Enlarged Liver (Hepatomegaly) Samples
Fresh frozen tissue and matched biofluid samples were, collected from unique patients diagnosed with enlarged liver.
Bio-samples are provided to a valued pharmaceutical customer for research, diagnostics, discovery, and drug development.
Enlarged Liver (Hepatomegaly) Overview
Hepatomegaly is having an enlarged liver. The liver is the largest internal organ in the human body. It helps your body do the following:
- Breaks down medications and toxins
- Control blood clotting
- Digest fats
- Fight infections
- Produce proteins and hormones
- Store sugar in the form of glycogen
The liver is also the only internal organ that can grow back after surgery, which makes live liver donation possible. If you donate a portion of your liver, it will regenerate to its original size. The transplanted portion will also grow.
If you have an enlarged liver, it could mean that you have the following conditions:
- A liver disease
- Cancer, such as leukemia
- A genetic disease
- Heart and blood vessel abnormalities
- An infection
- Toxin poisoning
Many of the symptoms that cause hepatomegaly can impair your liver’s ability to function and help your body.
Signs and Symptoms of Enlarged Liver (Hepatomegaly)
Hepatomegaly is the medical term for an enlarged liver. It is a symptom of an underlying disease, not a disease in itself.
When the liver is significantly enlarged, a patient may feel as though they are full on the right side of their body, or they may report some discomfort in that area.
Patients may also experience some accompanying symptoms of an underlying liver problem. These may include the following:
- A change in bowel habits
- Dark colored urine
- Fatigue
- Fever
- Itching
- Unexplained Weight Loss
- Nausea
Causes of Enlarged Liver (Hepatomegaly)
There are many potential causes of enlarged liver (hepatomegaly). Following are some of the most common causes of enlarged liver (hepatomegaly):
- Hepatitis: : Hepatitis is the medical term for inflammation of the liver. It typically occurs as a result of a viral infection or alcohol-induced liver damage. This condition can be short-term (acute) or long-term (chronic).
- Alcoholic liver disease (ALD): Excessive alcohol consumption can lead to a buildup of fat cells in the liver or fatty liver disease. Doctors refer to this as steatosis. Steatosis can interfere with the liver’s ability to carry out its vital functions. In severe cases, ALD may lead to severe liver scarring, or cirrhosis.
- Non-alcoholic fatty liver disease (NAFLD): This condition is also characterized by steatosis and associated liver dysfunction. Unlike ALD, it is not the result of excessive alcohol consumption. It is usually due to conditions such as diabetes or diets that are high in fats and cholesterol.
- Liver Cancer: Cancers that originate in the liver are known as primary liver cancers, while those that spread to the liver from other parts of the body are called secondary liver cancers. Each year, around 30,000 people in the United States receive a diagnosis of primary liver cancer.
- Heart Failure: The portal vein is the vein that provides blood to the liver. Heart failure can cause circulatory problems that increase pressure on the portal vein. Over time, this can lead to liver enlargement. Some doctors refer to heart-related liver problems as cardiac liver.
Other Causes of enlarged liver (hepatomegaly) from inflammation or fatty liver disease include the following:
- An infection (such as hepatitis B or hepatitis C)
- Autoimmune disease (when your body’s immune system attacks its own healthy tissue)
- Genetic disorders that cause fat, protein, or other substances to build up
- Metabolic syndrome (a group of risk factors for heart disease that includes high blood pressure, blood sugar and high cholesterol levels; and belly fat)
- Obesity
- Some medications or alcohol
- Toxins
Unusual growths, which may be due to the following reasons:
- Cysts
- Tumor that start in or spread to the liver
A problem with blood flow, which may be caused due to the following conditions:
- Congestive heart failure a condition in which your heart doesn’t pump blood the way it should
- Hepatic vein thrombosis, a blockage of veins in the liver
- Veno-occlusive disease, a blockage in the small veins in the liver
Liver Steatosis
The liver does not usually store fat. However, the following factors can cause it to do so:
- Alcohol abuse
- Obesity
- Hepatitis-C
- Increased levels of fat in the blood, or hyperlipidemia
- Insulin resistance
- Type-2 diabetes
Grades of Steatosis
Following are different grades of steatosis:
- Grade 0 (healthy): Fat cells comprise 0–5% of the liver’s overall weight.
