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class="vector-toc-numb">2</span> <span>Signs and symptoms</span> </div> </a> <ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mechanisms" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanisms"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanisms</span> </div> </a> <button aria-controls="toc-Mechanisms-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Mechanisms subsection</span> </button> <ul id="toc-Mechanisms-sublist" class="vector-toc-list"> <li id="toc-DNA_damage" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#DNA_damage"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>DNA damage</span> </div> </a> <ul id="toc-DNA_damage-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_relevant_aspects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_relevant_aspects"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Other relevant aspects</span> </div> </a> <ul id="toc-Other_relevant_aspects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Air_pollutants" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Air_pollutants"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Air pollutants</span> </div> </a> <ul id="toc-Air_pollutants-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> 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<div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Liver disease</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 19 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-19" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">19 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%B1%D8%B6_%D8%A7%D9%84%D9%83%D8%A8%D8%AF" title="مرض الكبد – Arabic" lang="ar" hreflang="ar" data-title="مرض الكبد" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hepatopatia" title="Hepatopatia – Catalan" lang="ca" hreflang="ca" data-title="Hepatopatia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Maksahaigused" title="Maksahaigused – Estonian" lang="et" hreflang="et" data-title="Maksahaigused" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Hepatopat%C3%ADa" title="Hepatopatía – Spanish" lang="es" hreflang="es" data-title="Hepatopatía" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A8%DB%8C%D9%85%D8%A7%D8%B1%DB%8C%E2%80%8C%D9%87%D8%A7%DB%8C_%DA%A9%D8%A8%D8%AF%DB%8C" title="بیماری‌های کبدی – Persian" lang="fa" hreflang="fa" data-title="بیماری‌های کبدی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/H%C3%A9patopathie" title="Hépatopathie – French" lang="fr" hreflang="fr" data-title="Hépatopathie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B0%84%EC%A7%88%ED%99%98" title="간질환 – Korean" lang="ko" hreflang="ko" data-title="간질환" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BC%D5%B5%D5%A1%D6%80%D5%A4%D5%AB_%D5%B0%D5%AB%D5%BE%D5%A1%D5%B6%D5%A4%D5%B8%D6%82%D5%A9%D5%B5%D5%B8%D6%82%D5%B6%D5%B6%D5%A5%D6%80" title="Լյարդի հիվանդություններ – Armenian" lang="hy" hreflang="hy" data-title="Լյարդի հիվանդություններ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Epatopatia" title="Epatopatia – Italian" lang="it" hreflang="it" data-title="Epatopatia" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%AF%E0%B2%95%E0%B3%83%E0%B2%A4%E0%B3%8D%E0%B2%A4%E0%B2%BF%E0%B2%A8_%E0%B2%B0%E0%B3%8B%E0%B2%97" title="ಯಕೃತ್ತಿನ ರೋಗ – Kannada" lang="kn" hreflang="kn" data-title="ಯಕೃತ್ತಿನ ರೋಗ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/M%C3%A1jbetegs%C3%A9gek" title="Májbetegségek – Hungarian" lang="hu" hreflang="hu" data-title="Májbetegségek" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Hepatopatia" title="Hepatopatia – Portuguese" lang="pt" hreflang="pt" data-title="Hepatopatia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Liver_disease" title="Liver disease – Simple English" lang="en-simple" hreflang="en-simple" data-title="Liver disease" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-su mw-list-item"><a href="https://su.wikipedia.org/wiki/Liver" title="Liver – Sundanese" lang="su" hreflang="su" data-title="Liver" data-language-autonym="Sunda" data-language-local-name="Sundanese" class="interlanguage-link-target"><span>Sunda</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%91%D0%B5%D0%BC%D0%BE%D1%80%D0%B8%D2%B3%D0%BE%D0%B8_%D2%B7%D0%B8%D0%B3%D0%B0%D1%80" title="Бемориҳои ҷигар – Tajik" lang="tg" hreflang="tg" data-title="Бемориҳои ҷигар" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tk mw-list-item"><a href="https://tk.wikipedia.org/wiki/Bagyr_keseli" title="Bagyr keseli – Turkmen" lang="tk" hreflang="tk" data-title="Bagyr keseli" data-language-autonym="Türkmençe" data-language-local-name="Turkmen" class="interlanguage-link-target"><span>Türkmençe</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%A7%D9%85%D8%B1%D8%A7%D8%B6_%D8%AC%DA%AF%D8%B1" title="امراض جگر – Urdu" lang="ur" hreflang="ur" data-title="امراض جگر" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/B%E1%BB%87nh_gan" title="Bệnh gan – Vietnamese" lang="vi" hreflang="vi" data-title="Bệnh gan" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a 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</div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For Injuries associated with liver, see <a href="/wiki/Liver_injury" title="Liver injury">Liver injury</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Liver disease</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Hepatic disease</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_(2).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg/220px-Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg/330px-Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg/440px-Human_liver_with_metastatic_lesions_from_primary_pancreas_carcinoma_%282%29.jpg 2x" data-file-width="768" data-file-height="512" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A <a href="/wiki/Gross_pathology" title="Gross pathology">gross pathology</a> specimen of <a href="/wiki/Liver_metastases" class="mw-redirect" title="Liver metastases">liver metastases</a> caused by <a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">pancreatic cancer</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Hepatology" title="Hepatology">Hepatology</a>, <a href="/wiki/Gastroenterology" title="Gastroenterology">gastroenterology</a></td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data"><a href="/wiki/Fatty_liver_disease" title="Fatty liver disease">Fatty liver disease</a>, <a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> (and several more)<sup id="cite_ref-medl_1-0" class="reference"><a href="#cite_note-medl-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Liver_function_tests" title="Liver function tests">Liver function tests</a><sup id="cite_ref-web_2-0" class="reference"><a href="#cite_note-web-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Depends on type (See types)</td></tr></tbody></table> <p><b>Liver disease</b>, or <b>hepatic disease</b>, is any of many <a href="/wiki/Disease" title="Disease">diseases</a> of the <a href="/wiki/Liver" title="Liver">liver</a>.