Signs associated with the diagnosis
Signs of Chronic Liver Disease can be divided into those that are associated with the diagnosis of chronic liver disease, associated with decompensation and associated with the aetiology.
- Clubbing
- Palmar erythema
- Spider nevi (angiomata)
- Scratch marks
- Gynaecomastia
- Feminising hair distribution
- Testicular atrophy
- Small irregular shrunken liver
- Anaemia
- Caput medusae (recanalisation of the umbilical vein) (Distended abdominal veins)
It may be noted here that the Chronic Liver Disease takes several years to develop.
Testing for chronic liver disease involves blood tests, x rays and a biopsy of the liver. The liver biopsy is a simple procedure done with a fine thin needle under local anesthesia. The tissue sample is sent to a laboratory where it is examined underneath a microscope
Signs associated with decompensation
- Drowsiness (encephalopathy)
- Hyperventilation (encephalopathy)
- Metabolic Flap/Asterixis (encephalopathy)
- Jaundice (excretory dysfunction)
- Ascites (portal hypertension and hypoalbuminaemia)
- Leukonychia (hypoalbuminaemia)
- Peripheral oedema (hypoalbuminaemia)
- Bruising (coagulopathy)
Signs associated with the aetiology
- Dupuytren's contracture (Alcohol)
- Parotidomegally (Alcohol)
- Peripheral neuropathy (Alcohol and some drugs)
- Cerebellar signs (alcohol and Wilson's disease)
- Hepatomegaly (alcohol, NAFLD, Haemochromatosis)
- Kayser-Fleisher Rings (Wilson's)
- Increased pigmentation of the skin (Haemochromatosis)
- Signs of Right Heart Failure
- Tattoos (Hepatitis C)
other diseases can involve the liver and even cause hepatomegaly but would not be considered part of the spectrum of chronic liver disease. Some examples of this would include chronic cancers with liver metastases, infiltrative haematological disorders such as chronic lymphoproliferative conditions, chronic myeloid leukaemias, myelofibrosis and metabolic abnormalities such as Gaucher's and Glycogen Storage Diseases.
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