Cirrhosis of the liver is a highly complex disease, which can be associated with numerous sequelae, symptoms and difficulties. Ultimately all chronic diseases of the liver tissue lead to a remodeling of the liver cells and cirrhosis without treatment or elimination of the causes.
Cirrhosis of the liver curbs all liver functions over time, making it a life-threatening and untreated, fatal condition. In addition to clear clinical signs and symptoms, blood levels can provide important evidence for the presence and severity of cirrhosis and its complications.
Cirrhosis is a chronic and incurable disease that progresses over time and results in an increasing restriction of liver function. The liver takes over vital filter functions as well as the production of essential substances of the body.
A first indicator of an incipient damage of the liver tissue represent the colloquially referred to as "liver values" transaminases. These are enzymes of the liver, which in cell damage in the blood and can be measured there. Furthermore, liver damage can also be used to measure enzymes of the bile ducts in the blood, which also indicate nonspecific liver disease.
First, the liver can compensate for the limited function well, so no further symptoms and blood levels are noticed. Not until cirrhosis of most of the liver is there noticeable changes due to reduced filter performance and limited production of the molecules produced in the liver.
The most important and life-changing changes occur in the detoxification of substances such as ammonia, the coagulation function of the blood, protein production and the production of blood cells and platelets. These malfunctions can be diagnosed on the basis of the blood values and checked in the course.
Blood clotting is a vital and complex system of numerous cells, messengers, so-called "coagulation factors" and the platelets. Liver function is very important for the maintenance of this functioning system.
If blood clotting is restricted due to liver cirrhosis, severe unquenchable bleeding may occur. Through the additional formation of severe vascular changes in the course of liver cirrhosis, life-threatening bleeding can be an important complication. Above all, liver function has a significant influence on the production of coagulation factors. But it can also lead to an accompanying malfunction of the spleen to disorders of platelets and thus weaken the blood coagulation in two ways.
Typical blood levels that measure the extent of the coagulation disorder are the so-called "Quick value" and the "INR value". The number of platelets, the platelets, can also be recorded as a laboratory value. In emergency therapy for severe bleeding and advanced liver damage, the deficiencies can be treated symptomatically by transfusion of platelets and blood plasma.
The symptoms of liver cirrhosis? Find out more about this topic here.
The so-called liver values represent an early diagnostic tool for liver damage of all kinds. The liver values are various substances and enzymes that are normally located within the liver cells or cells of the biliary tract and only released by damage to the tissue and increased in the blood are found.
However, an increase in these liver values does not mean that liver cirrhosis is present. Even harmless liver damage can cause abnormal liver function. Typical are repeated alcohol consumption, liver inflammation and fatty liver as the cause of high liver enzymes. However, these are principally curable diseases.
At the same time the liver values speak for an acutely occurring damage of the liver cells. Thus, the liver values may be in the normal range even with existing cirrhosis, if the disease is currently not progressing and the disease activity is low.
Bilirubin is a breakdown product of hemoglobin, which is located in the red blood cells and is responsible for the oxygen transport of the blood. Bilirubin is involved in numerous metabolic processes and an increase in bilirubin can have a variety of causes.
Normally, the bilirubin produced by the breakdown of blood cells enters the liver, where it undergoes various metabolic processes and is subsequently excreted into the intestine with the bile. If there is an extremely high level of red blood cell degeneration, liver damage, or liver / gut gall blight, blood bilirubin levels may increase. In liver damage, large amounts of bilirubin can enter the blood and cause the typical jaundice on the eyes or skin. However, this is by no means a specific blood value, as many other causes may be behind the bilirubin elevation.
Albumin is an important protein in the human body that, together with other proteins in the blood, performs many functions. One of his most important tasks is the maintenance of the so-called "colloid osmotic pressure" in the blood. It causes a solubility of certain poorly soluble substances and ensures in the blood through various processes that liquid remains within the vessels and does not pass into surrounding tissues through the vessel walls.
The albumin is produced predominantly in the liver with numerous other important proteins, which is why it leads to significant albumin deficiencies in an advanced liver injury. As a result, water deposits occur at unusual places in the body that can reach serious levels. Typical is the formation of ascites as a result of albumin deficiency. Within the abdominal cavity can accumulate several liters of water and cause complications.
The platelets, also known in the jargon as "platelets", are an important form of cells in the blood. Their most important function is taken by the platelets in the blood clotting. They are responsible for the first phase of haemostasis by attaching the cells to the first occlusion of the wound. Lack of platelets can consequently lead to severe and unquenchable bleeding.
However, a deficiency is often noticeable first by small punctate hemorrhages under the skin, so-called "petechiae". Even though the platelets are produced in the bone marrow they are dependent on liver function.
Increased spleen function in the cirrhosis of the liver causes the platelets to be increasingly degraded, which lowers their value in the blood. Again, this is a typical, but very unspecific, symptom of cirrhosis of the liver, as depressed platelets can be attributed to numerous causes.
The white blood cells comprise a number of blood cells that play a key role in the functioning of the immune system. The most important representatives are the granulocytes and the lymphocytes. Using a so-called "differential blood picture" can be further distinguished, which of the white blood cells are relatively increased or decreased, which allows further conclusions on the cause.
In the context of cirrhosis of the liver, the deficiency of white blood cells is also caused by over-functioning of the spleen. The hyperfunction arises as a direct result of the liver damage and causes a breakdown of various cells of the blood. The progressive immunodeficiency leads in the long term to a significantly increased susceptibility to bacterial, viral and all other infectious agents. This results in an enormous risk for cirrhotic patients to contract a life-threatening infection.
Nitrogen in the form of ammonia is a by-product of many of the body's metabolic processes. This is a poisonous substance that the body can normally easily break down in the liver via the so-called "urea cycle, " a chain of chemical reactions. In advanced cirrhosis, these detoxification and filtration functions of the liver fail In addition to ammonia, it can lead to an accumulation of numerous other toxins in the body. In the blood, the increased ammonia levels are also noted.
A serious complication of liver cirrhosis is a large increase in ammonia with damage to brain structures. These damages can manifest as lack of concentration, tremors, disturbances of consciousness and finally in a coma.
Cirrhosis describes a chronic remodeling process of liver tissue with a slowly progressive loss of liver function. In the early stages of liver cirrhosis, numerous portions of the liver are often still functional and can easily compensate for the cirrhotic areas. The healthy parts of the liver can also grow as a result of chronic damage, so that good liver functions are maintained for a long time.
Only at the loss of a large part of the liver function symptoms and symptoms appear, one speaks of a "decompensation". By this time, blood levels may also remain unremarkable.