Hepatitis

Toxic hepatitis of the liver - symptoms, treatment of acute and chronic forms

Toxic hepatitis - damage to the liver by industrial, agricultural and household chemicals, hepatotropic poisons, leading to an inflammatory reaction and necrosis of hepatocytes, changes in the reactivity of the liver. Clinically manifested by hepatomegaly and pain in the right hypochondrium, jaundice, dyspeptic symptoms, encephalopathy, ascites, anorexia. Diagnostics include clinical and biochemical blood tests, ultrasound, CT or MRI of the liver and Doppler blood pressure of its vessels, biopsy, radioisotope examination. The treatment is aimed at interrupting contact with a toxic substance, removing it from the body, conducting symptomatic therapy, and liver transplantation.

Causes of toxic hepatitis

Depending on the structure, all hepatotoxic chemicals are divided into several groups. The first group includes chlorinated hydrocarbons - chloroform, dichloroethane, carbon tetrachloride, methyl chloride, ethyl chloride, and others. These substances are used in the manufacture of automobiles, aircraft, fire extinguishers, in mechanical engineering, in shoemaking, in dry cleaners, in disinfection, disinsection and de-worming, as solvents for fats. They enter the body through the skin, breathing and ingestion. Stand out by the lungs, kidneys, intestines. Hydrochloride tetrachloride affects the endoplasmic reticulum, destroying the hepatocyte enzymatic systems, increase the over-oxidation of unsaturated fatty acids in cell membranes.

The second group of substances includes diphenyls and chlorinated naphthalenes - they are used in the sheaths of electrical wires, in electrical capacitors, and can be used as analogues of wax, resin, rubber. The third group consists of benzene and its derivatives: aniline, toluene, trinitrotoluene, etc. These compounds have been actively used in industry in the production of explosives and organic paints in recent years. In the blood flow after contact with the skin, mucous membranes, when taken orally.

The fourth group contains metalloids and metals - gold, phosphorus, arsenic, tin, mercury, lead. Currently, these chemical elements in the industry are rarely used, manufacturers are trying to find a safer replacement for them. Heavy metals bind to sulfhydryl groups, blocking the activity of liver enzymes. Natural hepatotropic poisons (poisonous mushrooms, heliotrope seeds), agricultural and household insecticides are taken as a separate group.

All chemicals entering the body are destroyed or bound. The main role in these processes is played by the liver. Some substances and their derivatives resulting from biotransformation may have a toxic effect on hepatocytes. At the same time, hepatotoxicity can be true (occurs in all people when a certain dose of a substance is introduced into the body) or manifest idiosyncrasy (individual hypersensitivity of the body to this compound). The mechanism of action of hepatotropic poison depends on its chemical structure and dose, but the result will in any case be the destruction of liver cells and the failure of metabolic processes in it.

The destructive effect of these toxic substances is greatly enhanced if in the past hepatocytes were exposed to high doses of alcohol, hepatotoxic drugs, viruses and bacteria. Also toxic hepatitis develops faster in people suffering from exhaustion and protein deficiency in the body.

What is toxic hepatitis?

Toxic hepatitis is an inflammatory liver disease that develops due to the pathological effects of toxic substances on the body.

The development of toxic hepatitis begins with the entry of chemicals into the body. Their harmful effects interfere with the normal functioning of organs and systems and lead to numerous violations.

Particularly severe damage is caused to the liver, because it is involved in cleansing the body and eliminating pathological substances. If there are too many of them, the organ cannot cope with them, and its cells gradually begin to break down.

In the future, the liver increases in size, the patient has severe pain and other negative changes.

According to etiological factors, toxic hepatitis is divided into 4 groups:

  • Toxic drug hepatitis
  • Toxic alcoholic
  • Caused by industrial poisons,
  • Caused by poisons of natural origin.

Symptoms of toxic hepatitis

With a mild course of the disease can occur without symptoms. In severe cases, acute toxic hepatitis is accompanied by pain in the right hypochondrium, signs of intoxication (high body temperature, general weakness, nausea). The patient has progressive jaundice, dark urine and light feces. As a result of an acute inflammatory process, the liver grows in size. Often, acute toxic hepatitis is accompanied by bleeding from the nose, minor hemorrhages on the skin and bleeding gums.

As for the chronic form of the disease, in this case, the symptoms are not so pronounced. The patient may be disturbed by pain in the right hypochondrium of moderate intensity, aggravated after eating. The disease is accompanied by increased fatigue, loss of appetite, abdominal distension, skin itching and an increase in the size of the liver.

Treatment of toxic hepatitis

In the treatment of toxic hepatitis, it is first necessary to completely eliminate contact with a toxic substance. When signs of acute toxic hepatitis appear, the patient must be hospitalized.

To cleanse the remaining poison spend washing the stomach. In addition, droppers with an electrolyte solution can be shown to remove the poisons to the patient.

To restore the functions of the liver enterosorbents are prescribed (lactofiltrum, etc.) hepatoprotectors and vitamins of groups B and C. Also receiving choleretic drugs. Together with the bile comes out and part of toxic substances.

Diet for toxic hepatitis

The patient must completely eliminate the use of alcohol and smoking. You need to eat small portions and often. Such a fractional diet improves the flow of bile, which is very important in the treatment of this disease.

The patient should significantly limit the consumption of fatty, fried, spicy and salty foods. The main foods for a patient with toxic hepatitis should be vegetables, fruits and legumes. Of meat products, only the consumption of chicken, rabbit and fish meat is desirable. From canned and smoked foods should be completely abandoned.

Medication

Toxic hepatitis while taking medication occurs in cases when the patient suffers from any chronic diseases and has to take prescribed drugs for a long time. The second common cause is an independent uncontrolled intake of drugs without control or without medical indications. Practically all antibacterial drugs are such drugs: sulfonamides, beta-lactam antibiotics, tetracyclines, nitrofurans, etc.

What symptoms accompany the disease?

Most often, the first symptoms of hepatitis are flu-like: headache, weakness and fatigue, vomiting, nausea, loss of appetite, fever. In addition, the skin and the whites of the eyes may turn yellow (jaundice appears), the urine turns brown, and the feces become colorless. Hepatitis is also accompanied by pain and heaviness under the ribs on the right. Often, liver damage is accompanied by itchy skin, red spots on the skin, neurotic syndrome, and bradycardia. Sometimes a spleen may enlarge. But in some cases (in particular, with the defeat of the hepatitis C virus), the disease can last for a long time without symptoms. That is why hepatitis C is sometimes metaphorically called the “gentle killer.”

Causes of hepatitis and its types

Depending on the cause of the disease, hepatitis can be divided into two groups: infectious and non-infectious.

Infectious diseases include viral hepatitis A, B, C, (and further, up to G), hepatitis caused by cytomegalovirus, bacterial hepatitis triggered by infections of yersiniosis, salmonellosis, and also caused by sepsis.

Among non-infectious hepatitis emit:

  • allergic (manifested against the background of a severe allergic reaction to any agent to which a person has hypersensitivity),
  • toxic or medicinal (with the adverse effect of a drug on the liver),
  • alcoholic (one type of toxic liver damage),
  • exchangeable (caused by metabolic disturbances, most often fat),
  • autoimmune (in cases where the immune system stops “recognizing” liver cells and “turns against” them),
  • hereditary (with genetically determined disorders of various types of metabolism at different levels),
  • cholestatic (arising from a violation of the outflow of bile),
  • secondary (in relation to the list of diseases of other organs and systems in the body).

Depending on the duration, hepatitis is acute (lasts less than two months) and chronic (lasts more than six months).