<sup id="cite_ref-medl_1-1" class="reference"><a href="#cite_note-medl-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> If long-lasting it is termed <a href="/wiki/Chronic_liver_disease" title="Chronic liver disease">chronic liver disease</a>.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Although the diseases differ in detail, liver diseases often have features in common. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Liver_diseases">Liver diseases</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=1" title="Edit section: Liver diseases"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div style="clear:both;" class=""></div> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 199.33333333333px"> <div class="thumb" style="width: 197.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Ground_glass_hepatocytes_high_mag_cropped_2.jpg" class="mw-file-description" title="Ground glass hepatocytes"><img alt="Ground glass hepatocytes" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/39/Ground_glass_hepatocytes_high_mag_cropped_2.jpg/296px-Ground_glass_hepatocytes_high_mag_cropped_2.jpg" decoding="async" width="198" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/39/Ground_glass_hepatocytes_high_mag_cropped_2.jpg/444px-Ground_glass_hepatocytes_high_mag_cropped_2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/39/Ground_glass_hepatocytes_high_mag_cropped_2.jpg/592px-Ground_glass_hepatocytes_high_mag_cropped_2.jpg 2x" data-file-width="1544" data-file-height="1252" /></a></span></div> <div class="gallerytext">Ground glass hepatocytes</div> </li> <li class="gallerybox" style="width: 246px"> <div class="thumb" style="width: 244px;"><span typeof="mw:File"><a href="/wiki/File:Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg" class="mw-file-description" title="Primary biliary cirrhosis"><img alt="Primary biliary cirrhosis" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg/366px-Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg" decoding="async" width="244" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg/549px-Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg/732px-Primary_biliary_cirrhosis_intermed_mag_much_cropping.jpg 2x" data-file-width="1089" data-file-height="714" /></a></span></div> <div class="gallerytext">Primary biliary cirrhosis</div> </li> <li class="gallerybox" style="width: 202.66666666667px"> <div class="thumb" style="width: 200.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Buddchiari2.PNG" class="mw-file-description" title="Budd–Chiari syndrome"><img alt="Budd–Chiari syndrome" src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Buddchiari2.PNG/301px-Buddchiari2.PNG" decoding="async" width="201" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Buddchiari2.PNG/452px-Buddchiari2.PNG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Buddchiari2.PNG/602px-Buddchiari2.PNG 2x" data-file-width="1149" data-file-height="916" /></a></span></div> <div class="gallerytext">Budd–Chiari syndrome</div> </li> <li class="gallerybox" style="width: 217.33333333333px"> <div class="thumb" style="width: 215.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Non-alcoholic_fatty_liver_disease1.jpg" class="mw-file-description" title="Micrograph of non-alcoholic fatty liver disease"><img alt="Micrograph of non-alcoholic fatty liver disease" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/323px-Non-alcoholic_fatty_liver_disease1.jpg" decoding="async" width="216" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/484px-Non-alcoholic_fatty_liver_disease1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/646px-Non-alcoholic_fatty_liver_disease1.jpg 2x" data-file-width="3460" data-file-height="2572" /></a></span></div> <div class="gallerytext"> <a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of <a href="/wiki/Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">non-alcoholic fatty liver disease</a></div> </li> </ul> <p>There are more than a hundred different liver diseases. Some of the most common are:<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Fascioliasis" class="mw-redirect" title="Fascioliasis">Fascioliasis</a>, a parasitic infection of liver caused by a <a href="/wiki/Liver_fluke" title="Liver fluke">liver fluke</a> of the genus <i><a href="/wiki/Fasciola" title="Fasciola">Fasciola</a></i>, mostly <i><a href="/wiki/Fasciola_hepatica" title="Fasciola hepatica">Fasciola hepatica</a></i>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a>, inflammation of the liver, is caused by various viruses (<a href="/wiki/Viral_hepatitis" title="Viral hepatitis">viral hepatitis</a>) also by some <a href="/wiki/Hepatotoxicity" title="Hepatotoxicity">liver toxins</a> (e.g. <a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">alcoholic hepatitis</a>), autoimmunity (<a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">autoimmune hepatitis</a>) or hereditary conditions.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a> is a hepatic manifestation of <a href="/wiki/Alcohol_abuse" title="Alcohol abuse">alcohol overconsumption</a>, including <a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">fatty liver disease</a>, alcoholic hepatitis, and <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>. Analogous terms such as "drug-induced" or "toxic" liver disease are also used to refer to disorders caused by various drugs.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver disease</a> (hepatic <a href="/wiki/Steatosis" title="Steatosis">steatosis</a>) is a reversible condition where large vacuoles of <a href="/wiki/Triglyceride" title="Triglyceride">triglyceride</a> fat accumulate in liver cells.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">Non-alcoholic fatty liver disease</a> is a spectrum of disease associated with obesity and <a href="/wiki/Metabolic_syndrome" title="Metabolic syndrome">metabolic syndrome</a>.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hereditary_disease" class="mw-redirect" title="Hereditary disease">Hereditary diseases</a> that cause damage to the liver include <a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">hemochromatosis</a>,<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> involving accumulation of <a href="/wiki/Iron" title="Iron">iron</a> in the body, and <a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a>. Liver damage is also a clinical feature of <a href="/wiki/Alpha_1-antitrypsin_deficiency" class="mw-redirect" title="Alpha 1-antitrypsin deficiency">alpha 1-antitrypsin deficiency</a><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Glycogen_storage_disease_type_II" title="Glycogen storage disease type II">glycogen storage disease type II</a>.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>In <a href="/wiki/Transthyretin-related_hereditary_amyloidosis" class="mw-redirect" title="Transthyretin-related hereditary amyloidosis">transthyretin-related hereditary amyloidosis</a>, the liver produces a mutated transthyretin protein which has severe neurodegenerative or cardiopathic effects. Liver transplantation can be curative.