9. Hepatic Manifestations of Systemic Disorders

  1. Eugene R. Schiff MD, MACP, FRCP3,
  2. Willis C. Maddrey MD, MACP, FRCP4 and
  3. Michael F. Sorrell MD, FACP5
  1. Stuart C. Gordon MD1 and
  2. Hemal K. Patel MD2

Published Online: 31 OCT 2011

DOI: 10.1002/9781119950509.ch9

Schiff's Diseases of the Liver, Eleventh Edition

Schiff's Diseases of the Liver, Eleventh Edition

How to Cite

Gordon, S. C. and Patel, H. K. (2011) Hepatic Manifestations of Systemic Disorders, in Schiff's Diseases of the Liver, Eleventh Edition (eds E. R. Schiff, W. C. Maddrey and M. F. Sorrell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119950509.ch9

Editor Information

  1. 3

    Center for Liver Diseases and Schiff Liver Institute, University of Miami Miller School of Medicine, Miami, FL, USA

  2. 4

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

  3. 5

    University of Nebraska College of Medicine, Omaha, NE, USA

Author Information

  1. 1

    Division of Hepatology, Henry Ford Health Systems, Wayne State University School of Medicine, Detroit, MI, USA

  2. 2

    Division of Gastroenterology and Hepatology, Henry Ford Health Systems, Detroit, MI, USA

Publication History

  1. Published Online: 31 OCT 2011
  2. Published Print: 9 DEC 2011

ISBN Information

Print ISBN: 9780470654682

Online ISBN: 9781119950509



  • Liver infection;
  • septic jaundice;
  • tuberculosis;
  • cholestasis;
  • fungal infection;
  • porphyria;
  • lymphoma;
  • sickle cell disease;
  • diabetes mellitus;
  • thyroid disorder;
  • celiac disease


The liver often serves as the host organ to a variety of systemic, especially infectious, disorders that originate elsewhere. In addition to the well-characterized hepatotropic viruses, various bacteria, rickettisa, spirochetes, and fungi infect the liver, either as a primary infection or as part of multisystemic disorders. Fever and unexplained cholestasis should raise the possibility of nonviral hepatic infection. As an extension of the reticuloendothelial system, several hematopoietic diseases including lymphoma, porphyria, and sickle cell disease result in distinct liver syndromes – including liver failure. Endocrine diseases including hypo- and hyperthyroidism cause unique liver dysfunction; furthermore, diabetes mellitus has a role in the development of both cirrhosis and hepatocellular carcinoma. Diseases of the gastrointestinal system, including celiac disease and inflammatory bowel disease, may hasten the development of cirrhosis. A remarkable array of rheumatologic and immunologic conditions may affect the liver, via mechanisms that are not yet elucidated. The hepatic manifestations of systemic disorders reflect the complexity of an organ that interrelates with the entire discipline of internal medicine.