What happens in the body with infectious and non-infectious hepatitis?

Infectious lesion occurs in this way: viruses, after penetrating the bloodstream into the human body, are delivered to the liver, then attached to the cell wall of the liver cell (hepatocyte) due to the special structures on the surface of the virus envelope. The virus DNA or RNA is released inside the hepatocyte due to membrane fusion. Next, the genetic material of the virus is inserted into the genome of the affected cell, due to which it begins to engage in the reproduction of viral particles. As a result, new populations of viruses appear, which, in turn, affect intact hepatocytes.

The most common non-infectious hepatitis is toxic and autoimmune. Toxic hepatitis affects the liver in the event that the number of toxins received from outside or formed in the body itself is too large. Affected hepatocytes stop coping with their functions, which is why the liver loses the ability to completely detoxify the blood and deactivate harmful substances. Toxins, interfering with the normal functioning of the liver over a long period, "kill" liver cells.

Autoimmune hepatitis is caused by a malfunction of the immune system, which malfunctions and begins to produce antibodies to the cells of the liver tissue. Because of this, the intercellular substance of the liver and the hepatocytes themselves are affected, and the gradual destruction of the liver tissue disrupts the normal functioning of the organ, causing hepatitis.

Characteristics of viral hepatitis

There are several types of infectious hepatitis: A, B, C, D, E, although more often in the literature one can see the Latin spelling of these letters: A, B, C, D, E, there are also viruses F and G.

Hepatitis A considered the most common and also known as "Botkin's disease." The hepatitis A virus spreads predominantly through food contaminated with the faeces of an infected person, drinking water, by eating raw mollusks that were kept in sewage-contaminated water, due to personal hygiene (“unwashed hands”). The incubation period of the hepatitis A virus is from 7-8 days to two months.

HepatitisB (or "serum hepatitis") is transmitted through contact with blood or other body fluids of an infected person. In addition, during childbirth, a mother with hepatitis B can infect a newborn baby.

Hepatitis C - A deadly disease that takes lives more than AIDS. The most common ways of infection are through blood through transfusions, the use of injection syringes, sexual contacts. In 80% of cases, acute hepatitis C enters a chronic stage, and after 15-25 years it ends with cirrhosis and liver cancer, and therefore with the death of the patient.

In addition, they also secrete hepatitis D and E, F, G - these are types of the hepatitis virus that are also transmitted through blood or bodily fluids from a sick person to a healthy person.

Viral hepatitis, the treatment of which is not started on time, can have dangerous consequences - the development of severe fulminant disease, cirrhosis of the liver, cancer and even death.

Characteristics of non-infectious hepatitis

Non-infectious hepatitis is as dangerous as viral liver diseases. Non-viral liver damage is a disease caused by toxic substances: alcohol, hepatotoxic drugs, pesticides, harmful industrial substances. In addition, the reason may be some features of the body, in particular, disruptions in metabolism. The risk group includes people who abuse alcohol and its surrogates, patients with obesity, who have to take medication for a long time, suffer from autoimmune diseases, and metabolic disorders.

Toxic agents cause liver disease, regardless of how they enter the body: with food, through the skin or with air. Once in the blood, they pass through the liver, which is the main organ of detoxification in the body, and damage hepatocytes, causing an acute attack of hepatitis.

Autoimmune hepatitis is currently regarded as a chronic inflammatory liver disease that occurs with an increased amount of immunoglobulins in the blood and the appearance of a wide spectrum of autoantibodies in blood serum. However, the immediate cause of the occurrence of autoimmune hepatitis is not definitively established. It is believed that a key role in the course of the disease belongs to impaired immunoregulation.

Allergic hepatitis often develops after taking drugs of the phenothiazine group, drugs that inhibit thyroid function, analgesic and anti-inflammatory drugs. Clinical manifestations of allergic hepatitis occur one to two days after taking the drugs. During the time between the end of the incubation period and the onset of the disease, allergization symptoms are expressed.

Cholestatic hepatitis is a rather rare pathology characterized by intrahepatic cholestasis with deterioration of the excretory function of cells and damage to the ducts, and then autointoxication of the liver with components of bile. Most often, this type of hepatitis is found in older people and may be due to intrahepatic or extrahepatic bile stasis.

Secondary hepatitis causes diseases such as gastric cancer, dumping syndrome, stomach ulcers, gallbladder disease, duodenal ulcers, systemic lupus, ulcerative colitis, rheumatoid arthritis, pancreatitis, polyarthritis nodosa, diabetes and other diseases of the endocrine system, infectious diseases. In connection with such diseases, the liver loses its detoxification function and undergoes inflammation.

Among the symptoms of non-infectious hepatitis most often appear:

  • fatigue and weakness
  • loss of appetite, bitterness and dry mouth, bloating,
  • dull pain in the upper quadrant of the abdomen during exercise,
  • joint pain,
  • fever of unknown origin,
  • bleeding from the nose and gums,
  • liver pain on palpation.

Up to 90% of acute non-viral hepatitis can be cured. The most dangerous consequences are hepatic coma (arising from the inability of the liver to perform detoxification function, leads to brain damage, and eventually to death), as well as liver cirrhosis.

What to do if you are suspected of having hepatitis?

At the first symptoms that may indicate hepatitis, you should immediately consult a doctor and calmly deal with the situation. It is worth noting that acute hepatitis A and B often pass without special antiviral treatment and ends with recovery (hepatitis A) or a transition to the chronic phase (hepatitis B) and only in rare cases do severe forms of viral hepatitis develop. Despite this, they still need medical supervision and treatment, especially hepatitis B. The main thing is not to panic: yes, it is impossible to completely clear the body of the hepatitis B virus, but you can achieve a stable remission of the disease and return to a full life.

What doctor should be consulted if this disease is suspected? Recall that viral hepatitis is an infection of the liver, so that infectious disease specialists can treat it. Gastroenterologists and hepatologists are competent in the treatment of both viral and non-viral hepatitis. Hepatologists are doctors who specialize in the diagnosis and treatment of liver diseases, therefore, a hepatologist can also treat hepatitis. For toxic liver damage, in addition to the hepatologist, you should also contact a toxicologist.

For the initial diagnosis of viral hepatitis, an analysis is performed for the presence of antigen to the surface protein of the hepatitis B virus (HBsAg), and antibodies to the hepatitis C virus (Anti-HCV). The presence of HbsAg in the blood indicates hepatitis B disease, and the presence of Anti-HCV only indicates that the body has once encountered a virus. But these tests are not enough to establish the final diagnosis, since they do not give a positive result during the incubation period of hepatitis. To accurately detect the presence of a virus in the blood, doing a "quality" analysis (PCR). In addition, to determine the characteristics of treatment and the timing of its implementation, an analysis is made to determine the genotype of the virus and a number of studies of the functional state of the liver.

A number of examinations are also needed to diagnose non-infectious hepatitis: laboratory biochemical and immunological tests to assess the functional state of the liver, bilirubin level, establish the phase of the disease, ultrasound with transcutaneous liver biopsy, followed by a histological examination of punctate to clarify the diagnosis and determine the degree of activity of the immune-inflammatory process.

Signs of acute toxic hepatitis:

In mild cases, it can occur with almost no symptoms, it is found only during a group examination (for example, the use of poisonous fungi).