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Gilbert%27s_syndrome" title="Gilbert's syndrome">Gilbert's syndrome</a>, a genetic disorder of <a href="/wiki/Bilirubin" title="Bilirubin">bilirubin</a> metabolism found in a small percent of the population, can cause mild <a href="/wiki/Jaundice" title="Jaundice">jaundice</a>.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> is the formation of fibrous tissue (<a href="/wiki/Fibrosis" title="Fibrosis">fibrosis</a>) in the place of liver cells that have died due to a variety of causes, including viral hepatitis, alcohol overconsumption, and other forms of liver toxicity. Cirrhosis causes chronic <a href="/wiki/Liver_failure" title="Liver failure">liver failure</a>.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup></li> <li>Primary <a href="/wiki/Liver_cancer" title="Liver cancer">liver cancer</a> most commonly manifests as <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a> or <a href="/wiki/Cholangiocarcinoma" title="Cholangiocarcinoma">cholangiocarcinoma</a>; rarer forms include <a href="/wiki/Angiosarcoma" title="Angiosarcoma">angiosarcoma</a> and <a href="/wiki/Hemangiosarcoma" title="Hemangiosarcoma">hemangiosarcoma</a> of the liver. (Many liver malignancies are secondary lesions that have metastasized from primary cancers in the gastrointestinal tract and other organs, such as the kidneys, lungs.)<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">Primary biliary cirrhosis</a> is a serious <a href="/wiki/Autoimmune" class="mw-redirect" title="Autoimmune">autoimmune</a> disease of the <a href="/wiki/Bile_canaliculus" title="Bile canaliculus">bile capillaries</a>.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a> is a serious chronic <a href="/wiki/Inflammation" title="Inflammation">inflammatory</a> disease of the <a href="/wiki/Bile_duct" title="Bile duct">bile duct</a>, which is believed to be autoimmune in origin.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a> is the clinical picture caused by <a href="/wiki/Vascular_occlusion" title="Vascular occlusion">occlusion</a> of the <a href="/wiki/Hepatic_vein" class="mw-redirect" title="Hepatic vein">hepatic vein</a>.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=2" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some of the signs and symptoms of a liver disease are the following: </p> <ul><li><a href="/wiki/Jaundice" title="Jaundice">Jaundice</a><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li>Confusion and altered consciousness caused by <a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">hepatic encephalopathy</a>.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Thrombocytopenia" title="Thrombocytopenia">Thrombocytopenia</a> and <a href="/wiki/Coagulopathy" title="Coagulopathy">coagulopathy</a>.<sup id="cite_ref-Blonski_Siropaides_Reddy_2007_pp._464–73_22-0" class="reference"><a href="#cite_note-Blonski_Siropaides_Reddy_2007_pp._464–73-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li> <li>Risk of <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">bleeding symptoms</a>, particularly taking place in the <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal tract</a><sup id="cite_ref-Tripodi_Mannucci_pp._147–156_23-0" class="reference"><a href="#cite_note-Tripodi_Mannucci_pp._147–156-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Mechanisms">Mechanisms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=3" title="Edit section: Mechanisms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Liver diseases can develop through several mechanisms: </p> <div class="mw-heading mw-heading3"><h3 id="DNA_damage">DNA damage</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=4" title="Edit section: DNA damage"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>One general mechanism, increased <a href="/wiki/DNA_damage" class="mw-redirect" title="DNA damage">DNA damage</a>, is shared by some of the major liver diseases, including infection by <i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">hepatitis B virus</a></i> or <i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">hepatitis C virus</a></i>, <a href="/wiki/Alcohol_use_disorder" class="mw-redirect" title="Alcohol use disorder">heavy alcohol consumption</a>, and <a href="/wiki/Obesity_and_cancer#Mechanisms" title="Obesity and cancer">obesity</a>.<sup id="cite_ref-urlChronic_Liver_Disease/Cirrhosis_|_Johns_Hopkins_Medicine_Health_Library_24-0" class="reference"><a href="#cite_note-urlChronic_Liver_Disease/Cirrhosis_|_Johns_Hopkins_Medicine_Health_Library-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p>Viral infection by hepatitis B virus, or hepatitis C virus causes an increase of <a href="/wiki/Reactive_oxygen_species" title="Reactive oxygen species">reactive oxygen species</a>. The increase in <a href="/wiki/Intracellular" class="mw-redirect" title="Intracellular">intracellular</a> reactive oxygen species is about 10,000-fold with chronic hepatitis B virus infection and 100,000-fold following hepatitis C virus infection.<sup id="cite_ref-enomoto_25-0" class="reference"><a href="#cite_note-enomoto-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> This increase in reactive oxygen species causes inflammation<sup id="cite_ref-enomoto_25-1" class="reference"><a href="#cite_note-enomoto-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> and more than 20 types of DNA damage.<sup id="cite_ref-pmid27989142_26-0" class="reference"><a href="#cite_note-pmid27989142-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Oxidative DNA damage is <a href="/wiki/Mutagen" title="Mutagen">mutagenic</a><sup id="cite_ref-pmid22293091_27-0" class="reference"><a href="#cite_note-pmid22293091-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> and also causes epigenetic alterations at the sites of DNA repair.<sup id="cite_ref-Nishida_28-0" class="reference"><a href="#cite_note-Nishida-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Cancer_epigenetics" title="Cancer epigenetics">Epigenetic</a> alterations and mutations affect the cellular machinery that may cause the cell to replicate at a higher rate or result in the cell avoiding <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a>, and thus contribute to liver disease.<sup id="cite_ref-pmid24473361_29-0" class="reference"><a href="#cite_note-pmid24473361-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> By the time accumulating epigenetic and mutational changes eventually cause hepatocellular carcinoma, epigenetic alterations appear to have an even larger role in <a href="/wiki/Carcinogenesis" title="Carcinogenesis">carcinogenesis</a> than mutations. Only one gene, <a href="/wiki/TP53" class="mw-redirect" title="TP53">TP53</a>, is mutated in more than 20% of liver cancers while 41 genes each have hypermethylated promoters (repressing gene expression) in more than 20% of liver cancers.<sup id="cite_ref-pmid23392071_30-0" class="reference"><a href="#cite_note-pmid23392071-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>Alcohol consumption in excess causes a build-up of <a href="/wiki/Acetaldehyde" title="Acetaldehyde">acetaldehyde</a>. Acetaldehyde and free radicals generated by metabolizing alcohol induce DNA damage and <a href="/wiki/Oxidative_stress" title="Oxidative stress">oxidative stress</a>.