Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Drug-induced liver diseases are diseases of the liver
that are caused by physician-prescribed medications, over-the-counter
medications, vitamins,
hormones, herbs, illicit ("recreational") drugs, and environmental toxins.
What is the liver?
The liver is an organ that is located in the upper right
hand side of the abdomen, mostly behind the
rib cage. The liver of an adult normally weighs close
to three pounds and has many functions.
The liver produces and secretes bile into the
intestine where the bile
assists with the digestion of dietary fat.
The liver helps purify the blood by changing potentially harmful chemicals
into harmless ones. The sources of these chemicals can be outside the body (for
example, medications or alcohol), or inside the body (for example, ammonia,
which is produced from the break-up of proteins; or bilirubin, which is produced
from the break-up of hemoglobin).
The liver removes chemicals from the blood (usually changing them into
harmless chemicals) and then either secretes them with the bile for elimination
in the stool, or secretes them back into the blood where they then are removed
by the kidneys and eliminated in the urine.
The liver produces many important substances,
especially proteins that are necessary for good health. For example, it produces albumin, the protein
building-block of the body, as well as the proteins that cause blood to clot
properly.
When drugs injure the liver and disrupt its normal
function, symptoms, signs, and abnormal blood tests of liver disease develop.
Abnormalities of drug-induced liver diseases are similar to those of liver
diseases caused by other agents such as viruses and immunologic diseases. For
example, drug-induced hepatitis (inflammation of the liver cells) is similar to
viral hepatitis; they both can cause elevations in blood levels of aspartate
amino transferase (AST) and
alanine aminotransferase (ALT)
(enzymes that leak from the injured liver and into
the blood) as well as anorexia (loss of appetite),
fatigue, and nausea. Drug-induced
cholestasis (interference with the flow of bile that is caused by injury to the
bile ducts) can mimic the cholestasis of autoimmune liver disease (e.g.,
primary
biliary cirrhosis or PBC) and can lead to elevations in blood levels of
bilirubin (causing jaundice), alkaline phosphatase
(an enzyme that is
leaked from injured bile ducts), and itching.
Drug-Induced Liver Disease - Describe Your ExperienceQuestion: The symptoms of drug-induced liver disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
The liver is the largest solid organ in the body, and is actually an gland. The liver has a wide variety of critical functions such as manufacturing proteins and metabolizing fats and carbohydrates. The liver also eliminates harmful biochemical waste products from the body (alcohol, drugs, toxins). The liver secretes bile that aids in digestion. Examples of diseases of the liver include cirrhosis, hepatitis, cancer, and fatty liver. Symptoms of liver disease include bleeding, easy bruising, edema, fatigue, and jaundice.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
HCV is one of several viruses that cause hepatitis (inflammation of the
liver).
Up to 85% of individuals who are initially (acutely) infected with HCV will
fail to eliminate the virus and will become chronically infected.
HCV is spread most commonly through inadvertent
exposure to infected blood. Intravenous
drug abuse is the most common mode of transmission. The risk of
acquiring HCV through sexual contact is low.
Generally, patients do not develop symptoms of chronic infection with HCV
until they have extensive scarring of the liver (cirrhosis). Some individuals,
however, may have fatigue and other non-specific symptoms in the absence of
cirrhosis. A minority of patients with HCV have symptoms from organs outside of
the liver.
In the U.S., Infection with HCV is the most common cause of chronic
hepatitis and the most common reason for liver transplantation.
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