In more severe cases, it may manifest itself in the form of the following symptoms:

  • Pains in the right hypochondrium, occur suddenly, 2-5 days after the penetration of the hepatotropic poison into the body, are the result of stretching the capsule by an enlarged liver (due to the acute inflammatory process in it),
  • Signs of intoxication: fever> 38 0 С, general weakness, lack of appetite, nausea, vomiting (maybe with blood), joint pain,
  • Bleeding from the nose, gums, small point hemorrhages on the skin, these manifestations are the result of the destructive action of the toxin on the walls of blood vessels,
  • Influence on the psyche of the patient in the form of agitation or lethargy, violation of orientation in space, tremor, as poisons have the ability to exert a toxic effect on nerve cells,
  • Progressive jaundice, dark urine, light feces (oily, shiny) appears simultaneously with signs of intoxication, and is the result of a violation of the flow of bile along small intrahepatic biliary tract,
  • Enlarged liver in size as a result of acute inflammation of the liver cells and their replacement with adipose tissue (fatty degeneration of the liver)

Diagnosis of toxic hepatitis

For the diagnosis of toxic hepatitis, the indications in the history of contact with hepatotropic poisons in combination with a characteristic clinical picture are of primary importance. Laboratory and instrumental studies are aimed at assessing the severity of liver damage in toxic hepatitis, the identification of associated diseases and lesions of other internal organs.

Laboratory diagnosis of toxic hepatitis does not reveal specific signs of this pathology. It should be remembered that in 3% of healthy people, liver function tests can be changed, approximately 5% of them have nothing to do with damage to the liver. Conversely, in about 10% of cases of toxic hepatitis, laboratory parameters will be within the normal range. The assessment of the severity of liver damage is carried out on the basis of a study of the levels of total bilirubin and its fractions, transaminases, enzymes (AP, GGTP, LDH), albumin and prothrombin. To identify certain hepatotoxic substances, special laboratory tests are possible. Be sure to conduct research on viral hepatitis, HIV.

From instrumental methods in the diagnosis of toxic hepatitis use ultrasound, CT and MRI of the liver, dopplerometry of the hepatic vessels, elastography, radioisotope study of the hepatobiliary system. These methods do not allow to determine the etiology of hepatitis, but will confirm the liver damage. The most accurate way to assess morphological changes in toxic hepatitis is a liver biopsy followed by a histological examination of biopsy specimens.

Toxic hepatitis should be differentiated from liver damage by alcohol, drugs, bacteria, viruses and parasites, with gallstone disease, liver cancer and other tumors of this localization, autoimmune hepatitis, liver malformations and gallstones, metabolic diseases, acute pancreatitis, reactive hepatitis.

Treatment and prevention of toxic hepatitis

The main direction of treatment of toxic hepatitis of any etiology is the cessation of contact with a chemical agent, neutralization and its rapid elimination from the body. When heavy metal poisoning antidotes are unithiol, sodium thiosulfate (for mercury, arsenic, lead), deferoxamine (for iron), benzylamine, glucocorticosteroids (for copper). All patients must be prescribed vitamins of group B, folic, nicotinic and ascorbic acids. If, against the background of toxic hepatitis, severe hepatic and / or renal failure has developed, hemodialysis is performed. Liver transplantation may be required in the formation of fulminant liver failure.

In most cases, manifestations of toxic hepatitis regress after cessation of contact with a toxic substance, complete recovery occurs. After severe toxic damage to the liver with massive hepatocyte necrosis, cirrhosis of the liver develops, in rare cases - liver cancer.

Prevention of toxic hepatitis is in strict adherence to safety when in contact with toxic substances, conducting regular medical examinations of the entire contingent of workers in contact with toxins (to timely identify people with liver pathology and prevent them from working with toxic chemical compounds), establishing a healthy diet with an adequate number of protein, anti-alcoholism.

Epidemiology

Analyzing statistics, found that women are more susceptible to liver lesions than men. The earlier the treatment, the better the outcome. The occurrence of bleeding is the cause of death in approximately 30-50%. Coma is fatal in 80-100%. The occurrence of ascites is fatal in 80%, death occurs within 3-4 years.

Risk factors

The risk group includes people whose professional activities are related to toxins and caustic components. Alcoholics, drug addicts often end up living with liver disease. Suiciders who took poison for the purpose of suicide but survived already have serious liver damage that can progress.

People who are forced to constantly take potent drugs should monitor the condition of the liver. This is especially true of those patients who take painkillers, anti-tuberculosis drugs. If a person already has any liver disease, viral hepatitis or he is a carrier of viral hepatitis, it automatically falls into the risk group. In old age, the risk of development increases significantly, since the liver cannot cope with the load and processes everything much more slowly. Women are more at risk than men. This is due to a lower metabolic rate. Toxins in women are eliminated much longer than in males.

An important role is played by heredity. There is a genetic predisposition to the development of liver diseases. Possible abnormalities of the liver structure, functional disorders are also taken into account. In addition, the incorrect production of enzymes can not only inhibit the neutralization of toxins, but also stimulate their additional synthesis in the body. Also today, people who practice non-traditional forms of intimate relationships and people with non-traditional orientations are at risk.

The basis of pathogenesis is the damaging effect of toxins on the human body. There is a defeat of hepatocytes, structural and functional disorders, further die-off and replacement with fatty tissue.

There is a second mechanism for the development of pathology. Microcirculation of blood can be disturbed in the liver. There is damage to the vascular bed, as a result of the supply is broken, the body does not receive the required amount of nutrients, oxygen. A high concentration of metabolic products and carbon dioxide accumulate. It damages the liver, has a toxic effect on it. Violated metabolic processes in the liver, including redox. Suffering carbohydrate and protein metabolism. Even the composition of blood gradually changes. This causes irreversible processes in the cell membranes: DNA replication is disturbed, enzyme activity decreases, and respiratory processes are inhibited. Hepatocytes undergo dystrophic processes and gradually die off.

The third way of disturbances is associated with impaired normal metabolism of bile acids, as a result of which bile metabolism is disturbed, blood flow in the bile capillaries decreases, bile flow through the intrahepatic bile ducts decreases. The result is the same as in the first two cases: hepatocytes are damaged, their degeneration and gradual death occur.

How is toxic hepatitis spread?

Many people worry about not infecting their relatives and family members with toxic hepatitis. It is safe to assure: there is no cause for concern. Cases of family development of hepatitis are impossible. The exceptions are the use of poisonous substances (eg, toadstools), or spoiled food. Transmission path through contacts and household items is excluded.

Exacerbation of toxic hepatitis

There is an alternation of the period of remission, in which a person is in good health, with aggravations. An exacerbation is accompanied by digestive disorders, an enlargement of the liver to such an extent that it can be safely felt under the right edge. The temperature may rise, intoxication appears.

Acute toxic hepatitis

A distinctive feature is that hepatitis develops very quickly, at a rapid pace. The peak of the disease falls on the 3rd day of toxin ingestion. There is intense pain that occurs as a result of hypertrophy. The temperature rises sharply, to 38 degrees and above. There is a weakness, body aches, fragility, dyspeptic syndrome.

Toxic drug hepatitis

Often, toxicosis is a consequence of drug poisoning. The reason is the excess dosage or long-term medication. With long-term administration, the chronic form most often develops, with overdose, the acute form. The liver is often the only target organ that is exposed to toxins. The liver primarily reacts to the action of medicinal substances, since their processing occurs in the liver. The liver also neutralizes residues and introduces them outside.

The dosage and duration of medication varies widely. Currently, there are several thousand drugs that can cause liver damage. Often the cause of such complications is self-medication, since many of these drugs are sold without a prescription. 50% are accounted for by the mistakes of doctors who incorrectly prescribe drugs, or incorrectly combine them.