<sup id="cite_ref-pmid20813101_31-0" class="reference"><a href="#cite_note-pmid20813101-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lee_32-0" class="reference"><a href="#cite_note-Lee-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-urlDrinking_alcohol_causes_cancer_by_damaging_DNA_-_Independent.ie_33-0" class="reference"><a href="#cite_note-urlDrinking_alcohol_causes_cancer_by_damaging_DNA_-_Independent.ie-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> In addition, activation of neutrophils in alcoholic liver disease contributes to the pathogenesis of hepatocellular damage by releasing reactive oxygen species (which can damage DNA).<sup id="cite_ref-pmid22524187_34-0" class="reference"><a href="#cite_note-pmid22524187-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> The level of oxidative stress and acetaldehyde-induced DNA adducts due to alcohol consumption does not appear sufficient to cause increased mutagenesis.<sup id="cite_ref-pmid22524187_34-1" class="reference"><a href="#cite_note-pmid22524187-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> However, as reviewed by Nishida et al.,<sup id="cite_ref-Nishida_28-1" class="reference"><a href="#cite_note-Nishida-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> alcohol exposure, causing oxidative DNA damage (which is repairable), can result in epigenetic alterations at the sites of DNA repair. Alcohol-induced <a href="/wiki/Epigenetics" title="Epigenetics">epigenetic</a> alterations of gene expression appear to lead to liver injury and ultimately <a href="/wiki/Carcinoma" title="Carcinoma">carcinoma</a>.<sup id="cite_ref-pmid24313164_35-0" class="reference"><a href="#cite_note-pmid24313164-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Obesity" title="Obesity">Obesity</a> is associated with a higher risk of primary liver cancer.<sup id="cite_ref-pmid27909908_36-0" class="reference"><a href="#cite_note-pmid27909908-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> As shown with mice, obese mice are prone to liver cancer, likely due to two factors. Obese mice have increased pro-inflammatory cytokines. Obese mice also have higher levels of deoxycholic acid, a product of <a href="/wiki/Bile_acid" title="Bile acid">bile acid</a> alteration by certain gut microbes, and these microbes are increased with obesity. The excess <a href="/wiki/Deoxycholic_acid" title="Deoxycholic acid">deoxycholic acid</a> causes DNA damage and inflammation in the liver, which, in turn, can lead to liver cancer.<sup id="cite_ref-urlGut_Bugs_Could_Explain_Obesity-Cancer_Link_|_Science_|_AAAS_37-0" class="reference"><a href="#cite_note-urlGut_Bugs_Could_Explain_Obesity-Cancer_Link_|_Science_|_AAAS-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_relevant_aspects">Other relevant aspects</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=5" title="Edit section: Other relevant aspects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Several liver diseases are due to viral infection. <a href="/wiki/Viral_hepatitis#Hepatitis_viruses" title="Viral hepatitis">Viral hepatitides</a> such as <a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">Hepatitis B virus</a> and <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">Hepatitis C virus</a> can be vertically transmitted during birth via contact with infected blood.<sup id="cite_ref-Benova2014_38-0" class="reference"><a href="#cite_note-Benova2014-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Komatsu2014_39-0" class="reference"><a href="#cite_note-Komatsu2014-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> According to a 2012 <a href="/wiki/NICE" class="mw-redirect" title="NICE">NICE</a> publication, "about 85% of hepatitis B infections in newborns become chronic".<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> In occult cases, Hepatitis B virus is present by hepatitis B virus <a href="/wiki/DNA" title="DNA">DNA</a>, but testing for <a href="/wiki/HBsAg" title="HBsAg">HBsAg</a> is negative.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> High consumption of <a href="/wiki/Alcoholic_beverage" title="Alcoholic beverage">alcohol</a> can lead to several forms of liver disease including <a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">alcoholic hepatitis</a>, <a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">alcoholic fatty liver disease</a>, <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>, and <a href="/wiki/Liver_cancer" title="Liver cancer">liver cancer</a>.<sup id="cite_ref-Suk2014_42-0" class="reference"><a href="#cite_note-Suk2014-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> In the earlier stages of alcoholic liver disease, <a href="/wiki/Adipose_tissue" title="Adipose tissue">fat</a> builds up in the liver's cells due to increased <a href="/wiki/Fatty_acid_synthesis" title="Fatty acid synthesis">creation of</a> <a href="/wiki/Triglyceride" title="Triglyceride">triglycerides</a> and <a href="/wiki/Fatty_acid" title="Fatty acid">fatty acids</a> and a decreased ability to <a href="/wiki/Beta_oxidation" title="Beta oxidation">break down fatty acids</a>.<sup id="cite_ref-Williams2014_43-0" class="reference"><a href="#cite_note-Williams2014-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Progression of the disease can lead to <a href="/wiki/Steatohepatitis" title="Steatohepatitis">liver inflammation from the excess fat in the liver</a>. <a href="/wiki/Fibrosis" title="Fibrosis">Scarring</a> in the liver often occurs as the body attempts to heal and extensive scarring can lead to the development of cirrhosis in more advanced stages of the disease.<sup id="cite_ref-Williams2014_43-1" class="reference"><a href="#cite_note-Williams2014-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Approximately 3–10% of individuals with cirrhosis develop a form of liver cancer known as <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a>.<sup id="cite_ref-Williams2014_43-2" class="reference"><a href="#cite_note-Williams2014-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> According to Tilg, et al., gut microbiome could very well have an effect, be involved in the pathophysiology, on the various types of liver disease which an individual may encounter.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Insight into the exact causes and mechanisms mediating pathophysiology of the liver is quickly progressing due to the introduction new technological approaches like <a href="/wiki/Single_cell_sequencing" class="mw-redirect" title="Single cell sequencing">Single cell sequencing</a> and kinome profiling <sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Air_pollutants">Air pollutants</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=6" title="Edit section: Air pollutants"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Particulates" title="Particulates">Particulate matter</a> or carbon black are common pollutants. They have a direct toxic effect on the liver; cause <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> of liver caused by and thereby impact lipid metabolism and fatty liver disease; and can translocate from the lungs to the liver.