Chronic liver disease

Chronic liver disease 

Hepatomegaly  may persist afteran attack of hepatitis. In chronic persistent hepatitis, liver biopsy shows continuing periportal inflammation,  but there is normal liver architecture. Enzymes may remain persistently high but other  biochemistry is normal. Although there are often no long-term sequelae, a  proportion of patients with this histological diagnosis progress to chronic active hepatitis and cirrhosis.

Chronic active hepatitis is also known as chronic hepatic  inflammation continuing progressively for up to 6 months  without any evidence of  improvement, confirmed by characteristic features on liver biopsy. It may occur as a sequel  to hepatitis B, C, D, autoimmune disease, drug- induced hepatitis and Wilson’s disease. Many patients present with evidence of advanced liver damage.  Biochemistry shows raised bilirubin, AST, ALT and alkaine phosphatase.  Markers for  hepatitis B,C and D may be present. Liver biopsy shows a plasma cell infiltrate with extensive  parenchymal necrosis. Progression to cirrhosis is common, and this is associated with a high incidence of primary liver cell cancer. Treatment is unsatisfactory,  but some patients respond to interferon.