Some drugs have inevitable side effects on the liver, regardless of the dose. But often taking such drugs can not be avoided. For example, chemotherapy, antiretroviral therapy, anticancer drugs. In people with increased sensitization of the body, frequent allergic reactions, in the elderly, the risk of developing toxic hepatitis increases with taking any drug. Even, at first glance, innocuous antibiotics and antipyretics can cause significant damage to the liver.

Hormones, antidepressants, psychotropic substances and antipsychotics, diuretics, antibacterial and antiviral drugs are especially dangerous for the liver. Some combinations of drugs may have a toxic effect. Exceeding the dosage of many drugs is fatal. So, if you take 10 g of paracetamol, liver necrosis develops. This drug is often taken for suicidal purposes. Often toxic hepatitis develops after treatment of diseases such as leukopenia, splenomegaly.

The main condition for recovery is the abolition of drugs that have a toxic effect on the liver. You also need to eliminate other causes that exacerbate the inflammatory process. After that, appropriate therapy is carried out, which leads to the reverse development of the pathology. If timely action is taken, the outlook may be favorable. In severe cases, hemodialysis may be required, which usually has a positive effect, helps to restore the body. If liver failure develops, a liver transplant may be urgently needed.

For the prevention of drug hepatitis, taking heavy drugs that have side effects should be combined with hepatoprotectors. They protect against negative effects, reduce the likelihood of damage and the severity of pathology.

Professional toxic hepatitis

It is a consequence of the impact on the body of harmful production factors. Most often observed in employees who work for a long time in manufacturing, in laboratories.Particularly increased risk of occupational hepatitis in employees with reduced immunity and concomitant viral hepatitis, or other liver diseases.

May develop in both acute and chronic form. In acute form, it develops as a result of industrial leaks, through carelessness, in the event of equipment malfunction or non-operating exhaust hood. In this case, the body receives immediately a large dose of the drug.

In chronic form, poisoning develops slowly, gradually. For example, a person inhales fumes for a long time. The main industrial poisons recognize yellow phosphorus, trichlorethylene, carbon. Biological agents are also dangerous, for example, fungi, viruses, bacteria, which microbiologists, virologists, and bacteriologists have to work with. No less dangerous are pharmaceutical and chemical preparations that are used for medicinal purposes or for conducting research.

Alimentary toxic hepatitis

This form of the disease is also called fecal-oral hepatitis. The main cause of the disease are fragments of fecal masses that fall from an infected person to a healthy one. Distribution occurs through the mouth, with oral contact. Subjects to this form of infection are people with a burden to nontraditional methods of sexual relations.

Such a mechanism mistakenly suggests that toxic hepatitis is contagious. But it is not. It must be understood that it is not the disease itself that is transmitted, but the toxic agent that causes it. It is he who leads to the development of similar damages in the body.

Viral toxic hepatitis

The cause of development is a virus that secretes toxins and products of viral metabolism into the blood. These substances are called endotoxins. They penetrate the liver and make pathological changes in it, including necrosis and fatty degeneration of the liver. Viral hepatitis is confirmed by virological studies. Sometimes the disease is hidden, so it is important to undergo prophylactic examinations, to be tested. This will allow to identify pathology in a timely manner and take the necessary measures.

Treatment depends on the type of virus that caused the change. This can not do without laboratory tests. Viral hepatitis B, C, D are transmitted sexually and with drug addiction. Infection can also occur during surgical interventions, during invasive procedures as a result of non-compliance with the rules of asepsis.

The most severe is hepatitis C. Outwardly, the disease may not always manifest. A person can feel quite well, after which comes a sharp crisis. The liver is damaged slowly and asymptomatically. Manifested ultimately cirrhosis of the liver, after which a person quickly dies. In addition, it can give complications to other organs.

Hepatitis B is widespread among the population and is often transmitted through blood transfusion. The main preventive measure is the control of donated blood and regular preventive examination. If detected in a timely manner, it is treatable. But late detection is often fatal.

Hepatitis D often overlaps with hepatitis B. Together, they form the most dangerous disease, which manifests itself in a severe form and gives serious complications. In most cases, it ends in death.

Toxic hepatitis after chemotherapy

One of the leading causes is the effect of chemotherapy and antiviral therapy, which contributes to liver damage in both acute and chronic forms. This is due to the fact that the main breakdown of anticancer drugs occurs in the liver. As a result, all liver functions, including detoxification, are impaired. Cytostatics stop the growth and division of tumor cells, but at the same time, they have a similar effect on liver cells. Cells lose their ability to regenerate. This leads to the fact that the drug accumulates in the liver and has a toxic effect on the liver. As a result of chemotherapy, toxic hepatitis is complicated by cholestatic disorders and hepatic encephalopathy. All this is accompanied by a rash, pain. Significantly increased body temperature.

In order to minimize the negative effect of chemotherapy on the liver, it is necessary to carry out continuous monitoring of the liver. The main analysis is a biochemical blood test. In accordance with modern requirements, a blood test must be taken before the start of chemotherapy, and then on the 14th day of treatment. Carefully monitored condition from 14 to 21 days. At this time, tests are often taken daily. Trace indicators of bilirubin and transaminases, which are a sign of toxic liver damage. After the end of cancer therapy, the liver is monitored for 6 months every month, then every 6 months.

Toxicosis during chemotherapy can be prevented by performing hepatoprotection. It restores the structure of damaged membranes, inhibits destructive processes in hepatocytes, prevents fibrosis.

Exogenous toxic hepatitis

Caused by exposure to environmental toxins. These are elements of any nature and origin, including heavy metals, vapors of acids, alcohol, medicines. They can provoke both acute and chronic forms of the disease. The basis of the pathogenesis is mainly a violation of the hemostasis of the liver.

Often exogenous poisoning occurs in agriculture when treated with insecticides, herbicides. The most severe forms are observed in case of poisoning with arsenic, carbon, phosphorus. Many drugs, and even hormonal contraceptives, damage the liver.

Industrial poisons

Toxic hepatitis on the background of exposure to poisons can be acute and chronic. Acute occurs when a large number of poison on the body, severely affects the liver and other organs, in many cases, is fatal. Chronic hepatitis is diagnosed mainly in employees of enterprises who for many years have had constant contact with small doses of toxins.

Prevention and treatment of viral hepatitis

The main protection and prevention of viral liver damage consists of two points: avoidance of infection from a sick person and vaccination (in particular, against hepatitis A, B). The treatment of different types of hepatitis is different, however, the general purpose is the administration of hepatoprotectors - drugs that protect the liver cells from damage, as well as detoxification therapy.

To prevent infection with hepatitis A, you can adhere to the rules of hygiene and sanitation, avoiding drinking water, the source of which may be unsafe. In addition, hepatitis A can be vaccinated. As for treatment, it is usually limited to means that support the work of the liver. Antiviral therapy is not appropriate, since this virus causes only acute hepatitis, and, as a rule, the body itself gets rid of the infection within a few weeks, complications develop in rare cases.

Vaccination against hepatitis B - reliable prevention of the disease, which allows you to form immunity against it and effectively protect against hepatitis D. Reducing the chances of infection will help personal hygiene, in particular, preventing the sharing of needles, toothbrushes, blades, scissors for nails, that belong to an infected person. In addition, you should abandon the application of tattoos or body piercing in untested salons. For the treatment of hepatitis B prescribe various antiviral drugs that slow down the reproduction of the virus. Children given birth to mothers infected with hepatitis B are vaccinated for twelve hours after birth to prevent the infection from spreading.