<sup id="cite_ref-kim_46-0" class="reference"><a href="#cite_note-kim-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p><p>Because particulate matter and carbon black are very diverse and each has different toxicodynamics, detailed mechanisms of translocation are not clear. Water-soluble fractions of particulate matter are the most important part of translocation to the liver, through extrapulmonary circulation. When particulate matter gets into the bloodstream, it combines with immune cells and stimulates innate immune responses. <a href="/wiki/Proinflammatory_cytokine" class="mw-redirect" title="Proinflammatory cytokine">Pro-inflammatory cytokines</a> are released and cause disease progression.<sup id="cite_ref-kim_46-1" class="reference"><a href="#cite_note-kim-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=7" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Liver diseases, including conditions such as <a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">non-alcoholic fatty liver disease</a> (NAFLD), <a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">alcohol-related liver disease</a> (ALD), and <a href="/wiki/Viral_hepatitis" title="Viral hepatitis">viral hepatitis</a>, are significant public health concerns worldwide. In the United States, NAFLD is the most common chronic liver condition, affecting approximately 24% of the population, with the prevalence rising due to increasing rates of obesity and metabolic syndrome.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> Alcohol-related liver disease accounts for about 4.5% of liver-related deaths globally, underscoring the substantial burden of alcohol misuse.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Viral hepatitis, primarily <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a> and <a href="/wiki/Hepatitis_C" title="Hepatitis C">hepatitis C</a>, remains a leading cause of liver cirrhosis and liver cancer worldwide, despite advances in antiviral therapies and vaccination efforts.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> Additionally, recent studies have highlighted lean steatotic liver disease (SLD), a subset of NAFLD, affecting over 12% of U.S. adults even in the absence of obesity.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> These data emphasize the importance of early detection and targeted interventions to manage liver disease and its associated complications effectively. </p><p>New research reports the prevalence of lean steatotic liver disease (SLD) in the United States using data from the National Health and Nutrition Examination Survey (2017-2023), researchers estimated the age-adjusted prevalence of lean SLD at 12.8%.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> This includes 9.3% for lean metabolic dysfunction-associated steatotic liver disease, 1.3% for metabolic dysfunction and alcohol-related steatotic liver disease, and 1.0% for alcohol-related liver disease.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=8" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A number of <a href="/wiki/Liver_function_tests" title="Liver function tests">liver function tests</a> are available to test the proper function of the liver. These test for the presence of <a href="/wiki/Enzyme" title="Enzyme">enzymes</a> in blood that are normally most abundant in liver tissue, metabolites or products. <a href="/wiki/Blood_proteins" class="mw-redirect" title="Blood proteins">serum proteins</a>, <a href="/wiki/Serum_albumin" title="Serum albumin">serum albumin</a>, <a href="/wiki/Globulin" title="Globulin">serum globulin</a>, <a href="/wiki/Alanine_transaminase" title="Alanine transaminase">alanine transaminase</a>, <a href="/wiki/Aspartate_transaminase" title="Aspartate transaminase">aspartate transaminase</a>, <a href="/wiki/Prothrombin_time" title="Prothrombin time">prothrombin time</a>, <a href="/wiki/Partial_thromboplastin_time" title="Partial thromboplastin time">partial thromboplastin time</a>.<sup id="cite_ref-web_2-1" class="reference"><a href="#cite_note-web-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Imaging tests such as <a href="/wiki/Transient_elastography" class="mw-redirect" title="Transient elastography">transient elastography</a>, <a href="/wiki/Medical_ultrasonography" class="mw-redirect" title="Medical ultrasonography">ultrasound</a> and <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">magnetic resonance imaging</a> can be used to show the liver tissue and the bile ducts. <a href="/wiki/Liver_biopsy" title="Liver biopsy">Liver biopsy</a> can be performed to examine liver tissue to distinguish between various conditions; tests such as <a href="/wiki/Elastography" title="Elastography">elastography</a> may reduce the need for biopsy in some situations.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>In liver disease, <a href="/wiki/Prothrombin_time" title="Prothrombin time">prothrombin time</a> is longer than usual.<sup id="cite_ref-Blonski_Siropaides_Reddy_2007_pp._464–73_22-1" class="reference"><a href="#cite_note-Blonski_Siropaides_Reddy_2007_pp._464–73-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> In addition, the amounts of both <a href="/wiki/Coagulation_factor" class="mw-redirect" title="Coagulation factor">coagulation factors</a> and <a href="/wiki/Anticoagulation_factor" class="mw-redirect" title="Anticoagulation factor">anticoagulation factors</a> are reduced as a diseased liver cannot productively synthesize them as it did when healthy.<sup id="cite_ref-Barton_2016_pp._1927–1933_55-0" class="reference"><a href="#cite_note-Barton_2016_pp._1927–1933-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Nonetheless, there are two exceptions in this falling tendency: <a href="/wiki/Factor_VIII" title="Factor VIII">coagulation factor VIII</a> and <a href="/wiki/Von_Willebrand_factor" title="Von Willebrand factor">von Willebrand factor</a>, a <a href="/wiki/Platelet_adhesive_protein" class="mw-redirect" title="Platelet adhesive protein">platelet adhesive protein</a>.<sup id="cite_ref-Barton_2016_pp._1927–1933_55-1" class="reference"><a href="#cite_note-Barton_2016_pp._1927–1933-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Both inversely rise in the setting of hepatic insufficiency, thanks to the drop of <a href="/wiki/Hepatic_clearance" class="mw-redirect" title="Hepatic clearance">hepatic clearance</a> and compensatory productions from other sites of the body.<sup id="cite_ref-Barton_2016_pp._1927–1933_55-2" class="reference"><a href="#cite_note-Barton_2016_pp._1927–1933-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Fibrinolysis" title="Fibrinolysis">Fibrinolysis</a> generally proceeds faster with acute liver failure and advanced stage liver disease, unlike <a href="/wiki/Chronic_liver_disease" title="Chronic liver disease">chronic liver disease</a> in which concentration of <a href="/wiki/Fibrinogen" title="Fibrinogen">fibrinogen</a> remains unchanged.