|
|
|
| A | B | C | D | E |F | G | H | I | J| K | L | M |
N | O | P | Q | R | S | T | U
| V | W |
X | Y | Z |
Following is a brief
glossary of liver disease terms used by physicians and other medical
professionals involved in the care of the patient. Special thanks
and credit for much of this information is due to Fred K. Askari,
M.D., Ph.D., author of Hepatitis C The
Silent Epidemic: The Authoritative Guide, from Perseus Books,
New York, New York, 1999. |
|
Abdomen
The area below the rib cage and above the legs, which contains the
stomach, liver, spleen and bowels.
Acute Hepatitis
Inflammation in the liver of less than six month's duration. Common
causes include viral hepatitis, drug reactions, autoimmune hepatitis
and Wilson's disease, a disorder of copper metabolism that leads
to accumulation of copper in the liver, resulting in liver fibrosis.
Albumin
A protein or molecule made in the liver that circulates in the blood.
Albumin functions to bind other molecules and drugs in the circulation,
and also serves a significant function in holding fluid inside
blood vessels. If serum albumin levels fall, fluid may seep out
of blood vessels into the abdomen. This may lead to ascites (fluid
accumulation in the abdomen) or ankle edema (fluid accumulation
in the ankles). The serum albumin level is used as a long-term
measure of liver synthetic function.
Aldactone
A diuretic that promotes urination and retention of potassium. This
drug is often prescribed in combination with another type of diuretic,
furosemide, in the treatment of ascites. Side effects include increased
serum potassium levels and breast tenderness.
Alpha-1 Antitrypsin Deficiency
A genetic disease that affects multiple organs including the liver
in 20% of cases. The disease is characterized by the production
of defective alpha-1 antitrypsin molecules in the liver, which
are improperly exported from liver cells. The accumulation of misfolded
alpha-1 antitrypsin molecules in the liver can lead to liver damage
and ultimately cirrhosis. The main hallmark of this disease is
lung problems, as alpha-1 antitrypsin normally functions to protect
the lungs from damage.
ALT—(a.k.a. SGPT)
A liver enzyme that is measured in the blood. Elevations in this
blood value are consistent with hepatitis or inflammation of the
liver. Often followed as a marker for response to treatment during
a course of therapy for hepatitis C.
Antibody
A protein made by the immune system that recognizes and binds to
a foreign invader or antigen to try to destroy it. Antibodies can
be made to fight specific foreign antigens, and their identification
in the blood may serve as a marker of prior or ongoing infection.
Many diagnostic tests for hepatitis C infection look for antibodies
to the hepatitis C virus.
Ascites
The accumulation of fluid within the abdomen. The presence of ascites
is one of the hallmark features of hepatic decompensation. Ascites
is often treated with diuretics or paracentesis.
AST—(a.k.a. SGOT)
A liver enzyme that is measured in the blood. Elevations in this
blood value are consistent with hepatitis or inflammation of the
liver. Often followed as a marker for response to treatment during
a course of therapy for hepatitis C.
Autoimmune Hepatitis
A form of liver disease in which the body's own immune system attacks
the liver, which leads to liver damage. This disease is diagnosed
through liver biopsies and inferred from serum tests of ANA (antinuclear
antibody), ASM or antismooth muscle antibody) or LKM (anti-LKM,
liver-kidney antibody). This disease often responds to steroid
treatment.
|
|
 BACK
TO TOP
|
|
Biliary
Atresia
Biliary Atresia begins in early infancy and causes damage
to the liver due to the destruction of ducts which carry bile from
the liver to the small intestine. Early damage mainly affects the
major bile duct outside the liver which is why this disease is also
called Extrahepatic Biliary Atresia; later damage mainly affects
bile ducts in the liver.
Billirubin
A breakdown product of hemoglobin, which functions to carry oxygen
in blood cells. This is a waste product that is normally eliminated
from the body through the liver. As billirubin levels build up
in the body, they give the skin and eyes a characteristic yellow
color, called jaundice. Long-term marked elevations of billirubin
can lead to damage to nerve cells, but this is generally not
a problem in patients with liver disease from hepatitis C.
|
|
|
Chronic Hepatitis
Generally defined as inflammation in the liver of greater than six
months' duration. Causes include drugs, viruses, autoimmune liver
disease, hemochromatosis (iron overload) and Wilson's disease (copper
overload). Hepatitis C is the most common cause of chronic hepatitis.
