The encyclopedia of hepatitis and other liver diseases

The Encyclopedia of Hepatitis and Other Liver Diseases The Encyclopedia of Hepatitis and Other Liver Diseases James H Chow, M.D Cheryl Chow The Encyclopedia of Hepatitis and Other Liver Diseases Copyright © 2006 by James H Chow and Cheryl Chow All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval systems, without permission in writing from the publisher For information contact: Facts On File, Inc An imprint of Infobase Publishing 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Chow, James H., 1948– The encyclopedia of hepatitis and other liver diseases / James H Chow, Cheryl Chow p cm Includes bibliographical references and index ISBN 0-8160-5710-9 (hc : alk paper) Liver—Diseases—Encyclopedias Hepatitis—Encyclopedias [DNLM: Hepatitis—Encyclopedias— English Liver Diseases—Encyclopedias—English WI 13 C552e 2005] I Chow, Cheryl, 1952– II Title    RC845.C46 2005 616.3’62’003—dc22 2005018489 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions, or sales promotions Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755 You can find Facts On File on the World Wide Web at http://www.factsonfile.com Text and cover design by Cathy Rincon Printed in the United States of America VB FOF 10 This book is printed on acid-free paper contents Foreword vii Acknowledgments ix Entries A–Z Appendixes 307 Bibliography 347 Index 353 Foreword T he liver is susceptible to numerous disorders that range from mild to advanced, irreversible disease Because the liver is the largest organ in the body, performing more than 200 different functions, including the processing of nutrients and storing of vitamins and iron, to name just a few, when the liver is injured for any reason, various bodily processes start to go wrong, leading to a variety of syndromes Thus, liver diseases are wide and varied, encompassing a large number of conditions with different causes Liver disease affects millions of people worldwide; overall, it is the seventh-leading cause of mortality in the United States Hepatitis C alone affects an estimated million people in the United States Hepatitis C turns into a chronic liver disease for 75 to 80 percent of those who become infected It is a progressive disease that leads to cirrhosis—irreversible liver scarring—in more than 25 percent of chronic sufferers of hepatitis C And cirrhosis in turn kills more than 25,000 Americans annually, ranking fourth in the cause of death for people between the ages of 25 and 44 Worldwide, some 300 million people— representing about percent of the world population—suffer from chronic hepatitis B infection, which is one of the major causes of liver cancer, particularly in developing countries Aside from viral hepatitis, common liver diseases include those induced by toxins (most notably alcoholic liver disease, which affects millions of individuals) and autoimmune chronic liver diseases such as autoimmune hepatitis, primarily sclerosing cholangitis, and primary biliary cirrho- sis Other types of liver disorders are hereditary diseases These include hemochromatosis, alpha 1antitrypsin deficiency, and Wilson’s disease Other liver diseases are cancer of the liver, cystic disease of the liver, and fatty liver There is some indication that fatty liver, often associated with diabetes and obesity, is on the rise because of an epidemic of vastly overweight people in the United States (But obesity is not the only factor contributing to fatty liver.) Some liver diseases also occur for as yet unidentifiable causes No one is exempt from liver disease, including children But with children, disorders of the liver mostly have a genetic origin More than 100 different liver diseases are found in infants and children, some of them fatal; fortunately, most of them are rare The economic cost of liver disease amounts to billions of dollars annually when lost productivity is added to the cost of medical care Quite aside from economics, the impact of liver disease on the daily lives of many individuals and their loved ones is incalculable It is my hope that this situation can be rectified by a better-informed public and policymakers As a clinician with a medical practice spanning more than two decades, I have long recognized the relative indifference or ignorance when it comes to the liver and the myriad diseases that can afflict it The number of patients with liver disease is increasing But compared to cardiovascular diseases, there is little awareness of disorders related to the liver—aside from a recent surge of interest in hepatitis C, thanks to a rising number vii viii The Encyclopedia of Hepatitis and Other Liver Diseases of baby boomers manifesting signs of the infection It is understandable, though unfortunate, that so many people, distracted by the urgencies of their daily lives, neglect their livers After all, the liver suffers in silence for many years More often than not, liver diseases are asymptomatic in the early stages; it is often only after irreparable damage has been done to the liver that any symptoms appear I cannot overemphasize the importance of becoming well acquainted with one’s liver Knowledge is power; it helps one lead a healthy lifestyle, and in the event of illness, it provides one the tools to make informed choices regarding medical care Those currently suffering from any type of liver disease should find out all they can about the condition, or learn as much as possible for the sake of their families or friends who may be so afflicted This book was written to fulfill such a need, to provide an easy-to-read reference for patients and their family, friends, employers, and coworkers, who have to live and work with the patients I have tried to clarify complex and confusing issues, and to write in language that is understandable to the layperson, my target audience for this book I have also attempted, however, to include enough information that the book may serve as well as a handy guide for health professionals involved in the care of patients with liver disease The materials have been compiled into an easily accessible, alphabetized format Yet this book is not meant to be a comprehensive or exhaustive description of every liver disease, known and unknown, as such an undertaking would require volumes Nor is the information in this book meant to substitute for proper medical care from an experienced and licensed physician Readers must understand that specific diagnosis and recommendations for treatment cannot be obtained from a book Finally, to anyone suffering from a chronic liver disease, I would like to offer a message of hope Even for chronic disease for which there is no cure at present, the patient and the physician can often a lot to extend the time before cirrhosis and its attendant complications develop The times between laboratory research and practical application are being continually narrowed, and significant strides have been made in the treatment and management of chronic liver disease Scientists are