<sup id="cite_ref-Barton_2016_pp._1927–1933_55-3" class="reference"><a href="#cite_note-Barton_2016_pp._1927–1933-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> </p><p>A previously undiagnosed liver disease may become evident first after <a href="/wiki/Autopsy" title="Autopsy">autopsy</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2021)">citation needed</span></a></i>]</sup> Following are <a href="/wiki/Gross_pathology" title="Gross pathology">gross pathology</a> images: </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 336px"> <div class="thumb" style="width: 334px;"><span typeof="mw:File"><a href="/wiki/File:Gross_pathology_of_alcoholic_liver_cirrhosis.jpg" class="mw-file-description" title="Diffuse cirrhosis"><img alt="Diffuse cirrhosis" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2c/Gross_pathology_of_alcoholic_liver_cirrhosis.jpg/501px-Gross_pathology_of_alcoholic_liver_cirrhosis.jpg" decoding="async" width="334" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2c/Gross_pathology_of_alcoholic_liver_cirrhosis.jpg/752px-Gross_pathology_of_alcoholic_liver_cirrhosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/2/2c/Gross_pathology_of_alcoholic_liver_cirrhosis.jpg 2x" data-file-width="958" data-file-height="631" /></a></span></div> <div class="gallerytext">Diffuse <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a></div> </li> <li class="gallerybox" style="width: 230.66666666667px"> <div class="thumb" style="width: 228.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:W%C4%85troba_marska_(Ultima_Thule).jpg" class="mw-file-description" title="Macronodular cirrhosis"><img alt="Macronodular cirrhosis" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6a/W%C4%85troba_marska_%28Ultima_Thule%29.jpg/343px-W%C4%85troba_marska_%28Ultima_Thule%29.jpg" decoding="async" width="229" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/6/6a/W%C4%85troba_marska_%28Ultima_Thule%29.jpg 1.5x" data-file-width="383" data-file-height="369" /></a></span></div> <div class="gallerytext">Macronodular cirrhosis</div> </li> <li class="gallerybox" style="width: 210.66666666667px"> <div class="thumb" style="width: 208.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Nutmeg_liver_(crop).jpg" class="mw-file-description" title="Nutmeg texture of congestive hepatopathy"><img alt="Nutmeg texture of congestive hepatopathy" src="//upload.wikimedia.org/wikipedia/commons/e/e0/Nutmeg_liver_%28crop%29.jpg" decoding="async" width="209" height="220" class="mw-file-element" data-file-width="281" data-file-height="296" /></a></span></div> <div class="gallerytext">Nutmeg texture of <a href="/wiki/Congestive_hepatopathy" title="Congestive hepatopathy">congestive hepatopathy</a></div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=9" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Ursodeoxycholic_acid_acsv.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6b/Ursodeoxycholic_acid_acsv.svg/220px-Ursodeoxycholic_acid_acsv.svg.png" decoding="async" width="220" height="136" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6b/Ursodeoxycholic_acid_acsv.svg/330px-Ursodeoxycholic_acid_acsv.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6b/Ursodeoxycholic_acid_acsv.svg/440px-Ursodeoxycholic_acid_acsv.svg.png 2x" data-file-width="810" data-file-height="500" /></a><figcaption>Ursodeoxycholic acid</figcaption></figure> <p>Anti-viral medications are available to treat infections such as <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a>.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> Other conditions may be managed by slowing down disease progression, for example: </p> <ul><li>By using steroid-based drugs in <a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">autoimmune hepatitis</a>.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup></li> <li>Regularly removing a quantity of blood from a vein (venesection) in the iron overload condition, <a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">hemochromatosis</a>.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a>, a condition where copper builds up in the body, can be managed with drugs that bind copper, allowing it to be passed from the body in urine.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup></li> <li>In cholestatic liver disease, (where the flow of bile is affected due to cystic fibrosis<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup>) a medication called <a href="/wiki/Ursodeoxycholic_acid" title="Ursodeoxycholic acid">ursodeoxycholic acid</a> may be given.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=10" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Model_for_end-stage_liver_disease" class="mw-redirect" title="Model for end-stage liver disease">Model for end-stage liver disease</a> (MELD)</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=11" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-medl-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-medl_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-medl_1-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/liverdiseases.html">"Liver Diseases"</a>. <i>MedlinePlus</i>.</cite><span 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href="http://www.nhs.uk/conditions/Cirrhosis/Pages/Introduction.aspx">"NHS Choices"</a>. <i>Cirrhosis</i><span class="reference-accessdate">. Retrieved <span class="nowrap">6 October</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Cirrhosis&rft.atitle=NHS+Choices&rft_id=http%3A%2F%2Fwww.nhs.uk%2Fconditions%2FCirrhosis%2FPages%2FIntroduction.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.nhs.uk/Conditions/liver-disease/Pages/Introduction.aspx">"Liver disease – NHS Choices"</a>. <i>www.nhs.uk</i><span class="reference-accessdate">. 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Retrieved <span class="nowrap">2015-06-20</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.cdc.gov&rft.atitle=Phlebotomy+Treatment+%7C+Treatment+and+Management+%7C+Training+%26+Education+%7C+Hemochromatosis+%28Iron+Storage+Disease%29+%7C+NCBDDD+%7C+CDC&rft_id=https%3A%2F%2Fwww.cdc.gov%2Fncbddd%2Fhemochromatosis%2Ftraining%2Ftreatment%2Fphlebotomy_treatment.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></span> </li> <li id="cite_note-59"><span class="mw-cite-backlink"><b><a href="#cite_ref-59">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20150621034922/http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/wilson-disease/Pages/facts.aspx">"Wilson Disease"</a>. <i>www.niddk.nih.gov</i>. 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Retrieved <span class="nowrap">2015-06-20</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.niddk.nih.gov&rft.atitle=Wilson+Disease&rft_id=http%3A%2F%2Fwww.niddk.nih.gov%2Fhealth-information%2Fhealth-topics%2Fdigestive-diseases%2Fwilson-disease%2FPages%2Ffacts.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></span> </li> <li id="cite_note-60"><span class="mw-cite-backlink"><b><a href="#cite_ref-60">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSuchySokolBalistreri2014" class="citation book cs1">Suchy FJ, Sokol RJ, Balistreri WF (2014-02-20). