The liver is one of the vital internal organs. It is located in the abdominal cavity under the diaphragm. The liver is an unpaired organ. It performs many different functions. In particular, it protects the body from the damaging effects of toxins, foreign substances, allergens and other harmful compounds.
Neutralization mechanism
Inactivation of compounds is a process of their chemical modification. It consists of two stages. In the first phase, the compound undergoes oxidation (electrons are disconnected). At the second stage, the substance undergoes hydrolysis or reduction (electron attachment). At the second stage, another substance joins the formed chemical active groups. As a result, the harmful compound is transformed into less toxic or harmless and easily excreted from the body. But in some cases, the body ceases to cope with its functions.
The cause of toxic hepatitis
Damage to the liver can be due to several factors. It can occur as a result of parenteral administration or ingestion of chemical or pharmacological substances, inhalations. Among the toxic compounds, industrial poisons, some types of mushrooms, are dangerous. Pharmacological agents used to treat various pathologies have a strong effect on the liver. Drug poisoning can occur, in turn, due to a number of reasons. One of the main ones is their uncontrolled reception.
Types of Poisoning
There are direct negative effects and idiosyncrasy. In the second case, the effect of the toxic compound is dose dependent. With prolonged administration of drugs, chronic toxic hepatitis may result. Many medication treatments pose a serious health threat. Most drugs undergo a metabolism in the liver, which results in the breakdown of funds. The resulting products provoke morphological changes. When taking medications in high doses, more active harmful metabolites are formed, causing serious liver damage.
Pathology
Usually the latent (latent) period is short. In some cases, it is only a few hours. Clinical signs, meanwhile, appear after a day or two. Acute toxic hepatitis can be triggered by systemic poisons or decay products formed in the liver. Each toxic compound has its own negative effect. For example, trichlorethylene, carbon tetrachloride cause necrotic processes, and yellow phosphorus leads to periportal damage. With a daily intravenous administration of Tetracycline in a dose of more than 1.5 g, small fatty deposits form in the liver. In some cases, the damaging effect goes unnoticed for a certain period until jaundice appears.
Idiosyncratic reactions
In these cases, hepatitis rarely occurs and is unpredictable. Its severity in this case depends on the dosage. A pathological condition can develop at any time during or after taking the medication. Symptoms of toxic hepatitis are usually the same. In particular, with idiosyncrasy, extrahepatic hypersensitivity reactions are noted: rash, fever, arthralgia. In patients, in almost 25% of cases, eosinophilia and leukocytosis are observed. In a series of studies, it was found that the hepatotoxic effect in such conditions is due to the activity of the formed metabolites of pharmacological agents.
Diagnosing conditions
Experts note that not all hepatic reactions that occur when taking certain drugs are classified as idiosyncratic or toxic. For example, birth control pills (gestagens, estrogens) can cause liver disorders, and in some cases jaundice. But these medicines do not cause necrotic processes or fat changes. In this case, the manifestation of a hypersensitivity reaction can be considered as genetically predetermined. Due to the fact that the diagnosis is presumptive in most cases, and against the background of other pathologies, a similar clinical picture takes place, it is sometimes difficult for a specialist to establish a causal relationship between the use of specific drugs and subsequent liver damage. In some cases, the symptoms of toxic hepatitis can be reproduced. In this case, provocation by a suspected agent after a latent period causes a number of signs, biochemical and morphological changes. However, such an artificial provocation in many cases is impossible for aesthetic reasons, as well as in connection with a high risk of developing serious complications. Toxic drug hepatitis, the treatment of which should be mainly supportive, is manifested primarily by adverse reactions to the drug. When diagnosing a suspected drug, it must be immediately canceled. Moreover, during the examination, the specialist should not be distracted from damage to the kidneys and other organs. Along with changes in the liver, damage to other organs can ultimately lead to death.
Therapeutic measures
Symptoms of toxic hepatitis manifest themselves in different ways: from a mild hypersensitivity reaction to severe conditions. Depending on the clinical picture, therapeutic measures are also prescribed. So, for example, with vomiting and severe anorexia, treatment of toxic hepatitis includes intravenous drip of a glucose solution (five or ten percent) in a dose of up to 500 milliliters. If signs of coma or congestion of the liver are detected, massive plasmapheresis is performed. Using a separator or centrifuge, 1.5-2 liters of the existing one are removed and two liters of frozen plasma are injected intravenously. In the absence of improvements, an increase in the level of prothrombin, the preservation of impaired consciousness, the procedure is repeated. Before normalizing the coagulation system, 1-2 liters of freshly frozen plasma are injected every day for 2-3 days. Therapeutic measures include diet. For toxic hepatitis, carbohydrate-rich foods and large quantities of fruit juices are recommended. The patient should be limited in fat intake.
Therapeutic measures without exacerbations
The factor that provoked the pathological state is of significant clinical importance when choosing measures that make up the treatment of long-term toxic hepatitis. With prolonged liver damage, moderate fibrosis and predominantly preserved lobular structure of the organ are noted. In the absence of exacerbation, treatment of toxic hepatitis provides a special diet. Spices, spicy dishes, fried foods, refractory fats are excluded from the diet. Recommended daily use of cottage cheese (up to 100-150 g), boiled low-fat fish, mild cheese. Treatment of toxic hepatitis in some cases is carried out in conjunction with the treatment of alcoholism (with alcohol poisoning). It is extremely important to ensure absolute cessation of contact with the poisonous substance.
Exacerbation therapy
In such conditions, hospitalization, a more strict diet are recommended. With toxic hepatitis, bed rest is necessary . Patients are prescribed predominantly B-group vitamins, as well as folic, nicotinic, ascorbic acid. To improve the course of anabolic processes, steroid hormones are used (inside - methandrostenol per day at 15-20 mg, with a gradual decrease in dosage, or intramuscularly retabolil every two weeks at 20-50 mg). In more severe conditions, corticosteroid hormones are recommended (Prednisolone 20-40 mg / day), immunosuppressants - for a long time, but in a small dosage.
Toxic hepatitis. Treatment with folk remedies
To alleviate the condition, there are several recipes using herbal ingredients. So, sauerkraut juice is effective. With a long course of the disease, it is recommended to drink half a glass a day. Duration of admission is not less than a month. Another quite popular remedy is horseradish tincture. For its preparation take 2 tbsp. l grated raw materials, pour milk. The mixture should be heated to boiling, removed from heat, cool. Accepted during the day in small sips. Duration - until the condition improves. Helps reduce the severity of symptoms tincture of mint (leaves). 2 tbsp. l plants pour 2 cups boiling water. The solution is infused for a day. They drink the drug up to three times a day.
Preventive actions
The main measures to prevent the development of pathological conditions are to carefully observe hygiene rules. Inedible or edible, but old mushrooms or other products with an expired date should not be eaten. As noted above, one of the main causes of toxic liver damage is taking high doses of medications. When prescribing potent drugs, the use of which is associated with a risk of hypersensitivity reactions and other complications, it is necessary to follow the doctorβs instructions and follow the recommendations in the annotations to the drugs. It is highly recommended not to change the treatment regimen yourself. With the development of pathological conditions associated with impaired liver function, you must immediately visit a specialist and get qualified help.