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Disorders and Drugs That Can Cause Hepatic Fibrosis

Categories of Disorders Specific Examples

Autoimmune hepatitis
Certain storage diseases and inborn errors of
metabolism

Alpha-1 antitrypsin deficiency

Copper storage diseases (eg, Wilson disease)

Fructosemia

Galactosemia

Glycogen storage diseases (especially types III, IV,

VI, IX, and X)

Iron-overload syndromes (hemochromatosis)

Disorders with direct hepatic
effects Lipid abnormalities (eg, Gaucher disease)

Peroxisomal disorders (eg, Zellweger syndrome)

Tyrosinemia
Congenital hepatic fibrosis
Infections

Bacterial (eg, brucellosis)

Parasitic (eg, echinococcosis)

Viral (eg, chronic hepatitis B or C*)

Nonalcoholic steatohepatitis (NASH)*
Primary biliary cholangitis (PBC)
Primary sclerosing cholangitis (PSC)

Budd-Chiari syndrome
Disorders affecting hepatic blood Heart failure
flow Hepatic sinusoidal obstruction syndrome†
Portal vein thrombosis

* Most common causes.

† Sometimes caused by pyrrolizidine alkaloids, present in herbal products such as

bush teas.
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Categories of Disorders Specific Examples

Alcohol*
Amiodarone
Chlorpromazine
Drugs and chemicals with hepatic Isoniazid
effects Methotrexate
Methyldopa
Oxyphenisatin
Tolbutamide

Disorders that cause mechanical Scarring due to prior liver surgery

obstruction Bile duct strictures due to impacted gallstones

* Most common causes.

† Sometimes caused by pyrrolizidine alkaloids, present in herbal products such as

bush teas.

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MSD MANUAL
Professional Version

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