Unfortunately, hepatitis C vaccinations do not exist. Because the way to prevent hepatitis C and B is the same - reducing the risk of infection through the blood. It is noteworthy that the previously incurable viral hepatitis C is now successfully treated with specific antiviral drugs. In some countries, there are entire programs to combat the hepatitis C virus, and almost 90% of patients who receive antiviral therapy recover within a few months. The latest achievement in the treatment of hepatitis C is the therapy with its own stem cells, which help to restore the structure and size of the liver. However, this method, like the “triple therapy” method, is not cheap: it will cost the patient 20 thousand dollars a year. And it is possible to reduce the cost of treatment only in the early stages of the disease, so you should not hesitate to visit the doctor at the first symptoms of hepatitis.

Narcotic drugs

Such a causal factor is rare, mainly diagnosed in people with severe drug addiction who take several types of narcotic drugs at once (for example, cocaine and phenobarbital).

Manifestations of the disease depend on the type of toxic effects on the body and the severity of the course of hepatitis. Violent symptoms of the disease and severe course are characteristic of the acute form. Most often, in the acute form of toxic hepatitis, the following manifestations are observed:

  • hepatosplenomegaly (enlarged liver and spleen),
  • sharp or dull pains in the right hypochondrium,
  • nausea, vomiting, disorders of the gastrointestinal tract,
  • fever, weakness, dizziness,
  • bleeding from the nose or gums, hemorrhage (subcutaneous hemorrhage), the appearance of spider veins,
  • signs of mental agitation or lethargy, clouding of consciousness, hallucinations,
  • jaundice, urine becomes dark, and feces - light,
  • loss of consciousness, stupor, stunning, coma.

Since chronic toxic poisoning occurs over a long period of time, the symptoms of hepatitis are not pronounced.

Such manifestations of the disease are not always specific and can sometimes be masked by other pathologies of the gastrointestinal tract and the liver.

The main symptoms of chronic toxic hepatitis:

  • recurrent pain in the right hypochondrium, which predominantly occurs after consuming heavy food or alcohol,
  • a slight increase in body temperature (up to 37.5),
  • yellowness of the skin,
  • skin itch, small dot subcutaneous hemorrhages,
  • recurrent nausea, bloating, digestive disorders,
  • bitterness in the mouth or belching bitter,
  • rapid fatigability, fatigue, decreased performance,
  • bile stasis, dyskinesia,
  • dark urine and light feces,
  • cytolysis (destruction) of hepatocytes,
  • neutrophilic leukocytosis (increase in the number of leukocytes in the blood),
  • weight loss up to anorexia.

Prevention and treatment of non-viral hepatitis

For the prevention of non-infectious hepatitis, it is recommended to abandon the use of alcoholic beverages, to take regular medication only under the supervision of a doctor, when working in hazardous conditions, it is necessary to use protective equipment - respirators, gas masks, suits. If necessary, regularly monitor the content of liver enzymes.

Treatment of non-viral hepatitis is primarily in the elimination of the damaging factor. In acute intoxication, gastric lavage, detoxification therapy, and antidotes are administered. In case of autoimmune, secondary and metabolic hepatitis, all efforts are directed towards the treatment of the underlying pathology. Patients are hospitalized only in case of exacerbation, and chronic forms of non-infectious hepatitis are treated at home.

In the treatment of all types of hepatitis, an important role is played by the intake of hepatoprotectors. This is an extensive group of drugs that may differ in their origin, a set of active ingredients and the structural features of a chemical formula, but combine their main functions: a beneficial effect on liver cells, stimulation of their regeneration and restoration of normal functioning of the liver as a whole. Such drugs as Gepabene, Carsil, Ursofalk, Heptral, Essentiale are referred to hepatoprotectors. In the modern practice of treating chronic hepatitis, the hepatoprotector Maksar has recommended itself well. The active substances from the Maakia Amur wood - the isoflavones and stilbenes included in its composition, normalize the functioning of the liver cells, the metabolism in them, stimulate the regeneration of hepatocytes and the flow of bile.

Hepatitis is an inflammation of the liver, in which the destruction of the cells of an organ (hepatocytes) and the development of its dysfunction occurs. The consequences of hepatitis can be extremely dangerous and lead to serious complications, even death. But it must be remembered that hepatitis is not a sentence, but an impulse to action: the earlier the treatment is started, the more chances for a speedy recovery and the opportunities to avoid life-threatening consequences.

Chronic toxic hepatitis of the liver

The development of the chronic type of this disease is due to a systematic minor effect on the body. In this case, the pathology is formed gradually, at first without even manifesting itself as symptoms. This can take months or even years.

The acute and chronic form of pathology is dangerous for human life. First, because such a disease can lead to liver failure, and also because cirrhosis of the liver can develop, followed by liver failure.

That is, in any case, without treatment, the prognosis of the course of the disease is unfavorable, and the probability of a fatal outcome is very high. Especially dangerous to humans is drug toxic hepatitis, caused by prolonged use of drugs, in particular antibiotics.

The path of ingress of toxic substances in the human body is different. This may be the long-term effect of chemical or toxic factors of production due to professional activity, accidental or deliberate poisoning, long-term or uncontrolled intake of hepatotoxic drugs. Such substances can get into the body through the digestive tract, respiratory system and skin.

For liver cells, poisons are:

  • many medications
  • alcohol,
  • poisons contained in plants and mushrooms,
  • components in industrial production, in particular insecticides, arsenic, phosphorus, pesticides and others.

Based on what substances can provoke this disease, it is possible to identify the main risk groups. It:

  • people engaged in hazardous production
  • persons prone to alcohol abuse
  • patients who prefer not to wait for a doctor's prescription for medication, but begin treatment on their own and without regard to instructions.

Signs of acute toxic hepatitis of the liver

The main symptoms of acute toxic hepatitis are:

  • The process begins abruptly, after a maximum of 3-5 days after poisoning,
  • Pain in the right hypochondrium, of severe intensity, associated with an increase in the size of the liver and its capsule,
  • Body temperature reaches 38 degrees and higher
  • Severe weakness
  • Whole body aches
  • Vomiting, possibly with blood,
  • Nausea,
  • Nosebleed,
  • Rifle hemorrhage under the skin,
  • Vascular stars,
  • Disturbance of orientation in space,
  • Inhibition, or vice versa, mental and nervous activity,
  • Dark urine
  • Lightening feces
  • Jaundice,
  • Enlarged liver.

Signs of chronic toxic hepatitis:

  • Periodic pain in the right hypochondrium, of medium intensity, aggravated after eating,
  • Severity in the right hypochondrium, associated with an increase in the liver,
  • Subfebrile body temperature 37-37.5 C,
  • Nausea, vomiting, loss of appetite, bitter taste in the mouth, bloating, diarrhea, these manifestations develop as a result of a violation of the flow of bile,
  • Fatigue, decreased performance,
  • Pruritus, itchy skin due to accumulation of bile acids,
  • Enlarged liver and spleen.

These symptoms may subside for a while (remission), and again manifest (worsen).

In most cases, manifestations of toxic hepatitis regress after cessation of contact with a toxic substance, complete recovery occurs. After severe toxic damage to the liver with massive hepatocyte necrosis, cirrhosis of the liver develops, in rare cases - liver cancer.

Complications

The mild form of the disease can be treated quite easily. As for the more severe and neglected forms, hepatitis can cause such complications:

  • liver failure, which disrupts the normal performance of this body,
  • damage to the central nervous system, which leads to periodic convulsions, loss of consciousness,
  • cirrhosis of the liver, which most often leads to death.

Complications of the disease lead to very serious consequences. Therefore, it is very important to stop the destructive effect on the liver in time.

