Toxic Hepatitis

DEFINITION

Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements.

In some cases, toxic hepatitis develops within hours or days of exposure to a toxin. In other cases, it may take months of regular use before signs and symptoms of toxic hepatitis appear.

The symptoms of toxic hepatitis often go away when exposure to the toxin stops. But toxic hepatitis can permanently damage your liver, leading to irreversible scarring of liver tissue (cirrhosis) and in some cases to liver failure.

CAUSES

Toxic hepatitis occurs when your liver develops inflammation because of exposure to a toxic substance. Toxic hepatitis may also develop when you take too much of a prescription or over-the-counter medication.

One of the liver’s roles involves removing and breaking down most drugs and chemicals from your bloodstream. Breaking down toxins creates byproducts that can damage the liver. Although the liver has a great capacity for regeneration, constant exposure to toxic substances can cause serious, sometimes irreversible harm.

Toxic hepatitis can be caused by:

• Alcohol. Heavy drinking over many years can lead to alcoholic hepatitis — inflammation in the liver due to alcohol.
• Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage your liver, especially if taken frequently or combined with alcohol.
• Prescription medications. Some medications linked to serious liver injury include the combination drug amoxicillin-clavulanate (Augmentin), halothane, isoniazid, valproic acid (Depakene), phenytoin (Dilantin, Phenytek), azathioprine (Azasan, Imuran), niacin (Niaspan), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), rosuvastatin (Crestor), ketoconazole, certain antibiotics, certain antivirals and anabolic steroids. There are many others.
• Industrial chemicals. Chemicals you may be exposed to on the job can cause liver injury. Common chemicals that can cause liver damage include the dry cleaning solvent carbon tetrachloride, a substance used to make plastics called vinyl chloride, the herbicide paraquat and a group of industrial chemicals called polychlorinated biphenyls.

SYMPTOMS

Mild forms of toxic hepatitis may not cause any symptoms and may be detected only by blood tests. When signs and symptoms of toxic hepatitis occur, they may include:

• Yellowing of the skin and whites of the eyes (jaundice)
• Itching
• Abdominal pain in the upper right portion of the abdomen
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Rash
• Weight loss
• Dark or tea-colored urine

When to see a doctor

See your doctor right away if you have any signs or symptoms that worry you.

Overdoses of some medications, such as acetaminophen (Tylenol, others), can lead to liver failure. Get immediate medical care if you think an adult or a child has taken an overdose of acetaminophen or develops signs or symptoms of a possible acetaminophen overdose, such as:

• Sweating
• Nausea and vomiting
• Upper abdominal pain
• Coma

If you suspect an acetaminophen overdose, immediately call 112, your local emergency services or, in the United States, a poison control center at 800-222-1222. An acetaminophen overdose can be fatal.