Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.6.1.2 (alanine aminotransferase)
 26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied infections in 101 consecutive patients who underwent liver transplantation between July 1984 and September 1985. The mean length of follow-up was 394 days. Eighty-three percent of population had 1 or more episodes of infection and 67% of the population had severe infections. The overall mortality was 26/101 (26%) and 23 of 26 deaths (88%) were associated with infection. Seventy percent of severe infections occurred in the first 2 months after transplantation. The most frequent severe infections were abdominal abscess, bacterial pneumonia, invasive candidiasis, Pneumocystis pneumonia, and symptomatic cytomegalovirus infection. Patients with more than 12 hours of cumulative surgical time had a higher rate of severe infections (P less than 0.001), particularly fungal (P less than 0.001) and bacterial (P less than 0.01) infections. Also, the use of choledocho-jejunostomy was associated with a higher rate of infection in patients who had more than 1 transplant operation (P less than 0.02). No increase in infection was found in patients who received azathioprine, or more than the median number of steroid boluses or "recycles"; but patients who received OKT3 therapy had a higher rate of protozoal infections (P less than 0.05). A result similar to that of our previous studies was a strong relation between the number of severe fungal infections and prolonged courses of antibiotics after transplant operation (P less than 0.001). Pretransplant manifestations of severe liver disease such as ascites, encephalopathy, and gastrointestinal bleeding were not associated with higher rates of infection after transplantation, but high serum levels of ALT were. Patients with lower ratios of T-helper to T-suppressor lymphocytes had more severe viral (P less than 0.02) and fungal (P less than 0.01) infections after transplantation.
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PMID:Infections after liver transplantation. An analysis of 101 consecutive cases. 328 Sep 44

Eleven patients of Chinese origin experienced spontaneous reactivation of chronic active hepatitis B. Eight HBsAg-positive patients were followed for an average of 15 months prior to, while three others presented during reactivation. Fatigue, hepatomegaly and jaundice were frequent findings. Elevation of both serum ALT (average = 1,212 units per liter) and hepatitis B virus DNA levels were noted in all patients, and reactivation lasted an average of 4.4 months. During resolution, clinical symptoms abated, serum ALT levels reverted toward normal, and in nine patients, the hepatitis B virus DNA values became undetectable. All patients lacked evidence for acute hepatitis A, Epstein-Barr Virus, cytomegalovirus or hepatitis delta virus infection. Histologic findings of liver tissue from eight patients showed piecemeal necrosis and fibrosis. Within the parenchyma, varying degrees of hepatocytolysis with cuffing, perivenular necrosis and acidophilic bodies were noted. Ground-glass cells and regenerative changes also were observed. Cirrhosis was not present in any of the liver biopsies. These findings suggest that spontaneous reactivation of hepatitis B occurs in heterosexual patients with chronic active hepatitis B and contributes to chronic inflammation and to the progression of their liver disease.
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PMID:Spontaneous reactivation of hepatitis B in Chinese patients with HBsAg-positive chronic active hepatitis. 361 49

Posttransfusion hepatitis of the non-A, non-B variety continues to be a significant problem in current hemotherapy. This disorder is many times more common than transfusion-associated disease caused by hepatitis B virus, cytomegalovirus, and Epstein-Barr virus, and also seems to be viral in origin. Several potential etiological agents have been implicated, but none has been identified with certainty, despite concerted efforts at doing so. Clinical disease is usually attended by few symptoms and signs, but evolution to chronic liver disease is distressingly common; over 50 percent of all cases of non-A, non-B posttransfusion hepatitis manifest this transition. Efforts at prevention of non-A, non-B hepatitis associated with blood transfusion have thus far been hampered by the lack of reliable laboratory markers for carriers of this disease, and controversy exists over the implementation of screening tests on blood donors, using such nonspecific indicators of possible viral carriage as serum alanine aminotransferase levels. It is probable, however, that simple measures such as more restrained blood usage, encouraged by greater educational efforts within the medical community, could be beneficial in minimizing the number of new cases of non-A, non-B posttransfusion hepatitis seen each year in the United States.
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PMID:Non-A, non-B hepatitis associated with blood transfusion. 392 Jul 92