Cirrhosis
The endpoint of many different kinds of liver disease. It involves
extensive fibrosis or scarring over throughout the liver. Cirrhosis
is generally felt to be irreversible. Cirrhosis can be broken
down into two phases: stable cirrhosis, during which the liver
continues to perform its normal functions, and unstable or decompensated
cirrhosis, during which the liver is not able to keep up with
all of its chores.
Consensus Interferon, INFERGEN
A brand of interferon manufactured by AMGEN pharmaceutical company. |
 |
|
Decompensated Cirrhosis
Also referred to as "unstable cirrhosis." Decompensated cirrhosis
consists of scarring over of the liver associated with symptoms of
ascites, encephalopathy (confusion due to toxins normally cleared by
the liver) or variceal bleeding (severe gastro-intestinal bleeding).
Liver transplantation should be considered at this time.
Diuretics
Drugs that promote urination and allow the body to get rid of excess
fluid and some salts. Often used to control ascites and accumulation
of fluid in the lower extremitieis or edema. |
|
|
Edema
Accumulation of fluid in the soft tissues outside of blood vessels,
particularly in the legs around the ankles. Severe edema can extend
from the ankles and into the abdomen.
Encephalopathy
Hepatic encephalopathy is mental confusion caused by the buildup
of toxic waste products in the body that the liver normally clears.
End-Stage Liver Disease (ESLD)
The point of no return has been reached in cirrhosis, and decompensated
or unstable cirrhosis has set in. At this time liver transplantation
may be considered. Symptoms include muscle wasting, fatigue,
ascites, encephalopathy or variceal bleeding.
Extracorporeal Biliary Lithotripsy
In this procedure, doctors find the gallstones using an ultrasound
machine and position the patient so the high-energy shock waves
focus on the stones. The waves break the gallstones into fragments,
which either pass into the intestine or are dissolved with the
help of medication. This treatment is performed in an outpatient
setting, however, very few centers are available for this technique. |
|
|
Furosemide
A diuretic that promotes urination and loss of sodium from the body,
which can be beneficial for people with liver diseases, as they frequently
have too much sodium in their bodies. |
|
|
Gallstones
Gallstones form in the gallbladder when cholesterol or pigments crystallize
out of bile. They can vary in size from as small as grains of sand
to as large as golf balls. Sometimes gallstones get stuck in the
bile ducts causing attacks of severe abdominal pain. The tendency
to form gallstones is partially inherited and is more common in people
who are obese, overeat or lose weight rapidly through extreme diets.
Gilbert's Syndrome
Gilbert's Syndrome is a fairly common, mild disorder. |
|
|
Hemochromatosis
A disease of iron metabolism in which too much iron is absorbed through
the gut and deposited in the liver, leading to cirrhosis. Other organs
damaged by excess iron include the heart and kidneys. Genetic tests
are available for the common mutations causing this disease. It is
treated by phlebotomy or bleeding treatments.
Hepatitis C (HCV)
A liver disease caused by the hepatitis C virus. The virus is transmitted
through contaminated blood from other people who have the disease.
The infection can be characterized by a prolonged symptom-free
period of chronic infection. Progresses to chronic hepatitis
in the majority of infections, and may ultimately lead to cirrhosis,
liver failure and liver cancer. In technical terms, the virus
is a positive stranded RNA virus of the Flavivirdae family. More
directly, a microscopic infectious particle consisting of RNA
carries the instructions for making more viruses and several
proteins, some of which cover the viral RNA molecule like an
envelope conceals a letter.
Hepatitis C Antibody
Includes many different antibodies to a broad range of hepatitis
C proteins. The initial test for antibodies usually is a straightforward
EIA assay, sometimes referred to as ELISA, in which plates are
coated with hepatitis C proteins and blood that reacts with the
hepatitis C proteins is developed to change color.
Hepatitis C RNA
A serum test performed to detect RNA derived from hepatitis C circulating
in the bloodstream. Two tests are commonly used - a qualitative
test, which detects the presence or absence of hepatitis C RNA,
and a generally less sensitive but more quantitative test which
assigns a specific numerical value to the quantity of hepatitis
C RNA circulating in the blood. Hepatitis C RNA levels are more
frequently used to confirm active infection with the virus.
Hepatologist
A physician who specializes in the treatment of individuals with
liver disease. At least one time, everyone with hepatitis C should
be under this specialist's care.
