Hepatic causes of weight loss

Question 1

What hepatic diseases can cause weight loss?

Answer 1

• Theiler’s disease or serum associated hepatitis
• Ragwort poisoning (pyrrolizidine alkaloid toxicosis)
• Cholangiohepatitis
• Cholelitiasis

Question 2

How does hepatic disease cause weight loss?

Answer 2

• CS result from hepatic failure
  ◦ More than 75% of liver must be damaged
• Weight loss
  ◦ Anorexia
  ◦ Abnormal metabolism
• & colic, diarrhea, ascites
  ◦ Hepatic swelling
  ◦ Portal hypertension
  ◦ Altered microflora
  ◦ Abnormal bile acids
• Altered behaviour (hepatic encephalopathy)
  ◦ GI-derived neurotoxins (NH3)
  ◦ ↑ GABAergic tone
  ◦ Altered benzodiazepine receptors
  ◦ ↑ Neurosteroid synthesis
  ◦ ↑ Manganese (neuronal loss)
  ◦ False neuro-transmitters
  ◦ ↑ Citokines
  ◦ ↑ BBB permeability & altered energy metabolism

Question 3

How does cholangiohepatitis occur?

Answer 3

• Ascending bacterial infection:
  ◦ Salmonellas spp., Klebsiella spp., E. coli., others
• Sepsis:
  ◦ Systemic spread into the liver