Acute alcoholic toxic fatty liver
Acute fatty degeneration of the liver in alcohol intoxication
Regular consumption of ethanol leads to irreversible violations of the functional activity of internal organs and brain. But the main target of toxic compounds is always to get the liver is responsible for neutralization of all toxic substances, appearing in the human body from the environment. There comes a time when the biological barrier is not able to fully do their job – a person develops acute alcoholic toxic fatty liver. The risk of pathology is minor severity of symptoms. This is a serious obstacle to the treatment of the disease at an early stage.
The mechanism of development of fatty liver disease in alcoholic intoxication
Toxic fatty liver – accumulation of fat droplets inside liver cells, the cause of which is prolonged use of alcoholic beverages. This pathology is diagnosed in all alcoholics regardless of sex and initial health status. The disease is considered the first stage of damage to hepatocytes (the main structural elements of the liver). In the absence of medical intervention dystrophic changes in growing, provoking the development of hepatitis and cirrhosis.
No matter what alcoholic beverage with any percentage content of pure ethanol uses. Acute fatty degeneration is formed even in people who regularly drank after work beer. The risk of disease increases with monotonous diets.
The liver is one of the most important organs responsible for metabolism of lipids. The fats contained in the food reaches the gastrointestinal tract. With the help of enzymatic compounds, the lipids are broken down, and then enter the bloodstream. The blood stream they are carried to the liver for further processing. Fat cells transformirovalsya in nutrients that the human body requires for normal functioning. These include:
Acute toxic fatty dystrophy develops with the accumulation in liver cells more than 10% of lipids, consisting mainly of triglycerides. The concentration of the fatty accumulations in the biological filter during prolonged alcohol intoxication may be more than 50% of the total mass of hepatocytes. The probability of the rapid progression of acute alcoholic degeneration, or steatosis, depend on hereditary predisposition to the appearance of addiction, the presence of endocrine system diseases, eating greasy and fried foods.
Varieties of fatty liver in chronic intoxication
In the diagnosis of patients with acute toxic fatty dystrophy using computed or magnetic resonance imaging specialists note different distribution of triglycerides in all departments of the liver. It allows to classify the disease according to the morphological characteristics:
- Disseminated focal. This pathology is characterized by the absence of obvious signs of deformation of hepatocytes. The liver produces several extensive accumulations of triglycerides, localized in the same Department.
- Disseminated severe. In this form of the disease the lipid are distributed in different liver sections (lobes) and is able to provoke a small amount of symptoms, e.g., aching pain in hypochondrium.
- Zonal. Triglycerides are found in all parts of the liver, damaging large areas. The signs are not very pronounced, can be confused with symptoms of different diseases of internal organs.
- Diffuse. Lipids are evenly placed in all gepatitah biological filter, greatly reducing the functional activity of the liver. The person experiences nausea, heaviness in my side, extreme fatigue.
Alcohol intoxication causes a rare form of fatty degeneration syndrome Tive. After the ingestion of significant doses of ethyl alcohol is poisoning not only the liver, but all internal organs and brain. After the death of the neurons are reduced, the processes of regulation of vital systems, cells and tissues are not able to perform its functions. This condition is a predisposing syndrome Tive, which is characterized by such irregularities:
- in the blood there is a significant amount of toxins, toxic compounds, products of disintegration of biologically active substances;
- increasing the concentration of bilirubin, the coloring ingredient of bile, formed after the collapse of red blood cells;
- increases the level of cholesterol, the organic compound contained in the cell membranes and impair blood flow.
In addition to changing the composition of the blood, acute toxic fatty dystrophy develops hemolytic anemia. In the blood decreases hemoglobin that is responsible for delivering molecular oxygen to the tissues.
The main reason for low hemoglobin level becomes the death of red blood cells due to deficiency of tocopherol. This biologically active substance is synthesized and accumulates in the liver in normal condition. Tive syndrome responds well to medical therapy, but only in total abstinence from alcohol.
