Steatosis (fatty liver)
The most common causes of accumulation of fat in the liver are alcoholism and non-alcoholic fatty liver disease (NAFLD) associated with obesity and diabetes. Drugs may cause fatty liver with or without associated hepatitis. Patients with drug-induced fatty liver may have only a few symptoms, or none. They typically have mild to moderate elevations in blood levels of ALT and AST, and also may develop enlarged livers. In severe cases, drug-induced fatty liver can lead to cirrhosis and liver failure.
Drugs reported to cause fatty liver include total parenteral nutrition, methotrexate (Rheumatrex), griseofulvin (Grifulvin V), tamoxifen (Nolvadex), steroids, valproate (Depakote), and amiodarone (Cordarone).
In certain situations, fatty liver alone can be life threatening. For example, Reye's syndrome is a rare liver disease that can cause fatty liver, liver failure, and coma. It is believed to occur in children and teenagers with influenza when they are given aspirin. Another example of serious fatty liver is caused by high doses of intravenous tetracycline or amiodarone. Certain herbs (for example, the Chinese herb Jin Bu Huan, used as a sedative and pain reliever) also can cause serious fatty liver.
Cirrhosis
Chronic liver diseases such as hepatitis, fatty liver, or cholestasis can lead to the necrosis (death) of liver cells. Scar tissue forms as part of the healing process that is associated with the dying liver cells, and severe scarring of the liver can lead to cirrhosis.
The most common example of drug-induced cirrhosis is alcoholic cirrhosis . Examples of drugs that can cause chronic liver diseases and cirrhosis include methotrexate (Rheumatrex), amiodarone (Cordarone), and methyldopa (Aldomet). Please read the article on Cirrhosis for more information.
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