making stunning contributions, ranging from an understanding of molecular virology to the genetics of many inherited diseases, allowing new drugs and treatments to be developed Liver transplantation, the final option for patients with end-stage liver disease, has made such astonishing progress that it is becoming a routine procedure But we have only just embarked on this incredible journey of hope—hope that every single person may have a healthy, functioning liver —James Y H Chow, M.D Medical Director Nihon Clinic Acknowledgments F rom the conception of this book, many people have contributed their assistance and advice We would especially like to thank the patients and individuals with liver disease who shared with us their perspective on living with a chronic disease Thanks also to the research librarians at the Boulder Public Main Library and Meadows Public Library in Boulder, Colorado We are also extremely grateful to our editor, James Chambers, for his patience and dedication in editing our manuscript And we are indebted to Elizabeth Knappman-Frost of New England Publishing Associates for her kindness James Y H Chow would like to thank the entire staff at the Nihon Clinic in New York, Atlanta, Chicago, San Diego, and Tokyo, as well as the staff of Noguchi Hideyo Memorial Foundation, New York Finally, he would like to thank his parents for put- ting him through college, in particular his mother, without whose encouragement he would never have entered medical school, and this book would never have been written Cheryl Chow would especially like to thank several individuals who have been exceptionally helpful in the execution of this book, notably Dr Marian Furst for her critical review and analysis of the manuscript; Professor Tian Tai Min for his generosity and unflagging support; and James Adams for his critical insight and keen mind Without them, this book could never have been completed She would also like to thank Dr Chen Tsui Chang and Dr Howard Worman And she remembers with regret her aunt Wen-fang, for whom medical attention for chronic liver disease came too late She was the impetus behind the undertaking of this book ix 358 The Encyclopedia of Hepatitis and Other Liver Diseases cocaine, and hepatitis C 147 coffee, and hepatitis C 202 coinfection 139, 290– 293 and alcoholic liver disease 12 and fulminant hepatitis 84 of hepatitis B and hepatitis C 118 of hepatitis B and hepatitis D 164, 165 and hepatitis C treatment 162 colchicine for alcoholic liver disease 14–15 for primary biliary cirrhosis 275 for primary sclerosing cholangitis 279 collateral shunts 258 colony-stimulating factors (CSFs) 39–40 colorectal carcinoma (CRC) 50, 208 primary sclerosing cholangitis and 281 recurrence of 210 treatment of 95–96, 209, 210, 212, 213 compensated cirrhosis 60–61, 116 complete blood count (CBC) 65–66 complete nonresponse, to antiviral therapy 160 computed tomography (CT) after radiofrequency ablation 285 for hydatid cysts 177 of liver tumors 238 condoms, for hepatitis B prevention 117 congenital defects, and biliary atresia 35–36 congestive gastropathy, cirrhosis and 62 congestive heart failure, and cardiac cirrhosis 50 congestive hepatopathy See cardiac cirrhosis copper, accumulation of, in Wilson’s disease 302 corticosteroids for alcoholic liver disease 14 for autoimmune hepatitis 30, 31 hepatotoxicity of 77t as immunosuppressants 185 and NSAIDs 256 for primary biliary cirrhosis 275 and proteins in blood 288 side effects of 186t coumadin, hepatotoxicity of 77t creatine phosphokinase (CPK; CK) test 21 creosote bush See chaparral Crigler-Najjar syndrome 33 Crohn’s disease, primary sclerosing cholangitis and 280–281 CRST syndrome, and primary biliary cirrhosis 273, 276 cryoablation See cryosurgery cryoshock syndrome 67 cryosurgery 66–67 for liver cancer 209, 211, 213 cryotherapy See cryosurgery CT See computed tomography CT angiography (CTA) 23 Cuprimine See penicillamine cutaneous porphyria 256, 257 cyclosporine (Sandimmune; Neoral) for autoimmune hepatitis 30–31 as immunosuppressant 186 for primary biliary cirrhosis 275 side effects of 186t cyclosporine A, hepatotoxicity of 77t cyst, hydatid 174–181 cystic duct 35 cystic echinococcosis (CE) 175, 179, 180 cytokines 15, 38, 184 cytomegalovirus, and neonatal hepatitis 245 D DCP See des-gammacarboxyprothrombin debulking, of tumors 56 decompensated cirrhosis 113 deep-vein thrombosis 270 deferoxamine, in chelation therapy 94 dentists, and hepatitis C transmission 149 Depakote See valproic acid Department of Health and Human Services (HHS) 3, 16 Depen See penicillamine dependence, on alcohol See alcohol, abuse and dependence depression 68–69, 89 antiviral treatment and 145–146 hepatitis C and 203 Deputyren’s contracture 216 dermatomyositis 273, 277 des-gamma-carboxyprothrombin (DCP) 20, 69 diabetes 69–70 and cirrhosis 62 and fatty liver 80 and hepatomegaly 172 interferon therapy and 189 dialysis albumin 25–26 for hepatorenal syndrome 174 liver 24 diet/nutrition 204–205 for Alagille syndrome for alcoholic liver disease 14 for ascites 27 for biliary atresia 37 for cirrhosis 13, 64 for encephalopathy 63 for fatty liver 81 and gallstones 88 for hepatic encephalopathy 99 for hepatitis B 121 for hepatitis C 201, 202 for intrahepatic cholestasis of pregnancy 197 for primary biliary cirrhosis 274–275 for primary sclerosing cholangitis 279–280 for tyrosinemia 296 Dilantin See phenytoin Index 359 dioxin, and cholangiocarcinoma 57 direct cholangiography 59 distal splenorenal shunt (DSRS) 43 diuretics, for ascites 27 donation of blood and hepatitis B 118 and hepatitis C 124, 147–148 of organs 70–72 after death 71 allocation of organs 16–17 donor criteria for 232–233 living donation 71–72, 86 organ procurement organizations and 17, 253–254 resources for 72 shortage of 232 waiting list for 17 whole body 71 dose-dependent drugs 74 D-penicillamine for primary biliary cirrhosis 275 for primary sclerosing cholangitis 279 drug-induced hepatitis 72–74, 102–103, 206 drugs/medications and anesthesia 267– 268 for chronic hepatitis B 240–244 and depression 68 and hepatitis B 110, 117 and hepatitis C 144– 146, 202 idiosyncratic reactions to 75 interactions of, posttransplantation 262 intranasal 147 intravenous 146– 147 and liver disease 74–77 overdose of 1, 75–76 during pregnancy 144 risks of taking 75 treatment for abuse of 145 dry eyes 280 dry gland syndrome See Sjögren’s syndrome dry mouth 280 DSRS See distal splenorenal shunt Duke cancer staging system 49 Durable Power of Attorney for Healthcare 268 E early virological response (EVR) 160 echinococcosis See hydatid cysts Echinococcus granulosus 174, 175, 179, 180 Echinococcus multilocularis 174, 175, 176, 179, 180 Echinococcus vogeli 174, 175 edema 5, 214 ELAD See Extracorporeal Liver Assist Device Elavil See amitriptyline electrophoresis, serum protein 287–288 ELISA test See enzymelinked immunosorbent assay test Elkhammas, Elmahdi 234 embolism 78 embolization 78, 211 See also chemoembolization emphysema, alpha-1antitrypsin deficiency