The clinical picture of acute fatty degeneration
Symptoms of steatosis at the initial stage, similar to the pathological signs of the disease Botkin, in which the patient’s health is deteriorating rapidly. Significantly damaged Central and peripheral nervous system, which provokes the appearance of numerous disorders on brain activity:
- A person develops delirium.
- He is not able to stay long in one position.
- There is a disorder of the digestive system.
- Reduced tactile, muscle and tendon reflexes.
Mental disorders in alcoholic intoxication is so strong that further treatment of acute toxic fatty dystrophy is possible only in a hospital. The pathological process in the liver may develop in a different scenario. The Central system responds to the degeneration and destruction of hepatocytes as follows:
- there is apathy, depression, indifference to what is happening;
- reduced vitality;
- there is drowsiness.
If a person in this condition is not medical care, he falls into unconsciousness. Hepatic coma develops in which the biological filter is not able to perform its function of cleansing the blood from toxic compounds and metabolic products. The lethal outcome occurs within a specific time period, dependent on the original condition of the body.
Acute toxic fatty dystrophy in the last stage is diagnosed in people who drink alcohol at least 10 years. This disease is extremely difficult therapy due to the significant replacement of hepatocytes by fat cells and connective tissue.
Ethyl alcohol in large quantities has a hepatotoxic effect. Acute fatty degeneration not only able to provoke the appearance of diseases, but often she becomes a signal for further diagnosis of cirrhosis or alcoholic hepatitis. In most cases at an early stage pathology develops fatty liver, or steatosis. This is the most common among alcoholics steatosis characterized by the accumulation of fat cells in hepatocytes and stable over. When steatosis occurs on the background of the inflammatory process result in steatohepatitis – progressive fibrosis or cirrhosis pathology. Toxic fatty degeneration typically asymptomatic and is found incidentally during diagnosis of other diseases. Can appear such signs of accumulation of triglycerides in liver cells:
- The heaviness and discomfort right upper quadrant, aggravated by physical exertion.
- Recurring nausea and bitter taste in my mouth.
- Fatigue, dizziness, weakness.
If the person is at this stage, the liver ceases to consume alcoholic beverages, then complying with all recommendations of the doctor fully recover after a few weeks.
Acute alcoholic toxic fatty degeneration of the liver similar to the clinical picture of chronic poisoning with ethanol:
- overweight or exhaustion;
- increased renal and (or) blood pressure;
- tremor of the upper and lower extremities;
- swelling of breast, ear glands;
- excessive sweating;
- red color of face and palms;
- dilation of superficial small blood vessels.
If a person is in the presence of 4-5 of these signs, he diagnosed chronic intoxication. It also reflects the acute fatty degeneration of the liver. In addition to the accumulation of triglycerides in hepatocytes, alcoholics at the same time develop pancreatitis, erosive gastritis, chronic glomerulonephritis. It also reduces the ability of the heart muscle normally to pump blood. Due to violation of the metabolism of biologically active substances in the body there is an acute shortage of vitamins and minerals that it becomes a cause of megaloblastic anemia.
The factors causing fatty degeneration
The main cause of acute toxic fatty dystrophy – the abuse of alcohol. For the occurrence of disease is not necessary to take alcohol daily, enough to drink ethanol rarely, but in large doses. The liver is not able to process a significant amount of alcohol. After penetration into the cells of toxins there is a splitting of molecules of ethyl alcohol to the toxic compound acetaldehyde.
When the human body gets a small dose of ethanol, with the participation of specific enzymes, it is decomposed into harmless acetic acid. She displays the urinary system without any consequences for health.
But the high concentration of alcohol is completely metabolized by hepatocytes, so there is a serious poisoning. Violated not only the functioning of all systems of life suffers, and the liver itself. Because it remains toxic acetaldehyde directly damage the liver cells. To fatty degeneration complicating factors also include:
- The death of hepatocytes faster than they are restored using pharmacological drugs. Damaged liver cells formed fibrous connective tissue.
