The term “white liver” is not a formal medical diagnosis. Instead, it is a colloquial expression that people might use to describe a liver that appears pale, yellowish, or unusually light in color. This visual description often points towards underlying medical conditions that affect the liver’s normal appearance.
Understanding “White Liver”
“White liver” commonly refers to a condition where the liver’s color changes due to the accumulation of certain substances, most frequently fat. The most common medical condition associated with a pale or yellowish liver appearance is hepatic steatosis, also known as fatty liver disease. In this condition, excess lipids, primarily triglycerides, build up within the hepatocytes. This fat accumulation can cause the liver to become enlarged, yellow, and greasy.
On imaging studies like computed tomography (CT) scans, a liver with moderate to severe steatosis may appear less dense than the spleen, or have an absolute low attenuation of less than 40 Hounsfield Units (HU). While fatty liver is the primary condition linked to a pale appearance, other less common causes can also result in a liver with increased density or an altered appearance on scans. For example, conditions involving the excessive accumulation of substances with high X-ray attenuation, such as hemosiderin in cirrhosis or iodine from certain medications like amiodarone, can lead to a “white liver” sign on imaging.
Causes and Symptoms of Related Conditions
The conditions that can lead to a “white liver” appearance, particularly fatty liver disease, have various causes. Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is frequently linked to obesity, type 2 diabetes, high cholesterol, and elevated triglyceride levels. Excessive alcohol consumption is another significant cause, leading to alcohol-related liver disease. Other contributing factors include rapid weight loss, certain medications like corticosteroids, and rare genetic disorders.
In its early stages, fatty liver disease often presents with no discernible symptoms. As the condition progresses, some people might experience non-specific symptoms such as fatigue or a dull or aching pain in the upper right side of the abdomen. In more advanced stages, particularly if inflammation and scarring (cirrhosis) develop, more severe symptoms may emerge, including unexplained weight loss, weakness, or jaundice.
Diagnosis and Management
Diagnosing conditions like fatty liver disease involves medical assessments. A physical examination may reveal an enlarged liver. Blood tests, including liver function tests, are commonly performed, though elevated liver enzyme levels alone do not definitively diagnose fatty liver disease. Imaging studies are important, with abdominal ultrasound, CT scans, and MRI used to identify fat accumulation and assess for fibrosis or scarring. In some cases, a liver biopsy may be performed to confirm the diagnosis and determine the extent of liver damage.
The management of fatty liver disease focuses on lifestyle modifications. For MASLD, weight loss is a primary recommendation, with even a modest reduction of 3% to 5% of body weight showing benefits for liver steatosis, and 7% to 10% for improving inflammation and scarring. This is achieved through a healthy diet, limiting calorie intake, and increasing physical activity. Avoiding alcohol is also key to treatment, especially for alcohol-related fatty liver disease. While there are no specific medications approved solely for fatty liver disease, managing underlying conditions like diabetes, high blood pressure, and high cholesterol is an important part of overall care.