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.
Patients with mild liver disease may have few or no symptoms or signs.
Patients with more serious disease develop symptoms and signs that may be
nonspecific or specific.
Nonspecific symptoms, that is, symptoms that don't suggest that the liver is
their cause, include:
Drugs can cause liver disease in several ways. Some drugs are directly
injurious to the liver; others are transformed by the liver into chemicals that
can be injurious to the liver directly or indirectly. (This may seem strange in
light of the liver's important role in transforming toxic chemicals into
nontoxic chemicals, but it happens.) There are three types of liver toxicity;
dose-dependent toxicity, idiosyncratic toxicity, and drug allergy.
Drugs that cause dose-dependent toxicity can cause liver
disease in most people if enough of the drug is taken. The most important
example of dose-dependent toxicity is acetaminophen (Tylenol) overdose (discussed later in
this article.).
Drugs that cause idiosyncratic toxicity cause disease in
only those few patients who have inherited specific genes that control the
chemical transformation of that specific drug, causing accumulation of the drug
or products of their transformation (metabolites) that are injurious to the
liver. These inherited idiosyncratic toxicities usually are rare, and depending
on the drug, typically occur in less than 1 to10 per 100,000 patients who are
taking that drug; however, with some drugs the prevalence of toxicity is much higher.
Even though the risk of developing drug-induced idiosyncratic liver disease is
low, idiosyncratic liver disease is the most common form of drug-induced liver
disease because tens of millions of patients are using drugs, and many of them
are using several drugs.
Idiosyncratic drug toxicity is difficult to detect in early clinical trials that
usually involve, at most, only a few thousand patients. Idiosyncratic toxicity
will surface only after millions of patients begin to receive the drug after the
drug is approved by the FDA.
Drug allergy also may cause liver disease, though it is uncommon. In drug
allergy, the liver is injured by the inflammation that occurs when the body's
immune system attacks the drugs with antibodies and immune cells.
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.
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