and 18, 19 encephalopathy See hepatic encephalopathy endocrine therapy See hormone therapy endoscopic retrograde cholangiopancreatography (ERCP) 78–79 for cholestasis 59 for hydatid cysts 177 for primary sclerosing cholangitis 279 endoscopy, for primary sclerosing cholangitis 280 enflurane, hepatotoxicity of 76t enlarged spleen See hepatomegaly entecavir (ETV), for hepatitis B 243 enterically transmitted non-A, non-B hepatitis See hepatitis E enzyme-linked immunosorbent assay (ELISA) test 128–129 enzymes, liver 218 epidemic non-A, non-B hepatitis See hepatitis E epidural anesthetic 266–267 epithelioid hemangioendothelioma 210 Epivir-HBV See lamivudine ERCP See endoscopic retrograde cholangiopancreatography erythromycin estolate, hepatotoxicity of 76t erythropoietin 40 esophageal balloon tamponade 63 esophageal sclerotherapy 42 esophageal varices 41 esophagogastroduodenoscopy 42 estrogen and hepatic adenomas 34 and intrahepatic cholestasis of pregnancy 194 and liver cancer 47 ETV See entecavir EVR See early virological response exercise 79 for depression 69 for hepatitis C 202 Extracorporeal Liver Assist Device (ELAD) 25 eye exams, for Wilson’s disease 303 F FAH See fumarylacetoacetate hydrolase familial erythrophagocytic syndrome 85 Fasciola californica 222 Fasciola gigantica 222 Fasciola halli 222 Fasciola hepatica 221, 222, 223 Fasciola jacksoni 222 Fasciola magna 222 Fasciola nyanzae 222 fascioliasis 222 fatigue 214 in hepatitis C 202– 203 interferon therapy and 189 in intrahepatic cholestasis of pregnancy 195 in primary biliary cirrhosis 273 360 The Encyclopedia of Hepatitis and Other Liver Diseases fatty liver (steatosis) 80–82 alcoholic 12, 80 exercise for 79 nonalcoholic 47, 80, 81 occupational risks for 248 of pregnancy 219, 264 ferritin 93 fever, in liver disease 214 FHF See fulminant hepatic failure fibrolamellar hepatoma 208 fibrosis 82–83 coinfection and 291 hepatitis C and 123, 132, 161 research on 64 filgrastim 39–40 Flaviviridae 124 FLD See fatty liver floxuridine (FUDR), for metastatic liver cancer 209 fluid intake, for hepatitis C 202 fluid retention in cirrhosis 62, 63 in liver disease 214 flukes See liver flukes flu-like symptoms interferon therapy and 189 in liver disease 214 fluvastatin (Lescol), hepatotoxicity of 77t FNH See focal nodular hyperplasia focal nodular hyperplasia (FNH) 34, 236 Food and Drug Administration (FDA) 186, 187 fractures, liver disease and 216 FUDR See floxuridine fulminant hepatic failure (FHF) 217 See also fulminant hepatitis; liver failure diagnosis of 219–220 drug-induced hepatitis and 72 liver transplantation for 232 outlook for 220–221 shock liver and 289 symptoms of 219– 220 treatment of 220– 221 fulminant hepatitis 83– 86 See also fulminant hepatic failure; liver failure causes of 84 in children 85–86 diagnosis of 84 hepatitis B and 111 hepatitis G and 169 prognosis for 85, 86 symptoms of 84 treatment of 86 Wilson’s disease and 304 fumarylacetoacetate hydrolase (FAH) 296 G galactosemia, in children 217 gallbladder 37, 87–88 inflammation of See cholecystitis gallstones See cholelithiasis Galzin See zinc acetate Gamastan 182 gamma globulins See immune globulin gammaglutamyltranspeptidase (GGTP) test 15–16, 216, 217, 225 gamma interferon See interferon(s), gamma Gammar 182 garlic 267 gastric lavage 63 gastropathy, congestive 62 GB virus C See hepatitis G G-CSF (filgrastim) 39–40 gender, and hepatitis C treatment 162 gene mutation in Alagille syndrome in hemochromatosis 92, 93 in Wilson’s disease 302 general anesthesia 267 gene therapy, for liver cancer 212 genetic testing, for Wilson’s disease 303 genotypes of hepatitis B 170 of hepatitis C 124, 131, 159, 161, 187 of viruses 187 germander 90 Geschwind, Jeff 51 GGTP test See gammaglutamyltranspeptidase test giant cell of newborns See neonatal hepatitis Gilbert’s syndrome (GS) 88, 246 ginger 203, 267 gingko biloba 267 ginseng 91–92, 267 globulins, concentration of 288 glomeronephritis 113 glycogen storage disease in children 217–218 and hepatic adenomas 34 and liver cancer 47 Glycyrrhiza glabra 91 GM-CSF (sargramostim) 39–40 gout medications, and cholestasis 58 granulomas, sarcoidosis and 287 granulomatous hepatitis 102 greasewood See chaparral grieving 88–89 GS See Gilbert’s syndrome H HAART See highly active antiretroviral therapy HAI See hepatic artery infusion chemotherapy Haley, Robert 150 halothane, hepatotoxicity of 76t “halzoun” 223 HAVRIX (vaccine) 299 HBcAb See hepatitis B core antibody HBcAg See hepatitis B core antigen HBeAg See hepatitis B e antigen HBIG See hepatitis B immune globulin HBsAg See hepatitis B surface antigen HCC See hepatocellular carcinoma HE See hepatic encephalopathy health care workers, occupational-related diseases of 148–149, 248 heart disease, primary biliary cirrhosis and 277 “heat sink effect” 285 helicase inhibitors, for hepatitis C 137 hemangiomas 34, 236 Index 361 hematocrit value, and interferon treatment 188 hematopoietic growth factors See colonystimulating factors hemochromatosis 92–95 and diabetes 69 diagnosis of 93–94 genetic mutation causing 92, 93 and hepatitis C 161–162 hereditary 92, 93 and liver cancer 47 neonatal 85 outlook for 94–95 symptoms of 93–94 treatment of 94–95 hemodialysis, and hepatitis C transmission 149 hemolytic anemia 304 hemophilia 147–148 Henry, Mitchell 234 hepatic adenomas 34, 47, 236 hepatic artery 204, 257 hepatic artery infusion chemotherapy (HAI) 95–97, 209 hepatic coma See hepatic encephalopathy hepatic duct 35 hepatic encephalopathy (HE) 97–99 ammonia and 62, 97, 205 cirrhosis and 62, 63 control of 63 in liver disease 216 in liver failure 218, 219, 220, 221 shunt operations and 42, 295–296 hepatic granulomas 102 hepatic ischemia See shock liver hepatic porphyria 256 hepatic portal vein 257, 258 hepatic vein catheterization, for Budd-Chiari syndrome 44 hepatitis 99–104 See also specific type acute 84, 100 alcohol and 2, 12, 102 autoimmune See autoimmune hepatitis causes of 99–100 in children 217 chronic 84, 100–101 and cirrhosis 64 definition of 99 diagnosis of 100–104 drug-induced See drug-induced hepatitis and fibrosis 82 fulminant See fulminant hepatitis granulomatous 102 neonatal See neonatal hepatitis nonviral 102 outlook for 104 symptoms of 100– 104 transmission of 100 treatment of 104 viral 101 See also specific type and cholestasis 57 and fulminant hepatic failure 219 interferon for 187– 188 misdiagnosis of vaccines for 299– 301 hepatitis A 101, 104– 108 in children 105 diagnosis of 106 diseases associated with 108 and fulminant hepatic failure 219 and fulminant hepatitis 84 immune globulin for 107–108, 182–183 liver biopsy for 206 outlook for 106 during pregnancy 106 prevention of 106– 108 primary biliary cirrhosis and 277 risk factors for 106 symptoms of 105– 106 transmission of 105–106 treatment of 106 vaccine for 30, 106– 107, 299, 300 hepatitis B 101–102, 108–122 acute 112 diagnosis of 120 recovery from 121 alcohol and 121 and alcoholic liver disease 12 in children 110, 190 chronic 112–113 ACH-126, 443 for 243 adefovir