- Grade 1 (mild): Fat cells comprise 5–33% of the liver’s overall weight.
- Grade 2 (moderate): Fat cells comprise 34–66% of the liver’s overall weight.
- Grade 3 (severe): Fat cells comprise more than 66% of the liver’s overall weight.
Congestive heart failure can also cause blood to back up into the hepatic veins. These are the veins that help drain blood from the liver. When they back up, the liver will become congested and grow larger. This is known as congestive hepatomegaly.
Less common causes of enlarged liver (hepatomegaly) include the following:
- Lymphomas or blood cancer in the lymphatic system
- Leukemia or a type of blood cancer of the bone marrow
- Multiple Myeloma (MM) or a type of blood cancer of the bone marrow specific to plasma cells
- Hemochromatosis, or iron buildup in the liver
- Wilson’s disease, or copper buildup in the liver
- Gaucher’s disease , or a disorder that causes fatty substances to build up in the liver
- Toxic hepatitis, or liver inflammation due to chemical poisoning
- Bile duct or gallbladder obstruction, or backup of bile and inflammation within the liver, often from gallstones
- Hepatic cysts, or fluid-filled sacs within the liver from a variety of causes
Some infections and certain medical conditions can cause growths to form within the liver. Growths in the liver can be benign (not cancer) or malignant (cancer). Typically, any growth will cause the liver to increase in size.
Diagnosis of Enlarged Liver (Hepatomegaly)
A doctor will perform a physical exam to assess if your liver is larger than it should be.
The liver is a triangular organ, which is located below the diaphragm, under the lower edge of your right ribcage. Enlarged liver can be felt by the doctor during a physical exam. A typical liver cannot be felt with your fingers.
The size and weight of your liver increases naturally with age. For children, the liver is typically measured by its span, through its thickest part from top to bottom. Adult livers are measured by length.
A Journal of Ultrasound in Medicine study used ultrasound to estimate the average diameter of an adult liver. The data below was gathered from 2,080 people ranging in age from 18 to 88. In this study, only 11.5 percent had a liver larger than 16 centimeters (cm).
The average liver size varies by age and can be:
- 6.4 cm for 1 to 3 months
- 7.6 cm for 4 to 9 months
- 8.5 cm for 1 to 5 years
- 10.5 cm for 5 to 11 years
- 11.5 to 12.1 cm for 12 to 16 years
- 13.5 cm +/- 1.7 cm for adult women
- 14.5 cm +/- 1.6 cm for adult men
Body shape, weight, and sex can also affect the size of the liver. The doctor will take these into account when examining the liver for possible signs of enlarged liver or hepatomegaly.
To diagnose enlarged liver (hepatomegaly) a doctor may order the following tests:
- A complete blood count to check for an abnormal number of blood cells
- Abdominal X-ray, a noninvasive X-ray study to evaluate abdominal organs
- CT scan for high-resolution images of the abdomen
- liver enzymes to evaluate liver function
- MRI for high-resolution images of specific abdominal organs
- Ultrasound, the use of sound waves to evaluate the liver and other abdominal organs
Your doctor may do an ERCP, a procedure that checks for problems in the ducts (tubes) that carry bile. An MRCP, a special type of MRI, also helps identify such a problem.
If your doctor suspects a more serious condition, they may recommend a liver biopsy. A liver biopsy is a surgical test where the doctor takes a small sample of your liver for microscopic examination.