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=A4LBAgAAQBAJ&q=cholestatic+liver+disease++cystic+fibrosis&pg=PA114"><i>Liver Disease in Children</i></a>. Cambridge University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-107-72909-4" title="Special:BookSources/978-1-107-72909-4"><bdi>978-1-107-72909-4</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Liver+Disease+in+Children&rft.pub=Cambridge+University+Press&rft.date=2014-02-20&rft.isbn=978-1-107-72909-4&rft.aulast=Suchy&rft.aufirst=Frederick+J.&rft.au=Sokol%2C+Ronald+J.&rft.au=Balistreri%2C+William+F.&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DA4LBAgAAQBAJ%26q%3Dcholestatic%2Bliver%2Bdisease%2B%2Bcystic%2Bfibrosis%26pg%3DPA114&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></span> </li> <li id="cite_note-61"><span class="mw-cite-backlink"><b><a href="#cite_ref-61">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFChengAshbySmyth2017" class="citation journal cs1">Cheng K, Ashby D, Smyth RL (2017). <a rel="nofollow" class="external text" href="http://www.cochrane.org/CD000222/CF_ursodeoxycholic-acid-for-liver-disease-related-to-cystic-fibrosis">"Ursodeoxycholic acid for liver disease related to cystic fibrosis"</a>. <i>Cochrane Database of Systematic Reviews</i>. <b>9</b> (9): CD000222. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD000222.pub4">10.1002/14651858.CD000222.pub4</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483662">6483662</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28891588">28891588</a><span class="reference-accessdate">. Retrieved <span class="nowrap">2015-06-20</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cochrane+Database+of+Systematic+Reviews&rft.atitle=Ursodeoxycholic+acid+for+liver+disease+related+to+cystic+fibrosis&rft.volume=9&rft.issue=9&rft.pages=CD000222&rft.date=2017&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6483662%23id-name%3DPMC&rft_id=info%3Apmid%2F28891588&rft_id=info%3Adoi%2F10.1002%2F14651858.CD000222.pub4&rft.aulast=Cheng&rft.aufirst=Katharine&rft.au=Ashby%2C+Deborah&rft.au=Smyth%2C+Rosalind+L.&rft_id=http%3A%2F%2Fwww.cochrane.org%2FCD000222%2FCF_ursodeoxycholic-acid-for-liver-disease-related-to-cystic-fibrosis&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=12" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFriedmanKeeffe2011" class="citation book cs1">Friedman LS, Keeffe EB (2011-08-03). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=uyKht3EwjA0C&q=liver+disease"><i>Handbook of Liver Disease</i></a>. Elsevier Health Sciences. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4557-2316-4" title="Special:BookSources/978-1-4557-2316-4"><bdi>978-1-4557-2316-4</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Handbook+of+Liver+Disease&rft.pub=Elsevier+Health+Sciences&rft.date=2011-08-03&rft.isbn=978-1-4557-2316-4&rft.aulast=Friedman&rft.aufirst=Lawrence+S.&rft.au=Keeffe%2C+Emmet+B.&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DuyKht3EwjA0C%26q%3Dliver%2Bdisease&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+disease" class="Z3988"></span></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_disease&action=edit&section=13" title="Edit section: External links"><span>edit</span></a><span 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style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q929737" class="extiw" title="d:Q929737">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1614179699">5C90</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D008107">D008107</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000205.htm">000205</a></li></ul></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 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plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <a href="https://commons.wikimedia.org/wiki/Category:Diseases_and_disorders_of_liver" class="extiw" title="commons:Category:Diseases and disorders of liver"><span style="font-style:italic; font-weight:bold;">Diseases and disorders of liver</span></a>.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1235681985"><div class="side-box metadata side-box-right"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/32/Scholia_logo.svg/40px-Scholia_logo.svg.png" decoding="async" width="40" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/32/Scholia_logo.svg/60px-Scholia_logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/32/Scholia_logo.svg/80px-Scholia_logo.svg.png 2x" data-file-width="107" data-file-height="104" /></span></span></div> <div class="side-box-text plainlist"><a href="https://www.wikidata.org/wiki/Wikidata:Scholia" class="extiw" title="d:Wikidata:Scholia">Scholia</a> has a <i>topic</i> profile for <i><b><a href="https://iw.toolforge.org/scholia/topic/Q929737" class="extiw" title="toolforge:scholia/topic/Q929737">Liver disease</a></b></i>.</div></div> </div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Medicine685" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style 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specialty">Specialties</a><br />and<br /><a href="/wiki/Subspecialty" title="Subspecialty">subspecialties</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Surgery" title="Surgery">Surgery</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li> <li><a href="/wiki/Cardiothoracic_surgery" title="Cardiothoracic surgery">Cardiothoracic surgery</a></li> <li><a href="/wiki/Endocrine_surgery" title="Endocrine surgery">Endocrine surgery</a></li> <li><a href="/wiki/Eye_surgery" title="Eye surgery">Eye surgery</a></li> <li><a href="/wiki/General_surgery" title="General surgery">General surgery</a> <ul><li><a href="/wiki/Colorectal_surgery" title="Colorectal surgery">Colorectal surgery</a></li> <li><a href="/wiki/Digestive_system_surgery" title="Digestive system surgery">Digestive system surgery</a></li></ul></li> <li><a href="/wiki/Neurosurgery" title="Neurosurgery">Neurosurgery</a></li> <li><a href="/wiki/Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">Oral and maxillofacial surgery</a></li> <li><a href="/wiki/Orthopedic_surgery" title="Orthopedic surgery">Orthopedic surgery</a></li> <li><a href="/wiki/Hand_surgery" title="Hand surgery">Hand surgery</a></li> <li><a href="/wiki/Otorhinolaryngology" title="Otorhinolaryngology">Otolaryngology</a> <ul><li><small>ENT</small></li></ul></li> <li><a href="/wiki/Pediatric_surgery" title="Pediatric surgery">Pediatric surgery</a></li> <li><a href="/wiki/Plastic_surgery" title="Plastic surgery">Plastic surgery</a></li> <li><a href="/wiki/Reproductive_surgery" title="Reproductive surgery">Reproductive surgery</a></li> <li><a href="/wiki/Surgical_oncology" title="Surgical oncology">Surgical oncology</a></li> <li><a href="/wiki/Organ_transplantation" title="Organ transplantation">Transplant surgery</a></li> <li><a href="/wiki/Trauma_surgery" title="Trauma surgery">Trauma surgery</a></li> <li><a href="/wiki/Urology" title="Urology">Urology</a> <ul><li><a href="/wiki/Andrology" title="Andrology">Andrology</a></li></ul></li> <li><a href="/wiki/Vascular_surgery" title="Vascular surgery">Vascular surgery</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Internal_medicine" title="Internal