact, alcoholism is only one of the causes of liver cirrhosis. Alcoholic cirrhosis accounts for about half of all cases of cirrhosis of the liver. It is associated with long-term alcohol abuse.
The amount of alcohol needed to damage the liver varies greatly from person to person. In women, 25-50 grams of alcohol a day can cause cirrhosis of the liver, while in men twice the amount is needed. Alcohol damages the liver by blocking the normal metabolism of proteins, fats and carbohydrates. A large percentage of cirrhosis is due to viral hepatitis – type B, C and D, which cause inflammation of the liver, and it can lead to cirrhosis for several decades.
Hepatitis B and C liver infection are widespread around the world and viral hepatitis is the most common cause of liver cirrhosis worldwide. The hepatitis D virus infects the liver of people who are already infected with hepatitis B. Prolonged use of hepatotoxic substances, albeit in small amounts, also causes cirrhosis of the liver.
The number and type of such hepatotoxic chemicals and drugs are constantly increasing and are currently difficult to cover. In 25% of cases the etiological cause cannot be assessed – cryptogenic cirrhosis.
Biliary liver cirrhosis
The causes of biliary cirrhosis are not well understood. It is relatively rare. The disease is probably a consequence of congenital underdevelopment of the intrahepatic bile ducts, intrauterine overexposure to viral hepatitis. It is thought to be an autoimmune process, as specific autoimmune antibodies have been found in patients with bile duct cells in the liver. The disease is more common in women.
When the bile ducts are blocked, this can also lead to cirrhosis. The disease is called biliary atresia and is the absence, damage or obstruction of the bile ducts, in which bile returns to the liver.
Cardiac / congestive / liver cirrhosis
In the liver, the normal outflow of blood that fills the liver veins is prevented, resulting in chronic oxygen deficiency. Most of the liver cells atrophy and in their place connective tissue grows / the so-called. fibrosis /, the normal structure of the liver and its function is disturbed.
Steatosis of the liver
Hepatic steatosis is a fatty degeneration of the liver. Liver cells accumulate a lot of fat in the form of fine fat droplets. The most common causes of hepatic steatosis are chronic alcoholism, diabetes, malnutrition or malnutrition, tuberculosis and other infectious diseases, pregnancy, menopause, chronic heart and lung disease.
Hemochromatosis
Hemochromatosis is a disease of the body’s metabolism. It is chronic and is characterized by increased deposition of iron (in the form of hemosiderin) in the liver and other internal organs (lungs, blood vessels and other places in the body). When a consequence of the accumulation of hemosiderin in the affected organs, changes occur that disrupt their normal function.
Wilson’s disease
Represents an excessive accumulation of honey in the liver, brain, kidneys and cornea of the eyes; 1-antitrypsin deficiency and other very rare diseases such as galactosemia, glygogen deposition disease.
Liver abscess
An abscess (abscess) is the accumulation of pus in the liver tissue to form a purulent cavity surrounded by a capsule. The abscess is usually single, but it is not uncommon for multiple abscesses to be found. It is a consequence of bacterial inflammation caused by streptococci, staphylococci, enterococci, protozoa, amoebae, various intestinal parasites. To find out if we have livr problems, the following symptoms will help us:
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heartburn after each meal
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bitterness in the mouth; weakness, reduced ability to work;
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red spots on the skin;
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too smooth and as if varnished palms;
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yellow circles around the eyes, white of the eye reddens;
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frequent headaches and heaviness in the temples.
Most of the livr diseases covered by the statistics have been found in already ill athletes. There are reports of unequivocal evidence of livr damage in athletes using anabolic steroids. Currently, the quality of products on the black market is deteriorating. Due to the efforts of the authorities to limit the trade in anabolics, more and more impure steroids are reaching the consumer.
Enzymes in blood serum
- Aspartate aminotransferase (AsAT)
- Alanine aminotransferase (ALT)
These are two coenzyme pyridoxal phosphate transferases that catalyze the transfer of amino groups between alpha-amino and alpha-keto acids. They have a particularly high activity in the livr, heart and skeletal muscles. When these organs are damaged, the level of both enzymes in the blood increases. ALT is entirely in the cytoplasm, while AST has cytoplasmic and mitochondrial forms (isoenzymes), which have a similar catalytic function but a different structure. Transaminases are the most commonly studied enzymes in the clinical laboratory.
- Indications for examination: suspicion of livr damage (viral hepatitis, damage from hepatotoxic drugs, livr tumor, cirrhosis, etc.)
- Reference limits: When measured in optimized conditions and 37 ° C, the upper reference limit for AST is 35 U / l, and for ALT – up to 40 U / l.
- Magnification 10 times or more above the upper reference limit: acute hepatitis and livr necrosis (hepatocytolysis);
- Magnification between 5 and 10 times above the upper reference limit: cholestasis and chronic hepatitis.
- Increase up to 5 times above the upper reference limit: newborns – livr disease (with hepatocytolysis);
Alkaline phosphatase
Alkaline phosphatase hydrolyzes various phosphate esters and transfers phosphate radicals to another acceptor at alkaline pH. The highest activity of AF is in the livr, bones (osteoblasts), placenta and intestinal epithelium. Indications for examination: differential diagnosis of jaundice (cholestasis or hemolysis), Reference limits: They depend on the method and have pronounced age characteristics.
- For older men and women: 98-279 U / l
- For adolescents and pregnant women: 190-1000 U / l
Increased serum AF activity in adolescents (increased osteoblast activity) and pregnancy (of placental origin) is physiological. Magnification more than 5 times above the upper reference limit:
- intra- and extra-hepatic cholestasis (increase in bile acids and salts in the interstitium “exfoliates” the membrane AF from the livr cells, which induces their synthesis and increases the enzyme in the serum);
- livr cirrhosis (by a similar mechanism).
Magnification up to 5 times above the upper reference limit:
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tumors, abscesses and other bulky processes in the livr;
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viral and other hepatitis;
Any sign on the part of our body that may suspect us of a problem with our livr should direct us to an immediate medical consultation and appointment of the necessary tests.
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