Toxic Hepatitis

The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis -- a condition that causes inflammation of the liver.

• Medications -- Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. In most cases when problems occur, they are mild and only apparent from blood tests and can be resolved by reducing the dose of medication or discontinuing use. In rare instances, however, some patients have an "idiosyncratic" reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. Patients experiencing a severe idiosyncratic drug reaction must stop taking the drug immediately. They also require an urgent referral to a transplant center for a liver transplant, which may be life-saving.

• Herbs and Nutritional Supplements -- Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. It is important to note that these substances are not subject to the same regulations, testing or approval processes as conventional drugs. Studies also have shown that some herbs and nutritional supplements are adulterated with steroids or antibiotics. Those that may be toxic to the liver include comfrey, chaparral, germander, kava, valerian, mistletoe and traditional Chinese herbs. People with liver disease should not use herbs or nutritional supplements without the approval of their doctor.

• Alcohol -- Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. In individuals who are prone to alcohol-related liver injury (possibly on a genetic basis), heavy drinking can result in acute liver failure, a life-threatening condition that requires hospitalization and intensive care. Other people may develop progressive liver disease from regular, heavy use of alcohol. The goal of treatment is eliminating alcohol from the diet and treating the psychological dependence on alcohol. Even at the advanced stage of cirrhosis, liver disease from alcohol may show significant improvement with total abstinence from alcohol.

In addition to caring for patients with toxic and all other forms of hepatitis, liver specialists at UCSF Medical Center have a particular interest in researching toxic hepatitis and new treatments. They are currently participating in a federally funded national network that is interested in defining the genetic factors that underlie idiosyncratic drug reactions.

For information or to make an appointment, please call:
Liver Clinic at (415) 353-2318

Reviewed by health care specialists at UCSF Medical Center.
Last updated August 29, 2007