Cases of toxic form of hepatitis in children

The toxic form of hepatitis in children is relatively less common than in adults. Such hepatitis occurs when the poison enters the body as a result of parental carelessness (for example, household chemicals), on the background of long-term drug therapy, or after mushroom poisoning.

In children, toxic forms of hepatitis are very difficult. In many cases, they can be fatal due to untimely provided specialized medical care.

Children mostly suffer from the acute form of the disease and the symptoms will be almost the same as in adults. The main task is to prevent severe irreparable consequences both for the liver and for the whole organism, which can occur against the background of poisoning. The forecast is mostly unfavorable.

Toxic hepatitis during pregnancy

Cases of hepatitis in pregnancy caused by toxic substances are quite common and, as a rule, there is a chronic form of the disease. Gradually, signs of severe liver failure develop, pregnant women feel well, but the prognosis is rarely favorable.

The main symptoms of the disease will be the following manifestations:

  • the occurrence of jaundice (skin and sclera),
  • discoloration of urine and feces,
  • pain in the right hypochondrium
  • nausea, vomiting.

Complications of the normal course of pregnancy in this case will be fetal fetal death, postpartum hemorrhage in the early period, the development of cholestatic hepatitis with coagulation disorder. Treatment of toxic hepatitis during pregnancy is carried out through active drug therapy.

Diet and nutrition

It is very important to follow a diet and proper nutrition in case of a toxic form of hepatitis, since the intake of heavy foods can complicate the course of the disease. A sample list of products and dishes is given in the table:

  • yesterday's bread
  • vegetable soups, meatless borscht,
  • vegetarian dishes
  • lean fatty meat (chicken, beef),
  • cereals,
  • fresh and steamed vegetables,
  • fresh fruits, berries,
  • tea, fresh juices, coffee with milk,
  • butter.
  • fresh bread, puff pastry,
  • fried foods
  • meat, fish, mushroom soups, broths,
  • fatty fish
  • fat cream, sour cream, cottage cheese,
  • canned food, semi-finished products,
  • lard, cooking oil,
  • chocolate, sweets, cakes.

Diet and proper nutrition significantly reduce the burden on the liver and contribute to faster recovery and easier course of the disease. Any errors in diet and nutrition can trigger an acute attack of pain and disrupt normal digestion.

Toxic hepatitis is a liver disease that occurs as a result of ingestion of chemical or other toxic substances. They, in turn, have a harmful effect on the liver, thereby destroying its tissues. Every person is affected. Therefore, what is toxic hepatitis, symptoms and treatment should be carefully considered.

The causes of the disease

The main reason for the development of this disease in humans is the effect of toxic substances that have entered the body on the functioning of the liver. The most common sources of damage are:

  1. Medication. Taking in excessive amounts of some highly effective drugs have a toxic effect on the body. Especially dangerous is non-compliance with the dosage of antiviral, antituberculosis, anticonvulsant drugs, as well as antibiotics.
  2. Industrial substances. Toxic poisons that are released during industrial production can affect the body through inhalation, as well as through the skin. The most dangerous are arsenic, chlorine, phenol, phosphorus and many others.
  3. Alcoholic beverages. Abuse of these beverages, especially of dubious production, leads to liver damage.
  4. Poisons of plant origin. Poisonous fungi and plants of the order of weeds are composed of toxic elements. Human exposure causes an acute form of the disease.

Important to remember! When dealing with these harmful substances, maximum caution should be exercised!

Diagnosis of the disease

In order to accurately detect hepatitis, should be a lot of research. After all, the symptoms of the disease are similar to other pathologies of the liver. Correctly determine the diagnosis will help such events:

  1. General analysis of urine and blood. Detects inflammatory processes in the body.
  2. Biochemical research. Shows abnormal blood components, which indicates the defeat of the body.
  3. Ultrasound of organs. Allows you to determine the severity of damage to the liver and other internal organs.
  4. Liver biopsy. It is used to determine the level of damage to this organ.

Important to remember! Establishing the diagnosis involved only a specialist! Only he can correctly decipher the results of the research.

Treatment of folk remedies

Toxic hepatitis liver can be treated at home with the help of traditional medicine recipes. The advantage is the use of natural ingredients that have a beneficial effect on the functioning of the liver and the removal of inflammatory processes. There are a number of ways to prepare such drugs.

It will take 2 tbsp. l chopped calendula flowers, pour 1 cup boiling water, leave for 1 hour. Strain the broth and take 50 ml 4 times a day. This medicine contributes to the rapid removal of bile.

It should be 0.5 liters of boiling water pour 2 tbsp. l chicory, add 1 tbsp. l honey and 1 tsp. lemon juice. Stir the mixture. Use as an unlimited amount of tea.

Grind 1 tbsp. l dandelion root, add 1 cup of purified water. Put to languish on a slow fire for about 1 hour. Then cool and take 1 tbsp. l decoction 3 times a day before eating.

Should take 2 tbsp. l minced Hypericum, pour 1 glass of hot water. Put on the fire, boil for 5 minutes. Cool and strain. Take 100 ml 3 times daily before meals.

Grind the stems of the plant, take 1 tsp. Pour 1 glass of hot water, leave overnight. Take 50 ml of the obtained medication 4 times a day.

Grate the horseradish root about 2 tbsp. l Bring 1 cup homemade cow's milk to a boil, add the original component, mix thoroughly. Take small amounts throughout the day preferably before eating food.

Honey and currant

It will take 1 kg of honey and the same number of black currant berries, which should be ground to a consistency of gruel. Mix the ingredients well. Consume before each meal. Continue this treatment until the end of the medication.

These methods can help with mild disease. More severe cases can cure only medication.

It is important to know! Before using such drugs, you should consult a doctor in order not to harm your health! It is possible to consider the option of taking the prepared medicines with medicines in a comprehensive manner.

Effects

The mild form of the disease can be treated quite easily. As for the more severe and neglected forms, hepatitis can cause such complications:

Complications of the disease lead to very serious consequences. Therefore, it is very important to stop the destructive effect on the liver in time. You should also pay special attention to the preventive measures for the occurrence of hepatitis.

Preventive measures are based on the causes of toxic hepatitis. Therefore, you should avoid exposure to toxic substances on the body. Do not forget that the defeat can occur not only through the stomach, but also penetrate the skin and through the lungs. Medication should be limited to the amount prescribed by the doctor. Supplements may have a very dubious effect, their reception should also be coordinated with the doctor. Restriction in the use of alcohol will protect against many diseases.

The liver is one of the vital internal organs. It is located in the abdominal cavity under the diaphragm. The liver is an unpaired organ. It performs many different functions. In particular, it protects the body against the damaging effects of toxins, foreign substances, allergens and other harmful compounds.

Neutralization mechanism

Inactivation of compounds is a process of their chemical modification. It consists of two stages. In the first phase, the compound undergoes oxidation (electrons are detached). At the second stage, the substance undergoes hydrolysis or reduction (the addition of electrons). At the second stage, another substance is added to the formed chemical active groups. As a result, the harmful compound is converted into a less toxic or harmless and easily excreted from the body. But in some cases, the body ceases to cope with its functions.

Cause of toxic hepatitis

Liver damage can be caused by a number of factors. It can occur as a result of parenteral administration or ingestion of chemical or pharmacological substances, inhalations. Among toxic compounds, industrial poisons, some types of fungi are dangerous. Pharmacological agents used to treat various pathologies have a strong effect on the liver. Poisoning drugs can occur, in turn, due to several reasons. One of the main ones is their uncontrolled reception.