dipivoxil for 242–243, 243t diagnosis of 120– 121 entecavir for 243 and hepatocellular carcinoma 46 interferon for 240– 241, 243t lamivudine for 240, 241–242, 243t LDT for 243 medications for 240–244 ongoing care for 121 and superinfections 290–291 chronic mutant 120 and cirrhosis 113 coinfections with 118, 291, 292 diagnosis of 111– 112, 117–119 discovery of 109 DNA of 116, 119– 120 and fibrosis 83 and fulminant hepatic failure 219 and fulminant hepatitis 84, 85–86, 111 hepatitis D and 164, 165 and hepatocellular carcinoma 65, 169–170 immune globulin for 183 and immunosuppressants 185 incidence of 109 and kidney disorders 113–114 and liver cancer 113 neonatal 245 occupational risk for 248, 249 outlook for 114–117 phases of 111–112 in pregnancy 110 prevention of 117 primary biliary cirrhosis and 277 risk factors for 117 symptoms of 111– 112 transmission of 109–110 362 The Encyclopedia of Hepatitis and Other Liver Diseases treatment of 114– 117 combination therapy 116–117 criteria for 114 effectiveness of 116 goals of 114 vaccine for 30, 107, 110–111, 117, 171, 299–300 YMDD variant of 241–242 hepatitis B core antibody (HBcAb) 118 hepatitis B core antigen (HBcAg) 118 hepatitis B e antigen (HBeAg) 109, 118– 119, 120 hepatitis B immune globulin (HBIG) 183, 299–300 hepatitis B surface antigen (HBsAg) 118 hepatitis C 102, 122– 140 acute 126, 134, 157 course of 135 treatment of 135 alcohol and 8–10, 156, 201 and alcoholic liver disease 12 antibodies to 127– 128 and autoimmune hepatitis 31 characteristics of 122–123 in children 140–144 course of 141–142 diagnosis of 141– 142 interferon therapy for 190–191 outlook for 142– 143 prevention of 143 risk factors for 143 symptoms of 141– 142 treatment of 142– 143 chronic 1, 122–123, 126–127, 134 alcohol and course of 135–136 and hepatocellular carcinoma 46 lifestyle and 200– 203 treatment of 135 and cirrhosis 130, 133, 135, 158 coinfections with 118, 291–293 depression in 203 diagnosis of 127–134 and drug use 144– 146 and fatigue 202–203 and fibrosis 83 and fulminant hepatitis 84 genotypes of 124, 131, 159, 161, 187 and hepatocellular carcinoma 169– 170 history of 122 and HIV/AIDS 141, 153, 157 in homeless people 155 and immunosuppressants 185 liver biopsy for 131– 133, 205 liver transplantation for 163–164 mutants of 124–125 and nausea 203 neonatal 245 outlook for 134–137 physicians’ attitude toward 200–201 in pregnancy 139, 142–143 prevalence of 123– 124 prevention of 137– 139 in prison inmates 155 public awareness of 146 risk factors for 124, 137–139 RNA of 129, 141 staging of 132 and superinfections 290–291 support groups for 203 symptoms of 125– 127 and thyroid disorders 294 transmission of 141, 146–156 blood products 124, 147–148 body piercing 149– 150 drug use and 144– 146, 146–147 household contact 151–152 kissing 151 medical procedures 149 occupational exposure 148–149 in pregnancy and childbirth 152– 154 sexual transmission 150–151 tattooing 149–150 unknown sources 154–155 treatment of 134– 137, 156–164 alcohol and amantadine for 137 antisense nucleotides for 137 criteria for 157 future therapies 136 goal of 158 helicase inhibitors 137 immunotherapy 136 inosine monophosphate dehydrogenase inhibitors for 137 IRES inhibitors for 137 liver transplantation 163–164 patients not receiving 157–158, 164 polymerase inhibitors 137 protease inhibitors 136 psychiatric care in 145–146 response to 159– 162 ribozymes 137 side effects of 162– 163 stem cell therapy 137 therapeutic vaccine 137 vaccine for 137, 202, 300 viral load in 130– 131 virus 122, 124–125 hepatitis C antibody test 127–128 Hepatitis C Check 129 hepatitis D 102, 164– 166 and fulminant hepatic failure 219 hepatitis B and 300–301 and superinfections 290–291 Index 363 hepatitis E 102, 166–167 and fulminant hepatic failure 219 vaccine development for 301 hepatitis F 102, 167– 168 hepatitis G 102, 168– 169 hepatoblastoma, in children 217 hepatocellular carcinoma (HCC) 169– 172, 207 alcohol and alpha-fetoprotein levels in 20 cirrhosis and 46, 62–63, 65 diabetes and 70 diagnosis of 170–171 hepatitis B and 46 hepatitis C and 46 incidence of 169, 208 liver flukes and 223–224 liver resection for 227 outlook for 171 prognosis for 213– 214 risk factors for 46, 47, 169–170 survival rates for 67 symptoms of 170– 171 transmission of 169–170 treatment of 171, 212 hepatocellular degeneration See Wilson’s disease hepatocytes 204 in bio-artificial livers 24, 25 in shock liver 288 transplantation of 234 hepatologist 270, 271 hepatoma See hepatocellular carcinoma hepatomegaly 44, 172–173 See also splenomegaly hepatorenal syndrome (HRS) 62, 173–174 hepatotoxicity 74–75, 204, 255 hepatotoxins 74 See also specific substances Hepsera See adefovir dipivoxil herbs 90–92 and anesthesia interactions 267 for depression 68, 69 for gallbladder disorders 87–88 harmful 90–91 helpful 91–92 Herceptin See trastuzumab hereditary hemochromatosis (HHC) 92, 93 HGBV-C See hepatitis G HHC See hereditary hemochromatosis HHS See Department of Health and Human Services highly active antiretroviral therapy (HAART) 292, 293 HIV/AIDS drug use and 144 and hepatitis B 291, 292 and hepatitis C 141, 153, 157, 291–293 lamivudine for 241 HLA-DR3 28, 29 HLA-DR4 28, 29 homeless people, hepatitis C in 155 hormones imbalances in 216 in liver 205 synthetic, as immunosuppressants 185 hormone therapy, for liver cancer 209, 212 HRS See hepatorenal syndrome human immunodeficiency virus (HIV) See HIV/AIDS hydatid cysts 174–181 causes of 174–175 complications of 179–180 diagnosis of 176–177 infection of 176 leaking of 176 outlook for 180 prevention of 180 research on 180 risk factors for 180 rupture of 176, 180 symptoms of 175– 176 treatment of 177–180 hydroxychloroquine, for porphyria 257 hyperbilirubinemia 245–247 hypertension, portal See portal hypertension hyperthermia, for liver cancer 211 hyperthyroidism 276, 294 hypoalbuminemia 5–6, 226 hypothyroidism 273, 276, 294 I ibuprofen (Motrin), hepatotoxicity of 76t, 255–256 ICP See intrahepatic cholestasis of pregnancy idiopathic neonatal hepatitis See neonatal hepatitis idiosyncratic drug reactions 57–58, 75 IFN See interferon IG See immune globulin IL See interleukins imaging studies 217 See also specific procedures for ascites 27 for autoimmune hepatitis 29 for chemoembolization 52 for cirrhosis 61 for hydatid cysts 177 for liver tumors 236, 237–238 for portal hypertension 260, 261 imipramine (Tofranil), and cholestasis 58 immune globulin (IG) 119, 182–183, 226 effectiveness of 182 for hepatitis A 107– 108, 182–183, 299 for hepatitis B 183, 299–300 IgG 106, 119 IgM 106, 119 side effects of 182, 183 and vaccinations 182 immune serum globulins See immune globulin immune stimulants, for chronic hepatitis B 243 immune system 183– 184 See also under autoimmune antigens in 24 barrier defenses 184 cellular defenses 184 restoration of, biological therapies for 38–41 immunizations See also vaccines development of 183–184 prior to liver transplantation 235 364 The Encyclopedia of Hepatitis and Other Liver Diseases immunosuppressants 