Merck Manual

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Some Conditions and Drugs That Can Cause Fibrosis of the Liver

Some Conditions and Drugs That Can Cause Fibrosis of the Liver

Type

Examples

Comments

Certain hereditary metabolic disorders

These disorders affect how foods are absorbed, broken down, and/or processed (metabolized) in the body. If foods are not broken down normally, substances can accumulate in various organs (such as the liver) and cause damage.

Infections

Viral infections such as chronic hepatitis B or C

Some infections can affect almost any organ of the body, including the liver. Some, such as hepatitis, affect mainly the liver.

Autoimmune disorders

The body attacks its own tissues (an autoimmune reaction).

In primary biliary cholangitis and primary sclerosing cholangitis, bile ducts become inflamed, scarred, and blocked.

Disorders that affect blood flow to, in, and out of the liver

Budd-Chiari syndrome (blockage of blood flow out of the liver by a blood clot)

Portal vein thrombosis (blockage of the main vein to the liver by a blood clot)

Veno-occlusive disease of the liver (blockage of the small veins in the liver)

When blood cannot leave the liver, the liver enlarges.

When liver cells do not receive enough blood, they die and are replaced with scar tissue.

Sinusoidal obstruction syndrome (veno-occlusive disease) is sometimes caused by pyrrolizidine alkaloids. These substances are present in certain herbal products such as bush (rooibos) teas, which are sometimes used for their supposed health benefits.

Drugs

Alcohol

Amiodarone

Chlorpromazine

Corticosteroids

Isoniazid

Methotrexate

Methyldopa

Oxyphenisatin

Tolbutamide

Most drugs must be processed in the liver. Some can harm the liver.

Other disorders

Congenital hepatic fibrosis

Nonalcoholic fatty liver (steatohepatitis)

Congenital hepatic fibrosis damages primarily the liver, gallbladder, and kidneys. It causes fibrosis in the liver and other symptoms. This disorder is present at birth.

In nonalcoholic fatty liver, fat accumulates in the liver and fibrosis develops. This disorder tends to occur in people who have metabolic syndrome.