Toxic hepatitis

Diagnosis

Liver biopsy Enlarge image

Close

Liver biopsy

Liver biopsy

A liver biopsy is a procedure to remove a small sample of liver tissue for laboratory testing. A liver biopsy is commonly performed by inserting a thin needle through the skin and into the liver.

To diagnose toxic hepatitis, a healthcare professional takes a medical history and does a physical exam. Bring to your appointment all medicines you take in the containers they came in. Tell your health professional if you work with industrial chemicals or may have been exposed to pesticides, herbicides or other environmental toxins.

Tests might include:

• Blood tests. Blood tests look for high levels of certain liver enzymes and check how well the liver is working.
• Imaging tests. These tests take pictures of the liver using ultrasound, computerized tomography (CT) or magnetic resonance imaging (MRI). There might be other imaging tests as well.
• Liver biopsy. A liver biopsy can help confirm the diagnosis of toxic hepatitis and help rule out other causes. During a liver biopsy, a needle is used to take a small sample of tissue from the liver. The sample is checked under a microscope.

Treatment

Treatment depends on what's causing the liver damage. Often, stopping contact with the cause will reduce symptoms.

Treatments for toxic hepatitis may include:

• Supportive care. People with severe symptoms are likely to get therapy in a hospital. This might include having fluids through a vein and taking medicine to relieve nausea and vomiting. A healthcare professional watches the liver for damage.
• Medicine to reverse liver damage caused by acetaminophen. Treatment for liver damage caused by an overdose of acetaminophen includes getting a medicine called N-acetylcysteine right away. The sooner this medicine is given after the overdose, the greater the chance of limiting liver damage. It works best within 16 hours of the acetaminophen overdose.
• Emergency care. For people who overdose on a toxic medicine, emergency care is vital. People who overdose on certain medicines other than acetaminophen might have treatments to remove the medicine from the body or lessen its toxic effect.

• Liver transplant. When the liver is badly damaged, a liver transplant may be the only choice for some people. A liver transplant is an operation to remove the diseased liver and replace it with a healthy liver from a donor.

  Most livers used in liver transplants come from people who have died. Sometimes livers come from living donors who donate a part of their livers.

Preparing for your appointment

Make an appointment with someone on your primary healthcare team if you have symptoms that worry you. You might then be referred to a liver specialist, called a hepatologist.

Here's some information to help you get ready for your appointment.

What you can do

Take a family member or friend along, if possible, to help you remember the information you get.

Make a list of:

• Your symptoms and when they began.
• Key personal information, including major stresses or recent life changes, and family history of liver disease.
• All medicines, vitamins and supplements you take, including doses. Even better, bring them to your appointment in the containers they came in.
• Questions to ask your healthcare professional.

For toxic hepatitis, some basic questions to ask include:

• What is likely causing my symptoms?
• What are other possible causes?
• Could one of the medicines I take be harming my liver?
• Is my liver damaged?
• What tests do I need?
• Is my condition likely to go away or last?
• What is the best course of action?
• I have other health conditions. Will these conditions or their treatment affect the outcome of toxic hepatitis? How can I best manage them together?
• Are there restrictions that I need to follow?
• Are there brochures or other printed material I can have? What websites do you recommend?

Be sure to ask all the questions you have.

What to expect from your doctor

Your healthcare professional will likely ask a few questions, such as:

• Do you have symptoms all the time or do they come and go?
• How bad are your symptoms?
• What, if anything, seems to make you feel better?
• What, if anything, makes you feel worse?
• Have you started a new medicine recently?
• Do you take acetaminophen?
• Do you take herbal or nutritional supplements?
• How much alcohol do you drink and how often?
• Have you noticed yellowing in the whites of your eyes?
• Does your urine look darker than usual?