184–186 for autoimmune hepatitis 30 hepatotoxicity of 77t post-transplantation 32, 33, 234, 262, 263–264 for primary biliary cirrhosis 275 for primary sclerosing cholangitis 279 for sarcoidosis 287 side effects of 185 immunotherapy See biological therapies IMPDH See inosine monophosphate dehydrogenase inhibitors Imuran See azathioprine Inderal See propranolol infants See also children; neonatal alpha-1-antitrypsin deficiency in 18, 19 biliary atresia in 35–37 red blood cells in 246 infections in liver failure 220 post-transplantation 234, 262–263, 270 inflammatory bowel disease 280–281 informed consent 268 INH See isoniazid inosine monophosphate dehydrogenase inhibitors (IMPDH), for hepatitis C 137 insecticides, and hepatitis C 202 insulin 205 resistance to 62, 80, 81 interferon(s) (IFN) 186–193 administration of 188 alcohol and 8, alpha 39, 187 in children 190, 191, 192 combined with ribavirin 191 for hepatitis B 190 for hepatitis C 134, 136, 143, 191 alpha-2b, for hepatitis B 115, 240 beta 187 as biological therapy 39 in children 142, 143, 189–192 coinfection and 291, 292 conventional 240– 241 and depression 69 dosage of 188 effectiveness of 187–188 gamma 187 for hepatitis B 115, 117 chronic 240–241, 243t for hepatitis C 142, 143, 158–159, 160–161 for hepatitis D 165 for HIV/HCVcoinfections 292 monotherapy 191– 192 and NSAIDs 256 pegylated 241 for hepatitis B 115, 117 chronic 241 for hepatitis C 134, 136, 158–159 side effects of 145, 163, 188–189, 192, 240–241 and thyroid disorders 294 types of 186–187 for viral hepatitis 187–188 interleukins (IL) 39 IL-2 39 IL-6 64 International Union Against Cancer, cancer staging system of 48, 49 intrahepatic cholangiocarcinoma See cholangiocarcinoma intrahepatic cholestasis of pregnancy (ICP) 58, 193–198, 264 diagnosis of 194–196 outlook for 196–198 and stillbirth 196 in subsequent pregnancies 198 symptoms of 194– 196 treatment of 196– 198 Intron A See interferon(s), alpha-2b IRES inhibitors, for hepatitis C 137 iron in hemochromatosis 47, 92–95 in hepatitis C 161– 162, 202 in porphyria 256, 257 iron deficiency anemia, primary biliary cirrhosis and 273, 276 iron overload 92 ischemic hepatitis See shock liver isoniazid (INH) drug interactions of 255 and fulminant hepatic failure 219 hepatotoxicity of 77t and proteins in blood 288 itching See pruritis J jaundice 38, 199, 215 alpha-1-antitrypsin deficiency and 19 in biliary atresia 36 in children 5, 217 in cholangiocarcinoma 56 diagnosis of 199 in Gilbert’s syndrome 88 in intrahepatic cholestasis of pregnancy 193, 194 in liver failure 221 neonatal 199, 217, 245, 245–247 treatment of 199 Jenner, Edward 183– 184 K Kasai procedure 4, 36–37, 235 kava kava 267 Kayser-Fleischer rings, in Wilson’s disease 303 kernicterus 217, 246– 247 kidney disorders cirrhosis and 62 hepatitis B and 113–114 hepatorenal syndrome 173–174 primary biliary cirrhosis and 277 Klatskin tumors 56 Koop, C Everett 123 L labor, premature, in intrahepatic cholestasis of pregnancy 195, 197 Index 365 lactic dehydrogenase (LDH) 225 lactulose (Cephulac), for encephalopathy 63, 98 LAM See lamivudine lamivudine for hepatitis B 115, 117 chronic 240, 241– 242, 243t for hepatitis D 165 resistance to 241– 242 laparoscopic liver biopsy 207 laparoscopic liver resection 229–230 laparoscopy, for liver tumors 238 latency, of viruses 104 LDH See lactic dehydrogenase LDT (Telbivudine), for chronic hepatitis B 243 Lescol See fluvastatin levamisole 38 Levine shunt, for hepatorenal syndrome 174 licorice root 91 LifeRing Secular Recovery lifestyle and alcoholic liver disease 14 and chronic hepatitis C 200–203 post-hepatic artery infusion chemotherapy 97 post-liver resection 229–230 post-transplantation 32–33, 234 Lipitor See atorvastatin liver 203–205 function of 204 granulomas in 287 nutrition and 204– 205 regeneration of 71 scarring of See fibrosis structure of 203–204 toxins to See hepatotoxicity liver-assist devices 24– 26, 221 liver biopsy 205–207 for Alagille syndrome for alcoholic liver disease 14 for autoimmune hepatitis 29 for biliary atresia 36 for cirrhosis 61, 205 complications of 207 for hemochromatosis 93–94 for hepatitis A 206 for hepatitis B 118 for hepatitis C 131– 133, 205 laparoscopic 207 for liver cancer 205 for liver failure 220 for liver tumors 237, 238 for neonatal hepatitis 245 for primary biliary cirrhosis 274 procedure for 206– 207 risks of 207 transvenous 207 for Wilson’s disease 303 liver cancer 207–210 See also specific types alpha-fetoprotein in 20 cirrhosis and 62–63, 65 classification of 207 diabetes and 70 diagnosis of 208 embolization for 78 hepatitis B and 109, 113 hepatitis B vaccine and 299 liver biopsy for 205 liver flukes and 223–224 metastatic 50, 207, 208–210, 236 porphyria and 257 primary 207–208, 211, 236 primary biliary cirrhosis and 277 prognosis for 213– 214 recurrence of 211 risk factors for 46–47 staging of 49–50, 211 survival rates for 67 symptoms of 113, 208 treatment of 210– 214 criteria for 212 liver-directed therapy 213 tumor markers for 69 “liver cleanse” 88 liver dialysis 24 liver-directed therapy 213 liver disease 214–218 See also specific diseases alcoholic See alcoholic liver disease diabetes and 69–70 diagnosis of 214– 217 drugs and 74–77 family history of 215 metabolic 47 occupational See occupational liver disease pediatric 217–218 symptoms of 214– 217 liver donor See donation, of organs; liver transplantation liver enzymes 218, 246 liver failure 218–221 See also fulminant hepatic failure; fulminant hepatitis acetaminophen overdose and 255 acute 85–86, 217 in children 85–86 diagnosis of 219–220 outlook for 220–221 process of 217 symptoms of 219– 220 treatment of 220–221 liver flap See astereixis liver flukes 57, 221– 224 “liver flush” 88 liver-function tests 224–225 for Alagille syndrome for autoimmune hepatitis 29 for cirrhosis 61 for intrahepatic cholestasis of pregnancy 195–196 liver palms 215 liver panel 216–217 See also liver-function tests liver proteins 225–227 liver resection 227–230 bloodless 228–229 and chemotherapy 55 complications of 229 criteria for 227 effectiveness of 283 for hepatocellular carcinoma 212 laparoscopic 229– 230 366 The Encyclopedia of Hepatitis and Other Liver Diseases lifestyle modifications following 229–230 for liver cancer 209, 211 outlook following 229–230 procedure for 228– 229 recuperation from 229 risks of 229 types of 228 liver transplantation 230–236 for Alagille syndrome for alcoholic liver disease 7, 14 for alpha-1-antitrypsin deficiency 19 for autoimmune hepatitis 31 auxiliary 32–33, 86, 231 for biliary atresia 37 for Budd-Chiari syndrome 45 in children 234–235 for cholangiocarcinoma 57 for cirrhosis 62, 63 complications of 233–234 contraindications to 271 donor criteria for 232–233 emotional issues following 264 for fatty liver 81 for fulminant hepatitis 86 for hepatic encephalopathy 98 for hepatitis C 163– 164 for hepatitis D 165 history of 230–231 for hydatid cyst 179 immunosuppressants and 185 lamivudine for 241 lifestyle modifications following 234 for liver cancer 209– 