Hepatic cirrhosis is the endpoint of different toxic, autoimmune, congenital or infectious diseases (see Table 4).
Different pathologies leading to hepatic cirrhosis
Toxic
- Alcohol Methotrexate Isoniazid : Methyldopa Amiodarone
- Infections Hepatitis B and C : Schistosomiasis
- Autoimmune Chronic active hepatitis Primary biliary cirrhosis
Metabolic
- Wilson’s disease
- α-1-antitrypsin-deficiency Hemochromatosis
- Glycogen storage disease Galactosemia
- Diseases of urea cycle Tyrosinemia
- Abetalipoproteinemia
Biliary obstruction
- Atresia Strictures, Cystic fibrosis
- Cholelithiasis
- Sclerosing cholangitis
Vascular
- Budd-Chiari syndrome Veno-occlusive disease
- Chronic cardiac insufficiency Hereditary hemorrhagic teleangiectasia with AV-shunts
Others
- Neonatal hepatitis-syndrome Indian childhood cirrhosis
- Intestinal bypass Sarcoidosis
Fibrosis is an integral part of cirrhosis and differentiates it from nodular regenerative hyperplasia. Structurally abnormal nodules may often occur
but sometimes they can only be identified by means of subtle architectural changes, such as a disordered or compressed cell plate pattern. Although
abnormalities in vasculature and blood flow are very important, they are not included in the definition since these changes are a consequence of the other pathologic features rather than primary abnormalities. Equally, true regenerative nodules can be a late occurrence in cirrhosis and therefore regeneration is also excluded from the definition. Although regeneration is not essential for the diagnosis of cirrhosis, it is important to point out that regeneration is a critical factor influencing the evolution of cirrhosis.TUMOR OF THE LIVER (CIRRHOSIS)