Signs and Symptoms of Liver Disease

  • Khalid Aziz
  • Jonathan Israel
Part of the Current Clinical Practice book series (CCP)


Liver disease is an important cause of mortality and morbidity worldwide. In third world countries, especially in Asia and Africa, viral infections are the major liver problem, whereas in the Western world, alcoholic damage is the most important cause of liver disease, accounting for up to 80% of patients with cirrhosis in some countries (1). In the United States, chronic liver disease, including cirrhosis, is the fourth most frequent cause of death among individuals 30–60 yr old (2). Fortunately, mortality from chronic liver disease has steadily declined in the past 10 yr in both the white and black populations (3). However, it remains costly, both in terms of human morbidity and financial resources, as the course of chronic liver disease is typically characterized by recurrent complications requiring repeated hospitalizations, and often results in loss of life.


Liver Disease Chronic Liver Disease Hepatic Encephalopathy Primary Biliary Cirrhosis Sclerosing Cholangitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Saunders JB, Latt, N. Epidemiology of alcoholic liver disease. Bailliere’s Clin Gastro 1993;7:555–579.CrossRefGoogle Scholar
  2. 2.
    Deaths and hospitalizations from chronic liver disease and cirrhosis—United States, 1980–1989. MMWR 52&53, 1993;4:969-973.Google Scholar
  3. 3.
    Age adjusted death rate for selected causes of death according to sex and race—United States, selected years 1950–1992. Health United States 1994: pp. 97, 98.Google Scholar
  4. 4.
    Tamburro CH. Clinical evaluation of liver status. In: Gitnick G, ed. Diagnosis of liver and biliary disease. Mosby, St. Louis, MO, 1992: 95–135.Google Scholar
  5. 5.
    McIntyre N. Symptom and signs of liver disease. In: McIntyre N, Benhamon J, Bircher J, Rizzetto M, Rodes J, eds. Oxford textbook clin hepatol. Oxford University Press, Oxford, UK, 1991: pp. 273–290.Google Scholar
  6. 6.
    Witt-Sullivan H, Heathcote J, Cauch K, Blandis L, Ghent C, Katz A, Milner R, Pappas C, Rankin J, Wanless R. The demography of primary biliary cirrhosis in Ontario, Canada. Hepatology 1990; 12:98–105.CrossRefGoogle Scholar
  7. 7.
    Swain MG, Maric M. Defective corticotropin-releasing hormone mediated neuroendocrine and behavioral responses in cholestatic rats: Implications for cholestatic liver disease-related sickness behaviors. Hepatology 1995; 5:1560–1564.Google Scholar
  8. 8.
    Swain MG, Patchev V, Vergalla J, Chrousos G, Jones EA. Suppression of hypothalamic-pituitary-adrenal axis responsiveness to stress in a rat model of acute cholestasis. J Clin Invest 1993; 91:1903–1908.PubMedCrossRefGoogle Scholar
  9. 9.
    Henkin RI, Smit FR. Hyposmia in acute viral hepatitis. Lancet 1971; 1:823–826.PubMedCrossRefGoogle Scholar
  10. 10.
    Mendenhall CL. Alcoholic hepatitis. Clin Gastroenterology 1981; 10:417–441.Google Scholar
  11. 11.
    Nicholl CG, Polack JM, Bloom SR. The hormonal regulation of food intake, digestion and absorption. Ann Rev Nutr 1985; 5:213–239.CrossRefGoogle Scholar
  12. 12.
    Deems RO, Friedman MI, Friedman LS, Munoz SJ, Maddrey WC. Chemosensory function, food preferences and appetite in human liver disease. Appetite 1993;3:209–216.CrossRefGoogle Scholar
  13. 13.
    Smith FR, Henkin IH, Dell RB. Disordered gustatory acuity in liver disease. Gastroenterology 1976;70:568–571.PubMedGoogle Scholar
  14. 14.
    Garrett-Laster M, Russell RM, Jacques PF. Impairment of taste and olfaction in patients with cirrhosis: the role of vitamin A. Hum Nutr-Clin Nutr 1984;3:203–214.Google Scholar
  15. 15.
    Uribe M, Briones A, Ramos GG. Successful administration of metoclopramide for the treatment of nausea in patients with advanced liver disease. Gastroenterology 1985;88:757–762.PubMedGoogle Scholar
  16. 16.
    Mezey E. Intestinal function in chronic alcoholism. Ann NY Acad Sci 1975;252:215–227.PubMedCrossRefGoogle Scholar
  17. 17.
    Jones EA, Bergasa NV. The pruritis of cholestasis: from bile acids to opiate agonists. Hepatology 1990; 11:884–887.PubMedCrossRefGoogle Scholar
  18. 18.
    Cornely CM, Schade RR, Van Thiel D, Gavaler JS. Chronic advanced liver disease and impotence: cause and effect? Hepatology 1984;4:1227–1230.PubMedCrossRefGoogle Scholar
  19. 19.
    Bach N, Schaffner F, Kapelman B. Sexual behavior in women with nonalcoholic liver disease. Hepatology 1989;9:698–703.PubMedCrossRefGoogle Scholar
  20. 20.
    Angeli P, Albino G, Carraro P, Dalla Pria M, Merkel C, Caregaro L, DeBei E, Bortoluzzi A, Plebani M, Gatha A. Cirrhosis and muscle cramps: evidence of a causal relationship. Hepatology 1996;23:264–273.PubMedCrossRefGoogle Scholar
  21. 21.
    Lee FY, Lee SD, Tsai YT, Lai KH, Chao Y, Lin HC, Wang SS, Lo KJ. A randomized controlled trial of quinidine in the treatment of cirrhotic patients with muscle cramps. J Hepatol 1991;2:236–240.CrossRefGoogle Scholar
  22. 22.
    Podolsky DK, Isselbacher KJ. Cirrhosis of the liver. In: Wilson JD, Braunwald E, Isselbacher KJ, eds. Harrison’ s principles of internal medicine. McGraw Hill, New York, 1991: pp. 1340–1350.Google Scholar
  23. 23.
    Attali P, Ink O, Pelletier G, Vernier G, Jean F, Moulton L, Etienne JP. Dupuytren’s contracture, alcohol consumption and chronic liver disease. Arch Int Med 1987; 147:1065–1067.CrossRefGoogle Scholar
  24. 24.
    Muehrcke RC. The finger-nails in chronic hypoalbuminemia. BMJ 1956;1:1327–1328.PubMedCrossRefGoogle Scholar
  25. 25.
    Munoz SJ, Maddrey WC. Major complications of acute and chronic liver disease. Gastroenterol Clin North Am 1988;17:265–287.PubMedGoogle Scholar

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© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Khalid Aziz
  • Jonathan Israel

There are no affiliations available

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