210, 211, 213 for liver failure 221 from living donor 71–72, 86, 221, 227, 231 and Medic-Alert tags 264 organ procurement organizations and 17, 253–254 outlook following 234 for portal hypertension 261 post-transplantation care 261–264 precautions following 262–263 pre-transplant evaluation 232, 270–272 for primary biliary cirrhosis 275–276 for primary sclerosing cholangitis 280 procedure for 233, 234 psychological issues following 264 recipient criteria for 231–232 recovery from 233 reduced-size 289 rejection of 185, 233–234, 262, 263, 305 risks of 233–234 sexual activity following 263–264 shortage of organs for 232 split-liver 231, 235, 289–290 transplant team for 271 travel following 264 types of 231 for tyrosinemia 296–297 for Wilson’s disease 304 xenotransplantation 231, 305 liver tremors See astereixis liver tumors 236–239 benign 34–35, 236 cryosurgery for 66 diagnosis of 237–239 imaging of 236, 237–238 malignant 236 metastatic 236 physical examination for 237 primary 236 living will 268 local anesthesia 266 look-back programs, of blood banks 148 lovastatin (Mevacor), hepatotoxicity of 77t lupoid hepatitis See autoimmune hepatitis LVD See lamivudine lymphocytes, in immune system 184 M magnetic resonance cholangiopancreatography (MRCP) 238 magnetic resonance imaging (MRI) of hydatid cysts 177 of liver tumors 238 maltolate, for primary biliary cirrhosis 275 MARS See molecular adsorbent recirculation system material safety data sheet (MSDS) 252 Matsumura, Kenneth 25 mebendazole (Vermox) for hydatid cysts 178 for liver flukes 223 meconium staining, in intrahepatic cholestasis of pregnancy 196 Medic-Alert tags 264 medications See drugs/ medications metabolic abnormalities, and fulminant hepatic failure 219 metabolic bone disease, primary biliary cirrhosis and 276 metabolic liver diseases, and liver cancer 47 metasectomy 50 methotrexate and fatty liver 81 hepatotoxicity of 77t for primary biliary cirrhosis 275 methoxyflurane, hepatotoxicity of 76t Mevacor See lovastatin milk thistle 91 mineral supplements, and hepatitis C 202 mitochondrial antibodies, in liver-function tests 225 mitochondrial disorders, and fulminant hepatitis 85 MOABs See monoclonal antibodies mofetil 185 molecular adsorbent recirculation system (MARS) 25 molecular tests 129–130 monoclonal antibodies (MOABs) 40 monocytes 184 Motrin See ibuprofen MR angiography (MRA) 23 Index 367 MRCP See magnetic resonance cholangiopancreatography MRI See magnetic resonance imaging MSDS See material safety data sheet mushrooms, hepatotoxicity of 77, 219 mycophenolate mofetol (Cellcept), side effects of 186t myocarditis, and cardiac cirrhosis 50 N Nabi-HB See immune globulin, for hepatitis B N-acetyl-cysteine for acetaminophen poisoning 75 for fulminant hepatitis 86 NAFLD See nonalcoholic fatty liver disease naltrexone, for hepatitis C naproxen (Anaprox), hepatotoxicity of 76t NASH See nonalcoholic steatohepatitis National Institutes of Health (NIH) 3, 68 National Organ Transplant Act 16 natural killer cells (NK cells) 184 needles, in radiofrequency ablation 284 needle-stick injuries 148–149 neoadjuvant therapy 55 neomycin for hepatic encephalopathy 98 and proteins in blood 288 neonatal acute liver failure 85, 86 neonatal hemochromatosis 85 neonatal hepatitis 85, 86, 103, 217, 245 neonatal jaundice 199, 217, 245–247 Neoral See cyclosporine nephrotic syndrome 288 neural tube defects, alpha-fetoprotein levels and 20 neuroendocrine neoplasms 209, 210 neurologic symptoms interferon therapy and 189 in neonatal jaundice 246–247 367 Blank in Wilson’s disease 302, 303, 304 NIH See National Institutes of Health NK cells See natural killer cells nonalcoholic fatty liver disease (NAFLD) 47, 80, 81 nonalcoholic steatohepatitis (NASH) 12, 80–81 nonresponse, to antiviral therapy 160 nonspecific immunomodulating agents 38 nonsteroidal antiinflammatory drugs (NSAIDs), hepatotoxicity of 75, 255–256 NSAIDs See nonsteroidal anti-inflammatory drugs 5NT See 5-nucleotidase NTBC, for tyrosinemia 297 nuclear scan See radioisotope scan nucleoside analogs for chronic hepatitis B 243 for hepatitis C 159 nucleoside drugs 241 5-nucleotidase (5NT) 225 nutrition See diet/nutrition nutritional supplements for depression 69 for intrahepatic cholestasis of pregnancy 197 O OAT See opioid agonist therapy obesity, and liver cancer 47 obstetric cholestasis (OC) See intrahepatic cholestasis of pregnancy occupational exposure, to hepatitis C 148–149 occupational liver disease 248–253 chemical exposure and 249–251, 249t–250t occupational history and 251–252 physicians’ role in 251 resources for 252– 253 Occupational Safety and Health Administration (OSHA) 252 octreotide, for bleeding varices 42 omeprazole (Prilosec) drug interactions of 255 hepatotoxicity of 77t opioid agonist therapy (OAT) 145 Opisthorchis felineus 221, 224 Opisthorchis viverrini 221, 222, 224 OPO See organ procurement organization oprelvekin 40 OPTN See Organ Procurement and Transplantation Network oral contraceptives and adenomas 34, 47 hepatotoxicity of 77t and liver cancer 47 organ(s) See donation; transplantation Organ Procurement and Transplantation Network (OPTN) 16, 298 organ procurement organization (OPO) 17, 253–254 Organ Transplant Act (OTA) 298 OSHA See Occupational Safety and Health Administration osteoporosis 281 OTA See Organ Transplant Act overdose See drugs/ medications, overdose of P painkillers 255–256 See also specific medications and cholestasis 58 hepatotoxicity of 74–75, 76t PAIR technique, for hydatid cysts 178, 180 palmar erythema 215 Panax ginseng 91–92 Panax quinquefolius 91–92 paracentesis, for ascites 27 paracetamol See acetaminophen paraneoplastic syndromes 171 368 The Encyclopedia of Hepatitis and Other Liver Diseases parasitic flatworms See liver flukes parental consent 268 patients advocacy 2–3 preparation for surgery 264–270 Patient’s Bill of Rights 2, “Patients’ Care Partnership, The” Patient SelfDetermination Act (1990) PBC See primary biliary cirrhosis PCR test See polymerase chain reaction test PCT See porphyria cutanea tarda Pegasys See pegylated interferon PEG-Intron A See pegylated interferon pegylated interferon for hepatitis B 115, 117 chronic 241 for hepatitis C 134, 136, 158–159 PEI See percutaneous ethanol injection penicillamine (Cuprimine; Depen), for Wilson’s disease 304 percutaneous ethanol injection (PEI) 212, 213 percutaneous transhepatic cholangiography 59 percutaneous treatment, for hydatid cysts 178, 180 perinatal transmission 141, 143, 154, 292 peripheral cholangiocarcinoma See cholangiocarcinoma peritoneum, inflammation of 290 peritonitis, spontaneous bacterial 27, 290 PERV See porcine endogenous retrovirus PET See positron emission tomography PFIC See progressive familial intrahepatic cholestasis phenothiazinederivative drugs, and cholestasis 58 phenytoin (Dilantin) drug interactions of 255 hepatotoxicity of 76t phlebotomy, for hemochromatosis 94 phototherapy, for neonatal jaundice 247 pigs and bio-artificial liver 24, 25 and xenotransplantation 305 plasmapheresis, for pruritis 