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TNF released by Kupffer cells is thought to play a key role in exacerbating liver damage, primarily by causing hepatocyte death but also by degrading the hepatic microcirculation by causing endothelial cells to swell and become activated, which leads to sinusoidal platelet aggregation and makes it easier for peripheral immune cells to enter

This is because your body adjusts to the medication during this time

That should be evaluated promptly

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