Types of poisoning

There are direct negative effects and idiosyncrasy. In the second case, the effect of the toxic compound depends on the dose. With prolonged receipt of drugs as a result, chronic toxic hepatitis may develop. Treatment with many medicines is a serious health threat. Most drugs undergo metabolism in the liver, which results in the breakdown of funds. The resulting products provoke morphological changes. When taking medications in higher dosages, more active harmful metabolites are formed, causing serious damage to the liver.

Pathology pathologies

Usually the latent (hidden) period is short. In some cases, it is only a few hours. Clinical signs meanwhile appear after a day or two. Acute toxic hepatitis can be triggered by systemic poisons or decomposition products formed in the liver. Each poisonous compound has its own negative effect. For example, trichlorethylene, carbon tetrachloride cause necrotic processes, and yellow phosphorus leads to periportal damage. With daily intravenous administration of the tetracycline agent in a dose of more than 1.5 g, small fat deposits are formed in the liver. In some cases, the damaging effect remains unnoticed for a certain period until jaundice appears.

Idiosyncratic reactions

In these cases, hepatitis is rare and unpredictable. Its severity depends on the dosage. The pathological condition can develop at any time during or after taking the medication. The symptoms of toxic hepatitis are usually of the same type. In particular, extrahepatic hypersensitivity reactions are observed in idiosyncrasy: rash, fever, arthralgia. Patients have eosinophilia and leukocytosis in almost 25% of cases. A number of studies have revealed that the hepatotoxic effect in such conditions is due to the activity of the formed metabolites of pharmacological agents.

Diagnosing States

Experts note that not all hepatic reactions that occur when taking these or other means are classified as idiosyncratic or toxic. For example, oral contraceptive drugs (gestagens, estrogens) can cause disorders of the liver, and in some cases jaundice. But these medicines do not cause necrotic processes or fatty changes. In this case, the manifestation of a hypersensitivity reaction can be considered as genetically predetermined. Due to the fact that the diagnosis is presumptive in most cases, and against the background of other pathologies, a similar clinical picture takes place, it is sometimes difficult for a specialist to establish cause-and-effect relationships between the use of specific drugs and subsequently resulting liver damage. In some cases, the symptoms of toxic hepatitis can be replicated. At the same time, provocation by a suspected agent after the latent period causes a number of signs, biochemical and morphological changes. However, this kind of artificial provocation in many cases is impossible for aesthetic reasons, as well as due to the high risk of severe complications. Toxic drug hepatitis, the treatment of which should be mainly supportive, is manifested primarily by adverse reactions to the drug. When diagnosing a suspected drug, you must immediately cancel it. In the process of examination, the specialist should not be distracted from damage to the kidneys and other organs. Along with changes in the liver, damage to other organs can ultimately be fatal.

Therapeutic activities

Symptoms of toxic hepatitis manifest themselves in different ways: from a mild hypersensitivity reaction to serious conditions. Depending on the clinical picture, therapeutic measures are also prescribed. For example, in case of vomiting and severe anorexia, the treatment of toxic hepatitis includes intravenous drip administration of a glucose solution (5% or 10%) in a dose of up to 500 milliliters. When signs of coma or liver congestion are detected, massive plasma exchange is performed. With the help of a separator or centrifuge, 1.5-2 liters of the existing plasma is removed and two liters of frozen plasma are injected intravenously. In the absence of improvements, an increase in the level of prothrombin, the preservation of impaired consciousness, the procedure is repeated.Before normalization of the coagulation system, 1-2 liters of fresh frozen plasma is injected every day for 2-3 days. Therapeutic measures include diet. When toxic hepatitis recommended food enriched with carbohydrates, fruit juices in large quantities. The patient should be limited in the intake of fat.

Exacerbation therapy

In such conditions, hospitalization, more stringent diet is recommended. For toxic hepatitis, bed rest is necessary. Patients are prescribed predominantly B-group vitamins, as well as folic, nicotinic, and ascorbic acid. To improve the flow of anabolic processes, steroid hormones are used (by mouth - methandrostenol per day at 15-20 mg, with a gradual decrease in dosage, or intramuscularly retabolil every two weeks at 20-50 mg). In more severe conditions, corticosteroid hormones are recommended (Prednisolone, 20-40 mg / day), immunosuppressants are long-term, but in a small dosage.

Preventive actions

The main measures to prevent the development of pathological conditions are to carefully observe the rules of hygiene. Do not eat inedible or edible, but old mushrooms or other foods that have expired. As noted above, one of the main causes of toxic liver damage is taking high doses of medication. In the appointment of potent drugs, the use of which is associated with the risk of hypersensitivity reactions and other complications, you must follow the instructions of the doctor and follow the recommendations in the annotations to the drugs. It is not recommended to change the treatment regimen by yourself. With the development of pathological conditions associated with impaired activity of the liver, you must immediately visit a specialist and get qualified help.

- is a liver disease, acute or chronic course, developing as a result of chemical or other harmful substances (drugs, alcohol, fungi toxins) entering the body, their toxic effect on liver cells, accompanying inflammation of the cells and their death, and size, pain in the right hypochondrium and progressive

Acute acute toxic hepatitis, called acute toxic hepatitis, develops as a result of a single, large concentration of poison or a small dose of poison that has affinity for hepatic cells, and symptoms usually appear in 2-5 days.

Toxic hepatitis chronic course, called "Chronic toxic hepatitis," develops with a multiple hit of poison, in small doses that do not have affinity with the liver cells, may occur after months or years. Manifestations of acute toxic hepatitis, severe, occur severely, the patient must be urgently hospitalized, and in case of delayed medical care, can lead to death. Chronic toxic hepatitis, develops slowly, symptoms appear gradually, if not eliminate the cause, then complicated by liver cirrhosis and liver failure.

Causes of toxic hepatitis The ingestion of harmful substances can be accidental, professional (work activity) or intentional (desired). Harmful substances that enter the body and infect the liver are called hepatic poisons. They enter the body in different ways. Through the digestive tract: mouth → stomach → blood → liver. Through the respiratory system: nose → lungs → blood → liver. Poisons can also penetrate through the skin into the blood and then into the liver. Penetrating into the blood alone hepatic poisons can have a direct effect on the hepatic cell (hepatotropic poisons), disrupting its function and vital activity. Other types of poisons that violate the blood circulation in small vessels feeding the liver, this leads to a lack of oxygen in the cells and their death, followed by a violation of the function of the organ.

Hepatic poisons have a different origin:

1. Drugs , in doses prescribed by the attending physician, have a therapeutic effect, with a single large dose (toxic) of one of the drugs of these groups, toxic liver damage and the development of acute toxic hepatitis occur.

  • sulfa drugs: Biseptol, Sulfadimetoksin
  • antiviral: interferon, amantadine,
  • TB: Ftivazid, Tubazid, Antipyretic: Paracetamol, Aspirin
  • anticonvulsants: Phenobarbital and others.


2. Industrial poisons

enter the body by inhalation or through the skin, when large doses are ingested, acute liver damage develops with the death of its cells and fat cells, with repeated small doses, chronic toxic hepatitis develops.

  • arsenic - it is allocated on metallurgical combines,
  • phosphorus - contained in phosphate fertilizers, used for metal processing
  • pesticides - used in agriculture, for the destruction of weeds
  • chlorinated hydrocarbons- oil components.
  • aldehydes (for example: acetaldehyde) is used in industrial facilities to produce acetic acid
  • phenols - contained in antiseptics used for disinfection, contained in canned food
  • insecticides - used in agriculture, to combat insect pests

3. Alcohol

chronic and excessive use of alcohol, especially of poor quality, leads to toxic liver damage. 20-40 grams of alcohol per day for men, and up to 20 grams for women, are considered safe doses, at higher doses, it has a toxic effect.