275 platelet count 65–66, 188, 226–227 police officers, occupational-related diseases of 249 polyarteritis nodosa 114 polymerase chain reaction (PCR) test 129–130 polymerase inhibitors, for hepatitis C 137 porcine endogenous retrovirus (PERV) 305 porphyria 256–257 porphyria cutanea tarda (PCT) 256, 257 porphyrins 256 portal hypertension 13, 257–261 and ascites 26 and bleeding varices 41 causes of 258–259 in children 258 cirrhosis and 62, 258, 259 diagnosis of 259–261 outlook for 261 in primary biliary cirrhosis 276 schistosomiasis and 258 symptoms of 259– 261 transvenous intrahepatic portosystemic shunt for 295 treatment of 261, 295 portal hypertensive gastropathy 62 portal system 257–258 portal vein 204, 257, 258, 260 portal vein shunting 261 positron emission tomography (PET), of liver tumors 238 post-transplantation care 261–264 pravastatin (Pravachol), hepatotoxicity of 77t praziquantel (Biltricide) for hydatid cysts 178 for liver flukes 223 prednisone for autoimmune hepatitis 30 hepatotoxicity of 77t as immunosuppressant 185 for primary biliary cirrhosis 275 side effects of 30, 186t pregnancy 264 and alcoholic liver disease 264 alpha-fetoprotein levels in 20 and autoimmune disorders 32 and autoimmune hepatitis 264 and cirrhosis 264 drug use during 144 fatty liver of 219, 264 and hepatic adenomas 34 and hepatitis A 106 and hepatitis B 110 and hepatitis C 139, 141, 142–143, 152–154 interferon treatment in 188 intrahepatic cholestasis of 58, 193–198 premature labor, in intrahepatic cholestasis of pregnancy 195, 197 pre-transplant evaluation 232, 270–272 Prilosec See omeprazole primary biliary cirrhosis (PBC) 31, 272–277 blood tests for 273– 274 causes of 272 and cholestasis 57 diagnosis of 272–273 genetics and 272 and hepatocellular carcinoma 65 life expectancy with 276 outlook for 274–276 related disorders 276–277 symptoms of 272– 273 and thyroid disorders 294 treatment of 274– 276 primary sclerosing cholangitis (PSC) 31, 277–281 blood tests in 278– 279 causes of 277–278 Index 369 characteristics of 278 and cholangiocarcinoma 57 and cholestasis 57 coexisting diseases 278 diagnosis of 78, 278–279 outlook for 279–280 related disorders 280–281 symptoms of 278 treatment of 279– 280 prison inmates, hepatitis C in 155 prodromal syndromes 111 progesterone, and intrahepatic cholestasis of pregnancy 194 Prograf See tacrolimus progressive familial intrahepatic cholestasis (PFIC) 194 propranolol (Inderal) for bleeding varices 42 for portal hypertension 261 protease inhibitors, for hepatitis C 136 protein(s) blood concentration of 287–288 in immune system 184 of liver 225–227 metabolism of 204– 205 restriction of, for hepatic encephalopathy 99 prothrombin time (PT) 216, 217, 225, 226, 281–282 in cirrhosis 61 in intrahepatic cholestasis of pregnancy 196 in liver failure 220 pruritis in Alagille syndrome 3, in intrahepatic cholestasis of pregnancy 193, 194, 195, 196, 197, 198 in liver disease 214 in primary biliary cirrhosis 273, 275 in primary sclerosing cholangitis 280 pruritus gravidarum See intrahepatic cholestasis of pregnancy PSC See primary sclerosing cholangitis pseudolymphoma 234 psoriasis 77t psychiatric care, in hepatitis C treatment 145–146 psychological issues hepatitis C and 200, 203 interferon therapy and 189 post-transplantation 264 PT See prothrombin time pulmonary complications postoperative 270 primary biliary cirrhosis and 277 pyridoxine See vitamin B6 pyrrolizidine, hepatotoxicity of 77 Q qualitative HCV assays 129–130 quantitative HCV assays 130 quantitative PCR (qPCR) assay 130 quasispecies, of hepatitis C 125 Questran See cholestyramine Quinidex See quinidine sulfate quinidine sulfate (Quinidex), and cholestasis 58 R race/ethnicity and alcoholic liver disease 11–12 and hepatitis C treatment 161 radiation therapy for cholangiocarcinoma 56–57 for hepatocellular carcinoma 212 for liver cancer 211 radiofrequency ablation (RFA) 209, 211–212, 213, 283–286 radioisotope (nuclear) scan, for Alagille syndrome ranitidine (Zantac), and cholestasis 58 Raynaud’s syndrome, primary biliary cirrhosis and 276 Rebetol See ribavirin recombinant immunoblot assay (RIBA) 129 rectal varices 41 red blood cells and bilirubin 37–38 in complete blood count 65–66 in infants 246 reduced-size transplantation 289 regional anesthesia 266–267 rejection, of transplant 185, 233–234, 262, 263, 305 relapse 160 replicon 136 reverse transcriptionpolymerase chain reaction (RT-PCR) 129–130 Reye’s syndrome 217, 219 RFA See radiofrequency ablation rheumatic disease 77t rheumatoid arthritis, and cholestasis 58 RIBA See recombinant immunoblot assay ribavirin (Rebetol) and birth defects 202 combined with interferon 191 for hepatitis C 134, 136, 159 in children 142 for HIV/HCV-coinfections 292 side effects of 163 ribozymes, for hepatitis C 137 Rituxan See rituximab rituximab (Rituxan) 40 Rizzetto, Mario 164 Rokitansky’s disease See Budd-Chiari syndrome Roman numeral cancer staging system 48, 49 RT-PCR See reverse transcriptionpolymerase chain reaction rubber-band ligation, for bleeding varices 42, 63 S Saint-John’s wort 267 Saldac See sulindac SAMe for depression 68 for intrahepatic cholestasis of pregnancy 197 Sandimmune See cyclosporine sarcoidosis 287 sargramostim 39–40 Save Our Selves (SOS) SBA test See serum bile acid test 370 The Encyclopedia of Hepatitis and Other Liver Diseases SBP See spontaneous bacterial peritonitis scarring See fibrosis schisandra (herbal medicine) 91 schistosomiasis 258 scleroderma 277 sclerotherapy 42 scolicidal agents, for hydatid cysts 178 screening for alcohol and drug use 6–7, 144–145 for alcoholic liver disease 13 in occupational history 251 second opinions 266 Secular Organizations for Sobriety (SOS) 7, selective serotonin reuptake inhibitors (SSRIs) 58, 145–146 septicemia, and acute liver failure 85 seroconversion 240, 242 serum bile acid (SBA) test 195 serum glutamic oxaloacetic transaminase (SGOT) See aspartate aminotransferase serum glutamic pyruvic transaminase (SGPT) See alanine aminotransferase serum protein electrophoresis 287–288 sexual activity, posttransplantation 263– 264 sexual transmission of hepatitis C 150– 151, 291–292 of HIV 291–292 SGOT See aspartate aminotransferase SGPT See alanine aminotransferase shifting dullness test 27 shock, postoperative 270 shock liver 51, 288–289 sho-saiko-to (herbal medicine) 91 shunts for bleeding varices 42–43 collateral 258 distal splenorenal shunt 43 for hepatic encephalopathy 42, 295–296 for hepatorenal syndrome 174 Levine shunt 174 portal vein shunt 261 transvenous intrahepatic portosystemic shunt 27, 43, 45, 295–296 Silybum marianum 91 simvastatin (Zocor), hepatotoxicity of 77t sinusoids 204 Sjögren’s syndrome 273, 276 SLE See systemic lupus erythematosus smallpox 183–184 SMART Recovery 7, smoking and anesthesia 267 and hepatitis B 121 and hepatitis C 201 and liver cancer 47 and primary sclerosing cholangitis 280 smooth-muscle autoantibodies (ASMA) 29, 31 Solumedrol, side effects of 186t SOS See Secular Organizations for Sobriety sphincter of Oddi 