medicine">Internal<br />medicine</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Allergy" title="Allergy">Allergy</a> / <a href="/wiki/Immunology" title="Immunology">Immunology</a></li> <li><a href="/wiki/Angiology" title="Angiology">Angiology</a></li> <li><a href="/wiki/Cardiology" title="Cardiology">Cardiology</a></li> <li><a href="/wiki/Endocrinology" title="Endocrinology">Endocrinology</a></li> <li><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a> <ul><li><a href="/wiki/Hepatology" title="Hepatology">Hepatology</a></li></ul></li> <li><a href="/wiki/Geriatrics" title="Geriatrics">Geriatrics</a></li> <li><a href="/wiki/Hematology" title="Hematology">Hematology</a></li> <li><a href="/wiki/Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li> <li><a href="/wiki/Infectious_diseases_(medical_specialty)" title="Infectious diseases (medical specialty)">Infectious diseases</a></li> <li><a href="/wiki/Nephrology" title="Nephrology">Nephrology</a></li> <li><a href="/wiki/Oncology" title="Oncology">Oncology</a></li> <li><a href="/wiki/Pulmonology" title="Pulmonology">Pulmonology</a></li> <li><a href="/wiki/Rheumatology" title="Rheumatology">Rheumatology</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Obstetrics_and_gynaecology" title="Obstetrics and gynaecology">Obstetrics and<br />gynaecology</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gynaecology" title="Gynaecology">Gynaecology</a></li> <li><a href="/wiki/Gynecologic_oncology" title="Gynecologic oncology">Gynecologic oncology</a></li> <li><a href="/wiki/Maternal%E2%80%93fetal_medicine" title="Maternal–fetal medicine">Maternal–fetal medicine</a></li> <li><a href="/wiki/Obstetrics" title="Obstetrics">Obstetrics</a></li> <li><a href="/wiki/Reproductive_endocrinology_and_infertility" title="Reproductive endocrinology and infertility">Reproductive endocrinology and infertility</a></li> <li><a href="/wiki/Urogynecology" title="Urogynecology">Urogynecology</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Radiology" title="Radiology">Radiology</a> <ul><li><a href="/wiki/Interventional_radiology" title="Interventional radiology">Interventional radiology</a></li> <li><a href="/wiki/Neuroradiology" title="Neuroradiology">Neuroradiology</a></li> <li><a href="/wiki/Nuclear_medicine" title="Nuclear medicine">Nuclear medicine</a></li></ul></li> <li><a href="/wiki/Pathology" title="Pathology">Pathology</a> <ul><li><a href="/wiki/Anatomical_pathology" title="Anatomical pathology">Anatomical</a></li> <li><a href="/wiki/Clinical_pathology" title="Clinical pathology">Clinical pathology</a></li> <li><a href="/wiki/Clinical_chemistry" title="Clinical chemistry">Clinical chemistry</a></li> <li><a href="/wiki/Cytopathology" title="Cytopathology">Cytopathology</a></li> <li><a href="/wiki/Medical_microbiology" title="Medical microbiology">Medical microbiology</a></li> <li><a href="/wiki/Transfusion_medicine" title="Transfusion medicine">Transfusion medicine</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Addiction_medicine" title="Addiction medicine">Addiction medicine</a></li> <li><a href="/wiki/Adolescent_medicine" title="Adolescent medicine">Adolescent medicine</a></li> <li><a href="/wiki/Anesthesiology" title="Anesthesiology">Anesthesiology</a> <ul><li><a href="/wiki/Obstetric_anesthesiology" title="Obstetric anesthesiology">Obstetric anesthesiology</a></li> <li><a href="/wiki/Neurosurgical_anesthesia" title="Neurosurgical anesthesia">Neurosurgical anesthesiology</a></li></ul></li> <li><a href="/wiki/Aviation_medicine" title="Aviation medicine">Aviation medicine</a></li> <li><a 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genetics</a></li> <li><a href="/wiki/Narcology" title="Narcology">Narcology</a></li> <li><a href="/wiki/Neurology" title="Neurology">Neurology</a> <ul><li><a href="/wiki/Clinical_neurophysiology" title="Clinical neurophysiology">Clinical neurophysiology</a></li></ul></li> <li><a href="/wiki/Occupational_medicine" title="Occupational medicine">Occupational medicine</a></li> <li><a href="/wiki/Ophthalmology" title="Ophthalmology">Ophthalmology</a></li> <li><a href="/wiki/Oral_medicine" title="Oral medicine">Oral medicine</a></li> <li><a href="/wiki/Pain_management" title="Pain management">Pain management</a></li> <li><a href="/wiki/Palliative_care" title="Palliative care">Palliative care</a></li> <li><a href="/wiki/Pediatrics" title="Pediatrics">Pediatrics</a> <ul><li><a href="/wiki/Neonatology" title="Neonatology">Neonatology</a></li></ul></li> <li><a href="/wiki/Phlebologist" class="mw-redirect" title="Phlebologist">Phlebology</a></li> <li><a href="/wiki/Physical_medicine_and_rehabilitation" title="Physical medicine and rehabilitation">Physical medicine and rehabilitation</a> (PM&R)</li> <li><a href="/wiki/Preventive_healthcare" title="Preventive healthcare">Preventive medicine</a></li> <li><a href="/wiki/Prison_healthcare" title="Prison healthcare">Prison healthcare</a></li> <li><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a> <ul><li><a href="/wiki/Addiction_psychiatry" title="Addiction psychiatry">Addiction psychiatry</a></li></ul></li> <li><a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation oncology</a></li> <li><a href="/wiki/Reproductive_medicine" title="Reproductive medicine">Reproductive medicine</a></li> <li><a href="/wiki/Sexual_medicine" title="Sexual medicine">Sexual medicine</a> <ul><li><a href="/wiki/Venereology" title="Venereology">Venereology</a></li></ul></li> <li><a href="/wiki/Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li> <li><a href="/wiki/Sports_medicine" title="Sports medicine">Sports medicine</a></li> <li><a href="/wiki/Organ_transplantation" title="Organ transplantation">Transplantation medicine</a></li> <li><a href="/wiki/Tropical_medicine" title="Tropical medicine">Tropical medicine</a> <ul><li><a href="/wiki/Travel_medicine" title="Travel medicine">Travel medicine</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_education" title="Medical education">Medical<br />education</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Medical_school" title="Medical school">Medical school</a></li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a></li> <li><a href="/wiki/Bachelor_of_Medical_Sciences" title="Bachelor of Medical Sciences">Bachelor of Medical Sciences</a></li> <li><a href="/wiki/Master_of_Medicine" title="Master of Medicine">Master of Medicine</a></li> <li><a href="/wiki/Master_of_Surgery" title="Master of Surgery">Master of Surgery</a></li> <li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a></li> <li><a href="/wiki/Doctor_of_Osteopathic_Medicine" title="Doctor of Osteopathic Medicine">Doctor of Osteopathic Medicine</a></li> <li><a href="/wiki/MD%E2%80%93PhD" title="MD–PhD">MD–PhD</a> <ul><li><a href="/wiki/Medical_Scientist_Training_Program" title="Medical Scientist Training Program">Medical Scientist Training Program</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alternative_medicine" title="Alternative medicine">Alternative medicine</a></li> <li><a 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