HIV
Human immunodeficiency virus, the virus that causes AIDS. Many
patients with HIV also are infected with hepatitis C. |
|
|
Interferon
A naturally occurring class of proteins used to simulate the immune
system to fight hepatitis and certain forms of cancer. When used
to fight hepatitis C, individual responses to treatment may be divided
into three broad categories: (1) sustained responders who rid the
virus from their blood and have their serum liver enzymes return
to normal even six months after therapy is stopped; (2)
nonresponders,
who do not show a disappearance of viral RNA levels from the blood
and do not have their serum liver enzymes return to normal; and (3)
partial responders, who drop their viral levels and liver enzymes
on treatment but fail to maintain these successes once treatment
is discontinued.
INTRON A
A brand of interferon manufactured by the Schering-Plough Corporation. |
|
|
Jaundice
The distinctive yellow color seen in the skin and eyes as bilirubin
levels build up in the body. This usually is caused by liver dysfunction
or blockage of the bile ducts leading from the liver to the small
bowel. It may also be a sign of hemolysis or excessive breakdown
of blood cells. |
|
|
Lactulose
A non-absorbable fluid that promotes loose bowel movements, helping
to eliminate toxins from the body that are normally cleared by the
liver. It is a liquid medicine to treat encephalopathy or confusion
that results from the build of toxins in the body.
Laparoscopic Cholecystectomy
Surgeons remove the gall bladder through small abdominal incisions
using a lighted tube (called a laparoscope). The surgeon views
the entire procedure on a television monitor. The procedure is
done under general anesthesia, but because there is no cutting
through the muscle of the abdominal wall, the recuperation period
is shorter.
Liver Biopsy
A sample of liver tissue taken with a needle through the skin,
through a catheter which passes through the blood vessels from
the neck down into the liver, or at the time of open or laparoscopic
surgery. The biopsy is considered the "gold standard" in
terms of defining the extent of liver damage and is often used
to determine the cause of the liver disease.
Liver Function Tests (LFTs)
A marker of the severity of liver disease. These generally consist
of the albumin (a long-term measure of liver synthetic function),
the transaminases or liver enzymes and the total bilirubin level. |
|
|
Multidose Pen
A prefilled pen for more convenient dosing of interferon. The desired
dose of interferon is selected and then injected under the skin using
a needle at the tip of the pin. Must be refrigerated between doses. |
|
|
Open Cholecystectomy
Open Cholecystectomy is the classical surgical treatment for gallstones.
Under general anesthesia, the patient's gall bladder is removed through
an abdominal incision. The patient is required to remain in the hospital
for five to seven days for recovery. |
|
|
Paracentesis
Draining off of excess fluid or ascites by inserting a needle into
the abdomen. Sometimes the fluid is sent to the laboratory to look
for infection or cancer or help determine the reason for the ascites.
The procedure is done using a local anesthesia.
PCR
Polymerase chain reaction. This test is probably the most single
useful test to assess the presence or absence of the hepatitis
C virus itself in the blood and other body tissue. It can detect
minute traces of the HCV in any given medium and works by taking
a sample of blood and amplifying the nucleic acid associated
with the virus many millions of times. This is the chain reaction,
a copying process. It brings the nucleic acid up to detectable
levels. The amplification effect is consistent, permitting an
assessment of how much of the original virus is present in the
sample (viral load). This test can detect the virus after only
three days of infection. Being PCR negative does not necessarily
mean that HCV has disappeared completely. It could be at undetectable
levels in the blood, but may still be present in liver cells
and in certain white blood cells. These can also be tested, but
such extensive screening is rarely carried out.
Pegylated Interferon
In Pegylated Interferon, interferon is attached to molecules of
polyethylene glycol; hence, the name pegylated, or PEG, for short.
Studies show that pegylated interferon is longer acting than
conventional formulations of interferon. Because so, dosing is
only once a week, compared with three times a week with other
formulations. Due to the higher sustained level of interferon
in the blood, pegylated interferon is thought to generate a greater
anti-hepatitis-C response. When used with ribavirin, studies
have shown that pegylated interferon produces a sustained virological
response in 56% to 61% of patients, overall. Schering-Plough's
brand, Peg-Intron, was approved by the FDA in January 2001.Roche's
brand, Pegasys, is awaiting approval.
Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a liver disease that affects
mostly women, but can also occur in men. It appears to arise
as a result of the body's immune system attacking the small bile
ducts in the liver. The symptoms of PBC are varied and include
fatigue, itching of the skin, bleeding and fluid retention. While
there is no cure for PBC, much can be done to treat patients'
symptoms.
Protein
A molecule composed of amino acids which generally functions as
an enzyme to catalyze a chemical reaction, structural protein
or molecular messenger. Hepatitis C contains a number of proteins
as well as enzymes that catalyze replication of the virus.
Prothrombin Time (PT)
An excellent marker of short-term liver function. Prothrombin time
is a measure of blood clotting; the prothrombin time increases
as the liver fails.
Pruritus
Itching of the skin due to liver disease. |
|
|
Qualitative RNA Assay
A test for the presence of hepatitis C RNA in the blood. Results are
reported as "positive" or "negative." Usually
more sensitive than quantitative hepatitis C RNA assays.
Quantitative RNA Assay
A test to determine the quantity of hepatitis C RNA present in the
blood. Used to assess response to therapy by measuring a decrease
in the amount of RNA present in the bloodstream. Current assays
can miss low levels of hepatitis C RNA in the blood. |
|
|
Rebetron
A formulation of interferon and ribavirin, an antiviral compound, marketed
by Schering-Plough pharmaceutical company.
RIBA
Recombinant immunoblot assay. This is a more specific method of
detecting antibodies to hepatitis C proteins than the EIA or
ELISA test.
Ribavirin
An antiviral compound shown to have activity against hepatitis
C in combination with interferon. Because this drug can cause
damage to an unborn baby, men and women of childbearing age should
both use contraceptives while using this drug and for six months
after completing treatment.
RNA
Ribonucleic acid. Hepatitis C is an RNA virus, meaning it carries
its genetic information or the instructions to make hepatitis
C viral proteins in the form of RNA. Hepatitis C RNA circulates
in the blood of chronically infected patients. It can be tested
for in the serum using PCR assays.
Roferon
A formulation of interferon marketed by the Roche Pharmaceuticals
Corporation. |
|
|
SBP
Spontaneous bacterial peritonitis. SBP consists of the growth of bacteria
in ascitic fluid in the abdomen. Affected people may have increased
tiredness or acute abdominal pain and fever. SBO is diagnosed by
the examination of ascitic fluid for increased white blood cells
or infectious organisms, and is generally treated with antibiotics.
Sclerotherapy
A procedure used to control bleeding from esophageal varices (engorged
blood vessels in the food pipe).
Surgical Shunt
A surgical technique employed to relieve the increased pressure
in the vessels draining around the liver, which can lead to variceal
bleeding. |
|
|
TIPS
Transcutaneous interhepatic portal-systemic shunt. A method of relieving
the increased pressure in the major blood vessels feeding into a
cirrhotic liver.
Transaminases or Serum Liver Enzymes
Refers to the liver enzymes commonly referred to AST (SGOT) and
ALT (SGPT). The levels of each enzyme are normally detectable
in the blood, whether in good health or not. During liver damage
or inflammation, these enzymes leak into the bloodstream to higher
levels than normal. |
|
|
Varices
Engorged blood vessels the lining the esophagus (food pipe) and stomach
due to the presence of cirrhosis. Emesis, or vomiting of large quantities
of bright red blood is a medical emergency condition requiring immediate
medical attention.
Viral Hepatitis
Viral hepatitis is an inflammation of the liver caused by one of
several viruses: hepatitis A, B, C (formerly non-A, non-B), D
and E.
Most people who become infected with a hepatitis virus remain
well and symptom-free, which means that this infectious disease
may go unrecognized. Some people develop minor symptoms such as
fatigue, weakness and nausea, while about 25% develop fever, loss
of appetite, darkening of the urine, clay-colored stools, abdominal
pain and jaundice (a yellow discoloration of the skin and eyes).
In most cases, the body's own defense mechanism will eliminate
the virus but some people will develop chronic hepatitis which
may lead to cirrhosis and liver cancer.
Virus
A microscopic particle of protein and nucleic acid that enters
a cell and produces copies of itself using the cell's metabolic
properties. Hepatitis C is a good example of a virus. |
|
|
Wilson's Disease
A genetic defect leading to excessive accumulation of copper in the
body which can lead to cirrhosis of the liver. Wilson's disease is
diagnosed by liver biopsy and is associated with characteristic jerky
muscular movements. Copper-colored rings around the eyes is typical
of this condition. |
|
|
|
|