87 spider angiomatas 216 spinal anesthetic 266 spleen 226–227 splenomegaly See also hepatomegaly in Budd-Chiari syndrome 44 portal hypertension and 259, 260 splenoportograph 260– 261 split-liver transplantation 231, 235, 289–290 spontaneous bacterial peritonitis (SBP) 27, 290 SSRIs See selective serotonin reuptake inhibitors staging, of cancer 48–50 Starzl, Thomas E 230, 231 steatohepatitis 12, 80–81 steatosis See fatty liver stellate cell activation 83 stem cells, for bioartificial livers 26 stem cell therapy, for hepatitis C 137 steroids See also corticosteroids for autoimmune hepatitis 30, 31 as immunosuppressants 263 for sarcoidosis 287 sulindac (Clinoril; Saldac), and cholestasis 58 superinfections 290–293 and fulminant hepatitis 84 with hepatitis D 164, 165 superior mesenteric vein 258 support groups 203 surgery anesthesia for 266– 268 costs of 266 postoperative complications 269–270 postoperative discomfort 269 preparing for 264– 270 checklist for 269 items for discussion 265–266 physical preparation 268–269 preoperative interview 267–268 preoperative paperwork 268 recovery from 270 second opinions on 266 sustained response, to antiviral therapy 160 synthetic hormones, as immunosuppressants 185 Syprine See trientine systemic lupus erythematosus (SLE) 28 T TACE See transarterial chemoembolization tacrolimus (Prograf) as immunosuppressant 185 for primary biliary cirrhosis 275 side effects of 186t Tagamet See cimetidine tamoxifen and fatty liver 81 hepatotoxicity of 76t tapeworm See hydatid cysts Index 371 tattoos, and hepatitis C 149–150 3TC See lamivudine TCAs See tricyclic antidepressants Tegretol See carbamazepine Telbivudine See LDT tetrathiomolybdate, for Wilson’s disease 304 thermal therapy 283 See also radiofrequency ablation Thorazine See chlorpromazine thorotrast and cholangiocarcinoma 57 and liver cancer 47 thrombosis, and portal hypertension 258 thyroid diseases 294– 295 hyperthyroidism 276, 294 hypothyroidism 273, 276, 294 interferon therapy and 189 primary biliary cirrhosis and 276 thyroiditis 294 TIPS See transvenous intrahepatic portosystemic shunt T lymphocytes (T cells) 184 TMA assay See transcription-mediated amplification T/N/M cancer staging system 48–49 Tofranil See imipramine total protein, in liverfunction tests 225 toxic hepatitis See druginduced hepatitis toxins See also hepatotoxicity and fulminant hepatic failure 219 and hepatitis C 162, 201 transaminase tests 225 See also aminotransferase tests transarterial chemoembolization (TACE) 51 transcription-mediated amplification (TMA) assay 129, 130 transferrin 93 transfusion-transmitted virus (TTV) 291, 295 transjugular liver biopsy See transvenous liver biopsy transmission of hepatitis C 146– 156, 162, 291–292 of HIV 291–292 transplantation of hepatocytes 234 liver See liver transplantation transvenous intrahepatic portosystemic shunt (TIPS) 295–296 for ascites 27 for bleeding varices 43 for Budd-Chiari syndrome 45 transvenous liver biopsy 207 trastuzumab (Herceptin) 40 travel, and hepatitis vaccines 106, 107 trematodes See liver flukes triclabendazole, for liver flukes 223 tricyclic antidepressants (TCAs), and cholestasis 58 trientine (Syprine), for Wilson’s disease 304 tropism, of viruses 103 TTV See transfusiontransmitted virus tumor markers, for liver cancer 20, 69, 237 tumors benign 34–35 liver 236–239 TWINRIX (vaccine) 300 TWINRIX JUNIOR (vaccine) 300 Tylenol See acetaminophen tyrosine 296 tyrosinemia 296–297 in children 217 and liver cancer 47 type 85 U UDCA See ursodeoxycholic acid UICC See Union Internationale Contre le Cancer ulcerative colitis cholangiocarcinoma and 57 primary sclerosing cholangitis and 280–281 ulcer medications, hepatotoxicity of 77t ultrasound for Budd-Chiari syndrome 44 for hydatid cysts 177 for intrahepatic cholestasis of pregnancy 196 for liver tumors 35, 237–238 for portal hypertension 261 Union Internationale Contre le Cancer (UICC) 48, 49 United Network for Organ Sharing (UNOS) 16, 17, 232, 289, 298 urinary retention, postoperative 270 urokinase, for BuddChiari syndrome 44 URSO See ursodeoxycholic acid ursodeoxycholic acid for intrahepatic cholestasis of pregnancy 196– 197 for primary biliary cirrhosis 275 for primary sclerosing cholangitis 279 ursodiol See ursodeoxycholic acid V vaccines cancer 40 hepatitis A 30, 106– 107, 299, 300 hepatitis A and B combined 107 hepatitis B 30, 107, 110–111, 117, 171, 299–300 hepatitis C 137, 202, 300 hepatitis E 301 immune globulin and 182 post-transplantation 262 for viral hepatitis 299–301 valproic acid (Depakote), hepatotoxicity of 76t VAQTA (hepatitis A vaccine) 299 variceal ligation 42 varices, bleeding See bleeding varices 372 The Encyclopedia of Hepatitis and Other Liver Diseases vasopressin for bleeding varices 42 for portal hypertension 261 Vermox See mebendazole vertical transmission 141, 152–153 vinyl chloride and liver cancer 47 and occupational liver disease 249 viral diversity, of hepatitis C 161 viral hepatitis See hepatitis; hepatitis A; hepatitis B; hepatitis C; hepatitis D; hepatitis E viral load, in hepatitis C 130–131, 161 virus(es) See also specific virus(es) characteristics of 103–104 genotypes of 187 mutation of 103 transfusiontransmitted 291, 295 vision, in Alagille syndrome vitamin(s) deficiencies, in Alagille syndrome 3, supplements for Alagille syndrome for alcoholic liver disease 14 hepatitis C and 202 vitamin A, in Alagille syndrome vitamin B6 (pyridoxine), for Wilson’s disease 304 vitamin C, for fatty liver 82 vitamin D, in Alagille syndrome vitamin E in Alagille syndrome for fatty liver 82 vitamin K in Alagille syndrome and blood clotting 65, 226, 282 in intrahepatic cholestasis of pregnancy 196, 197 vitiligo 277 W waterborne non-A, non-B hepatitis See hepatitis E WBCs See white blood cells weight loss 215 white blood cells (WBCs) in complete blood count 65–66 interferon treatment and 188 whole body donation 71 Wilson’s disease 302– 304 and fulminant hepatic failure 219 and liver cancer 47 Women for Sobriety X xanthalasmas 273 xanthomas Alagille syndrome and primary biliary cirrhosis and 273 xenotransplantation 231, 305 xiao-chai-hu-tang (herbal medicine) 91 x-rays in angiography 22–23 for hydatid cysts 177 for portal hypertension 260 for primary sclerosing cholangitis 279 Y YMDD variant, of hepatitis B 241–242 Z Zantac See ranitidine zinc acetate (Galzin), for Wilson’s disease 304 Zocor See simvastatin Zyloprim See allopurinol .. .The Encyclopedia of Hepatitis and Other Liver Diseases The Encyclopedia of Hepatitis and Other Liver Diseases James H Chow, M.D Cheryl Chow The Encyclopedia of Hepatitis and Other Liver Diseases. .. deficiency, and Wilson’s disease Other liver diseases are cancer of the liver, cystic disease of the liver, and fatty liver There is some indication that fatty liver, often associated with diabetes and. .. offer The trans4 T plant team gathers and considers the offer of the organ Among the factors considered are the condition of the organ, the condition of the patient, staff availability, and transportation