Complications of Enlarged Liver (Hepatomegaly)
Because enlarged liver can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important to follow the treatment plan to reduce the risk of potential complications including the following:
- Cirrhosis (scarring of the liver that causes severe dysfunction)
- Hepatocellular carcinoma (liver cancer)
- Hepatic encephalopathy (brain disorder caused by liver disease)
- Liver failure
- Portal Hypertension (increased blood pressure in the veins around the liver, stomach and esophagus)
- Spread of cancer
Treatment of Enlarged Liver (Hepatomegaly)
Following are some of the treatments of enlarged liver (hepatomegaly) that your may recommend:
- A liver transplant for a damaged liver
- Chemotherapy, surgery, radiation therapy for liver cancer
- Stopping alcohol consumption and other drugs
- Treatment for lymphoma or leukemia
- Medications for liver failure or infections like hepatitis C
- Treatment for metastatic cancer
If a person has a lot of fat in the liver or drink too much alcohol, following lifestyle changes may help:
- Losing weight
- Cut back on how much you drink
- Eating a healthy diet
- Physical activity and regular exercise
Hepatitis
- Hepatitis-A: There is no specific treatment for hepatitis A. Most patients fully recover within several weeks or months.
- Hepatitis-B: There is no specific treatment for acute hepatitis B. Treatment for chronic hepatitis B involves antiviral medications to reduce liver damage and increase long-term survival.
- Hepatitis-C: Chronic hepatitis C infections require treatment with drugs called direct-acting antivirals. Treatment typically takes 12–24 weeks, depending on the extent of the liver damage.
- Hepatitis-D: People with hepatitis D require treatment with PEGylated interferon-alpha (PEG-IFN). This drug helps slow the progression of the disease. Those with end stage liver disease may require a liver transplant.
Alcoholic Liver Disease (ALD)
The treatment for ALD will involve treating the alcohol use disorder itself. This may include one or more of the following:
- Behavioral therapies, such as cognitive behavioral therapy or motivational enhancement therapy.
- Family therapy
- Group therapy
- Treating any comorbid mental-health conditions
- Undergoing a supervised medical detox
NAFLD
- Controlling blood sugar levels.
- Dietary changes, including reducing the intake of cholesterol and fats.
- Managing underlying health conditions, such as increased insulin levels and type 2 diabetes.
Cancer
- Chemotherapy
- Immunotherapy
- Liver transplant
- Surgery to remove the tumor
Heart Failure
There is currently no cure for heart failure, although there are treatments available that can help manage the disease and prevent further complications. Some examples include the following:
- Making lifestyle changes, such as:
- Avoiding alcohol
- Quitting smoking
- Avoiding or limiting caffeine
- Healthy diet
- Managing stress
- Losing weight
- Physical activities
- Taking medications, such as:
- Angiotensin converting enzyme inhibitors
- Beta-blockers
- Angiotensin 2 receptor blockers
- Diuretics
- Undergoing surgery to correct irregularities or blocked arteries
Prevention of Enlarged Liver (Hepatomegaly)
The best way to prevent hepatomegaly is to take good care of the liver. The following tips may help:
- Consuming alcohol in moderation, if at all
- Following a healthful diet that is low in saturated and trans fats
- Exercising regularly
- Limiting exposure to toxic substances, such as chemicals in cleaning products and paints
- Not sharing personal grooming tools, such as razors or tweezers or needles
- Using condoms, during sex
- Maintaining a moderate weight
- Routine physical exams by healthcare professionals
- Using medications sparingly and not mixing medications without a doctor’s approval
Enlarged Liver (Hepatomegaly) in Pregnancy
Some women experience hepatomegaly during pregnancy. Some causes of hepatomegaly during pregnancy can severely affect the health of the woman and the fetus.
Enlarged Liver (Hepatomegaly) in Children
- Peripheral whole-blood
- Amniotic fluid
- Bronchoalveolar lavage fluid (BAL)
- Sputum
- Pleural effusion
- Cerebrospinal fluid (CSF)
- Serum (sera)
- Plasma
- Peripheral blood mononuclear cells (PBMC)
- Saliva
- Buffy coat
- Urine
- Stool samples
- Aqueous humor
- Vitreous humor
- Kidney stones (renal calculi)
- Other bodily fluids from most diseases including cancer.
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