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64. Cirrhosis. Etiology & pathogenesis. (etiology (genetic disease…
64. Cirrhosis. Etiology & pathogenesis.
CIRRHOSIS- irreversible distortion of normal liver architecture characterised by...
hepatic injury
fibrosis
nodular regeneration
etiology
Drugs and poisons e.g. methotrexate and alcohol
infections
viral hepatitis B, C and D
genetic disease
Wilson's disease
hemochomatosis
glycogen storage disease
cystic fibrosis
IBS
diabetes mellitus
congestive heart failure
pathogenesis
increased/ altered collagen and CT synthesis in dev of hepatic fibrosis
fibrosis can affect hepatic blood flow and hepatocyte function
hepatic fibrosis occurs...
as
immune response
(to HBV infection)
wound healing
(HA virus cause necrosis of hepatocytes). Fibrosis triggered by cytokine release from invading inflammatory cells
response to agents that induce
primary fibrogenesis
e.g. alcohol and iron (+) collagen gene transcription, (+) CT secreted by cells
2 stages
1) change in EC matrix composition from non cross linked to dense cross linking form (reversible)
2) formation of sub-endothelial collagen crosslinks, proliferation of myoepithelial cells and distortion of hepatic architecture w/ regenerating nodules