All taken alcohol from the digestive tract with blood enters the liver. In the liver, active treatment of the ingested alcohol occurs. The main component of alcohol conversion in the liver is its interaction with the enzyme alcohol dehydrogenase. As a result of this enzymatic conversion, the breakdown of alcohol leads to the formation of acetaldehyde. Acetaldehyde is a fairly toxic substance, under the action of which, violations of various chemical reactions in the liver (in particular, and fat metabolism) occur. Fatty acids accumulate and the liver cells are replaced by fatty tissue.

4. Plant Poisons (weed poisons: gorchak, krestovnik, fungus poisons: pale toadstool), have a hepatotropic effect (act directly on the hepatic cell, disrupting its vital activity and replacing it with adipose tissue), as a result of which a clinic of acute toxic hepatitis develops.

Symptoms of toxic hepatitis Signs of acute toxic hepatitis:

In mild cases, it can occur with almost no symptoms, it is found only during a group examination (for example, the use of poisonous fungi).

In more severe cases, it may manifest itself in the form of the following symptoms:

  • Pains in the right hypochondrium, occur suddenly, 2-5 days after the penetration of the hepatotropic poison into the body, are the result of stretching the capsule by an enlarged liver (due to the acute inflammatory process in it),
  • Signs of intoxication: fever> 380 ° C, general weakness, lack of appetite, nausea, vomiting (maybe with blood), pain in the joints,
  • Bleeding from the nose, gums, small point hemorrhages on the skin, these manifestations are the result of the destructive action of the toxin on the walls of blood vessels,
  • Influence on the psyche of the patient in the form of agitation or lethargy, violation of orientation in space, tremor, as poisons have the ability to exert a toxic effect on nerve cells,
  • Progressive jaundice, dark urine, light feces (oily, shiny) appears simultaneously with signs of intoxication, and is the result of a violation of the flow of bile along small intrahepatic biliary tract,
  • Enlarged liver in size as a result of acute inflammation of the liver cells and their replacement with adipose tissue (fatty degeneration of the liver)

Signs of chronic toxic hepatitis:

  • Periodic pain in the right hypochondrium, of medium intensity, aggravated after eating,
  • Severity in the right hypochondrium, associated with an increase in the liver,
  • Subfebrile body temperature 37-37,50C,
  • Nausea, vomiting, loss of appetite, bitter taste in the mouth, bloating, diarrhea, these manifestations develop as a result of a violation of the flow of bile,
  • Fatigue, decreased performance,
  • Pruritus, itchy skin due to accumulation of bile acids,
  • Enlarged liver and spleen.

These symptoms may subside for a while (remission), and again manifest (worsen).

Complications of toxic hepatitis In mild cases, toxic hepatitis is completely cured. In other cases, it may be complicated by one of the following diseases:

1. Hepatic failure is the result of the death of hepatic cells, their replacement with fat cells and the violation of its functions, manifested by the following symptoms:

  • Edemas (as a result of protein metabolism disorders),
  • Jaundice
  • Bleeding (reduced production of blood clotting factors),
  • Weight loss of the body (due to lack of saturation of the body with proteins, fats, carbohydrates, energy, produced by the liver),
  • Hepatic encephalopathy (mental and neuromuscular disorders) develops as a result of impaired toxic function of the liver,

2. Hepatic coma, progressive impairment of the liver and central nervous system (impaired consciousness, reflexes, convulsions, etc.), the result can be death,

3. Cirrhosis, a chronic disease that results in the death of liver cells and their replacement with connective tissue.

Treatment of toxic hepatitisTraditional methods of treatment of toxic hepatitis The first step is to prevent contact with the poison. To prevent poison from entering the bloodstream, and later on to the liver, it is necessary to remove it from the stomach (in cases where it has entered the digestive tract), by artificially induced vomiting. Take a comfortable position for vomiting (half-sitting position with the head tilted forward), by irritating the root of the tongue, as a result of pressing on it with your finger (but this is not used in all cases). To reduce the effects of poison on the stomach wall, you can drink milk, a decoction of flax seeds. If there is an increase in temperature, you can apply cold compresses on the forehead. While we are doing all this, we urgently call an ambulance, or urgently contact a specialized medical institution (toxicology department).

If symptoms of acute toxic hepatitis are manifested, the patient should be urgently hospitalized, where the following treatment methods will be carried out under the supervision of the attending physician:

Treatment of toxic hepatitis

  • Bed rest
  • Gastric lavage, cleansing the remaining poison in the stomach. A special probe is inserted into the stomach of a patient sitting on a chair with the head tilted forward, and a funnel joins the other end of the probe. When pouring water, a funnel (with a capacity of 1 liter), raise the level of the mouth, if it is filled, it is lowered and water from the stomach is poured into the vessel. And again, pour a new portion of water. Water should be body temperature, for an adult, for washing the stomach, you need 8-10 liters of water.
  • Removal of poisons from the body (activated carbon, droppers with electrolyte solutions), hemosorption, plasmapheresis (purification of the blood from toxic substances). Activated carbon sucks on its surface the toxins remaining in the stomach, preventing them from entering the blood.
  • Vitamin therapy - the use of vitamins B and C.
  • Hepatoprotectors (Leaf 52, Heptral, Essentiale). These drugs are actively involved in the processes of reproduction of liver cells and their recovery after injury. Leaf 52 is prescribed 2 tablets 3 times a day, the duration of admission is individual, depending on the degree of liver damage.
  • Choleretic drugs (Holosas, Holenzim). Together with the bile, a part of toxic substances is removed from the liver. Bile preparations activate this process.
  • Antidotes (with mushroom poisoning, Atropine). Chemicals that specifically affect toxic agents or cell receptors, preventing toxic damage.

Hepatoprotectors of plant origin for the treatment of toxic hepatitisHepatoprotectors - increase the resistance of the liver to harmful effects (drugs, alcohol, vegetable and chemical poisons). Accelerate the recovery of damaged cells. Strengthen the neutralizing function of the liver.

Drug Liv.52, description, composition, action

Composition: chicory ordinary, captors spiny, yarrow, western cassia, terminal arguna, black nightshade, Gallic tamarix.

The mechanism of action and the effects of Liv. 52:- Neutralization of toxic substances Increases the activity of enzymes (cytochrome P 450, acetaldehyde dehydrogenase, etc.), which are involved in the neutralization of toxic substances. Acetaldehyde dehydrogenase reduces the damaging effect of alcohol and promotes its removal from the body.

- fights free radical damage The components of the drug stimulate the production of substances (tocopherols, glutathione), which reduce the effect of free radicals (antioxidant effect). Free radicals - These are molecules with an unpaired electron on the electron shell (O ·, HO ·, RO ·, etc.). Such molecules damage healthy cells, accelerate their aging and death.

-Zhelchegonny effect The drug stimulates the formation of bile by the liver cells and promotes its removal through the bile ducts. Excess fat (cholesterol, B-lipoproteins, triglycerides) and toxic substances (phenols, benzoperenes, etc.) are excreted from the body's bile.

- Anti-inflammatory effect The effect is achieved due to the action of the active components of the drug on inflammatory factors (leukotrienes, prostaglandins, cyclins). So extract from the nightshade black part of Liv. 52 reduces the formation of leukotrienes, substances responsible for the formation of allergic and inflammatory reactions.

Watch the video: What is Toxic Hepatitis? Chemical-Driven Liver Damage (February 2020).