Toxic hepatitis is an inflammation of the liver in reaction to toxic substance exposure. Some chemicals or drugs are difficult for the liver to process causing damage and resulting in inflammation. Excessive or chronic exposure to these toxins causes toxic hepatitis. The exposure can be accidental due to occupational circumstances or deliberate such as in cases of attempted suicide. In some cases, toxic hepatitis develops within hours or days of exposure. Other times, it may take months of regular use before signs or symptoms occur. Because many chemicals, medical drugs, and alcohol can cause serious liver injury, preventing toxic hepatitis begins with safe work practices, safe prescription and over-the-counter medication practices, and safe alcohol practices.
Toxic hepatitis can occur slowly as a gradual progressive result of recurrent exposure to toxins or as a single rapid event. The disease can be caused by alcohol, over-the-counter pain relievers, prescription medications, herbs and supplements, and industrial chemicals. Toxic hepatitis may develop after taking too much prescription or over-the-counter medication.
Patients who consume excessive alcohol or those with liver disease are at a greater risk of developing toxic hepatitis when exposed to one or multiple causes of the disease.
Mild cases of toxic hepatitis may not cause any symptoms. However, some patients do develop symptoms that include abdominal pain, vomiting and nausea, poor appetite, itching skin or rash, headache, and fatigue. Diarrhea and changes in stool color may also occur.
The symptoms of toxic hepatitis often end when exposure to the toxin ends. Unfortunately, toxic hepatitis can permanently damage the liver, leading to liver cirrhosis (scarring) and liver failure.
There is no specific test to diagnose toxic hepatitis; a variety of tests may be used for diagnosis including comprehensive medical and drug history, physical exam, liver enzyme and blood testing, ultrasound imaging, and liver biopsy. A liver biopsy can help confirm a diagnosis of toxic hepatitis and measure liver damage, if applicable.
In treating toxic hepatitis, the overall priority is to eliminate exposure to the toxin as soon as possible. Depending on the cause, it is sometimes possible to administer medication to counteract the effects of the toxin in the body. Patients are advised to rest and may need supportive care in the hospital. Symptoms usually go away within a few days or weeks. In severe cases, or if the condition was untreated for a prolonged time, toxic hepatitis can lead to irreversible liver failure, a fatal condition requiring a liver transplant.