Toxic Hepatitis

The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis — a condition that causes inflammation of the liver.

Causes

Medications

Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. In most cases when problems occur, they are mild and only apparent from blood tests, and can be resolved by reducing the dose of medication or discontinuing use.

In rare instances, however, some patients have an idiosyncratic reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. Patients experiencing a severe idiosyncratic drug reaction must stop taking the drug immediately. They also require an urgent referral to a transplant center for a liver transplant, which may be life-saving.

Herbs and Nutritional Supplements

Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. It is important to note that these substances are not subject to the same regulations, testing or approval processes as conventional drugs. Studies have shown that some herbs and nutritional supplements are adulterated with steroids or antibiotics.

Herbs that may be toxic to the liver include comfrey, chaparral, germander, kava, valerian, mistletoe and traditional Chinese herbs. People with liver disease should not use herbs or nutritional supplements without the approval of their doctor.

Alcohol

Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. In individuals who are prone to alcohol-related liver injury — possibly due to genetics — heavy drinking can result in acute liver failure, a life-threatening condition that requires hospitalization and intensive care. Other people may develop progressive liver disease from regular, heavy use of alcohol.

The goal of treatment is to eliminate alcohol from the diet and treat the psychological dependence on alcohol. Even at the advanced stage of cirrhosis, liver disease from alcohol may show significant improvement with total abstinence from alcohol.

Our Approach to Toxic Hepatitis

UCSF offers the most advanced diagnostic and treatment options for patients with toxic hepatitis. The first and most important step we will take is to identify and eliminate the substance that's causing the condition. This may be a medication, an herbal or other nutritional supplement, certain chemicals or alcohol. When alcohol is causing a patient's liver inflammation, we will need to address the underlying substance use disorder.

Toxic hepatitis can lead to severe liver damage or failure. In these cases, a liver transplant may be necessary. Our liver transplant program, designated a center of excellence by the U.S. Department of Health and Human Services, is known for outstanding outcomes and for helping pioneer techniques that have made transplants safer and more successful. We perform more than 100 transplants each year, and our survival statistics are among the very best in the country.