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.
Normally, blood from the intestines is delivered to the
liver via the portal vein, and the blood leaving the liver for the heart is carried via the hepatic
veins into the inferior vena cava
(the large vein that drains into the heart). Certain drugs can cause blood clots
to form (thrombosis) in the hepatic veins and in the inferior vena cava. Thrombosis of the hepatic vein and inferior vena
cava can lead to an enlarged liver, abdominal pain, fluid collection in the
abdomen (ascites), and liver failure. This syndrome is called the Budd Chiari
syndrome. The most important drugs that cause Budd-Chiari syndrome are birth
control pills (oral contraceptives). Birth control pills also can cause a
related disease called veno-occlusive disease in which blood clots only in the
smallest hepatic veins. Pyrrolizidine alkaloids found in certain herbs (e.g.,
borage, comfrey) also can cause veno-occlusive disease.
How is drug-induced liver disease diagnosed?
The diagnosis of drug-induced liver diseases often is difficult. Patients may
not have symptoms of liver disease or may have only mild, nonspecific symptoms.
Patients may be taking multiple drugs, which makes it difficult to identify the
offending drug. Patients also may have other potential causes of liver diseases
such as non-alcoholic fatty liver disease (NAFLD) and alcoholism.
The diagnosis of liver disease is based on a patient's
symptoms (such as loss of appetite, nausea, fatigue, itching, and dark urine),
findings on the physical examination (such as jaundice, enlarged liver), and
abnormal laboratory tests
(such as blood levels of liver enzymes or bilirubin and blood clotting times).
If a patient has symptoms, signs, and abnormal liver tests, doctors then try to
decide whether drug(s) are causing the liver disease by:
Taking a careful history of alcohol consumption to
exclude alcoholic liver disease.
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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