- The tissue hypoxia. After the destruction of the red corpuscles in the bloodstream accumulates molecular oxygen, while all the cells feel its acute shortage.
- The decline in volume. After the appearance of fibrous areas in the lobes of the liver reduces the area of active surface.
- Violation of exchange processes. The shortage of protein ingredients provokes excessive swelling of tissues.
Due to disorder of metabolic regulation of the Central nervous system is a violation of metabolic processes in the biological filter. Triglycerides penetrate into the cytoplasm of the hepatocytes and begin to accumulate in them. The kernel is shifted to the shell that makes the internal state of a cell is extremely unstable.
Acute toxic fatty dystrophy develops rapidly over a short period of time when all of the following negative factors:
- the use of ethanol for more than three consecutive days;
- intake of alcoholic beverages with a considerable time gap, but in large quantities;
- genetic predisposition to physical and psychological dependence;
- the deficit in the diet of foods with a high content of protein;
- overweight, a metabolic disorder in result of endocrine diseases in the anamnesis.
In the presence of an inflammatory process in the liver, which has a viral etiology, degeneration of hepatocytes in the connective tissue are greatly accelerated. Therefore, when the diagnosis of toxic fatty degeneration specialists will carry out the seeding of the biological sample in the culture medium. Pathology triggered by viruses, have several different treatment plan.
The main symptoms of fatty liver
As in the initial stage fatty infiltration pronounced the symptoms are virtually absent, the pathology experienced doctors identify when conducting a differential diagnostic methods. The accumulation of triglycerides by the liver cells increases the severity of the negative symptoms of alcoholic degeneration:
- On the entire surface of the skin appear vascular «mesh» and «star» reddish, mostly localized on the cheeks.
- On the soles of thickened and red skin.
- In men, adipose tissue begins to be distributed on the female type: arms and legs become thinner, rounded hips, Breasts become larger.
- Slows down hair growth in the armpits and on the pubis.
- Reduced the volume of tissues of the testicles, reduced their functional activity.
- There is a sexual dysfunction and impotence – man is unable to commit full sexual intercourse.
- The tendons in the palm thicken and take the shape of the harness. This leads to a restriction of functionality of the palm, it is not able to bend at the correct angle.
- The skin and mucosa gradually turn yellow, eventually turn even eye sclera.
- Disrupted gastrointestinal tract: the alcoholic suffers from constant nausea and vomiting, flatulence, heartburn, sour belching, bloating.
- Reduced peristalsis of the intestine against the development of chronic constipation or diarrhea.
- Reduced appetite that causes weight deficit.
- Have pain in the right hypochondrium, which may be given in the left torso.
The above symptoms of acute toxic fatty dystrophy may appear all or only person to bother some of them. If the alcoholic continues to drink alcohol, the disease begins to worsen with relapses. During this period, the disease symptoms are felt stronger pains become sharp, opens with a painful vomiting.
Treatment of alcoholic fatty degeneration
So, the totality of the symptoms of fatty infiltration similar to the clinical picture of alcoholic hepatitis, Botkin’s disease and cirrhosis, patients undergo diagnosis using the latest instrumental techniques. An important part of the examination is a biopsy taken from human liver tissue. The procedure relates to invasive methods is in the liver puncture is done with special tools to remove the material for study.
Before diagnosis and drug therapy of fatty degeneration, the patient is strongly recommended to change their way of life: you must stop any use of alcohol and observe sparing diet with a high content of protein-rich foods.
Treatment of liver starts with a detoxification therapy (hemosorbtion, plasmapheresis). After eliminating accumulated toxic compounds a doctor prescribes medication in the form of IVS and tablets to repair damaged liver cells. To improve the General condition of the human body helps to prolonged use of Immunostimulants, vitamins and minerals.