Seven hundred and sixty-eight patients were seen and tested at frequent intervals after transfusion of whole blood. Eight patients were judged to have developed icteric or anicteric post-transfusion viral hepatitis, an incidence of 1%. Five were icteric and four of these were hepatitis B antigen (HB Ag) positive; two of these four died. One of the fatal cases and one non-fatal HB Ag positive case had received HB Ag positive blood. Two other antigen-positive patients had received blood or plasma or both which had not been tested for antigen.Thirty-five patients showed conspicuous or sustained elevations of alanine transaminase without clinical features of hepatitis.Four were positive for HB Ag but had not received antigen positive blood.Two who had received antigen positive blood remained antigen negative, but one developed hepatitis B antibody (HB Ab).Two other patients were also transfused with plasma.Five had serological evidence of cytomegalovirus (CMV) infection accompanying the enzyme changes.One patient who had received HB Ag positive blood remained antigen-negative and showed no abnormalities.Five patients who became HB Ag positive, although they had been given antigen-negative blood, remained clinically and biochemically well.Cytomegalovirus primary infection or reactivation occurred in another 32 patients; five had isolated, transient enzyme rises, one other was associated with a drug-induced focal liver necrosis and 26 showed no enzyme changes. Epstein-Barr virus infections, one of which was associated with a transient upset of enzyme activity, were detected in five patients. There were no cases of post-perfusion syndrome.
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PMID:Post-transfusion hepatitis in a London hospital: results of a two-year prospective study. A report to the M.R.C. Blood Transfusion Research Committee by the Medical Research Council Working Party on Post-Transfusion Hepatitis. 437 Jun 14

Abrupt increases of alanine transaminase were observed in 6 of 23 non-treated, male homosexuals with chronic hepatitis associated with hepatitis B virus. Before this occurrence, all subjects had hepatitis B e antigen (HBeAg) and elevated DNA polymerase activity. Within 3 months, HBeAg was nondetectable in 3 subjects and elevated DNA polymerase disappeared in 4. These serologic events were not always sustained, however. In 3 subjects, reactivation of hepatitis B virus infection occurred within the subsequent 6-month period. Serologic testing for cytomegalovirus, Epstein-Barr virus, delta agent, and hepatitis B surface antigen (HBsAg) subtype showed that episodes of clearance and reactivation were not explainable by secondary infection with these agents or infection with a different HBsAg subtype. Spontaneous clearance and reactivation of hepatitis B virus infection may commonly occur among male homosexuals with chronic type B hepatitis. These phenomena should be considered when evaluating the need for treatment or interpreting the results of investigations that use anti-viral therapy.
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PMID:Spontaneous clearance and reactivation of hepatitis B virus infection among male homosexuals with chronic type B hepatitis. 669 58

Radioimmunoassays for detection of hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), antibody to hepatitis A virus (anti-HAV), and anti-HAV of IgM class were used to verify hepatitis A and hepatitis B infection in 33 drug addicts with multiple attacks of hepatitis. Hepatitis A was confirmed serologically in 23 (32%) of 71 total hepatitis episodes, while hepatitis B was confirmed in 30 episodes (42%). The remaining 18 hepatitis episodes (25%) were, by serological exclusion, also of Epstein-Barr virus and cytomegalovirus infection, classified as hepatitis non-A, non-B. However, while as many as 13 (39%) of the 33 primary attacks of hepatitis were of the type non-A, non-B, this type was never observed as a third attack. In no case were two attacks of hepatitis A or hepatitis B demonstrated in the same individual, but two different episodes of hepatitis non-A, non-B were observed in one patient. The maximal serum levels of alanine aminotransferase and bilirubin were significantly lower in patients with hepatitis non-A, non-B as compared with those with hepatitis B. Development of chronic liver disease occurred in only two (7%) of the 28 addicts who continued to be followed up.
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PMID:Multiple hepatitis attacks in drug addicts. 676 7

To assess the relationship of liver dysfunction and hepatitis markers in hemophilic patients treated with factor VIII or IX concentrates, we studied 103 patients with hemophilia A and B for 6-36 mo. Elevated serum alanine aminotransferase was noted in 79% of the patients, with 51% of the patients showing persistent elevation for longer than 6 mo. Thirteen patients (12%) were HBsAg-positive, with 8 patients showing persistence of HBsAg and abnormal serum alanine aminotransferase for more than 6 mo. Overall, anti-HBs was detected in 77% of patients. Twelve episodes of acute hepatitis were documented in 10 patients during 36 mo. Six episodes were due to hepatitis B virus. The remaining 6 episodes were due to non-A, non-B hepatitis with negative HBsAg and absence of seroconversion to hepatitis B virus, hepatitis A virus, cytomegalovirus, and Epstein-Barr virus. In the six episodes of non-A, non-B hepatitis, the incubation period was less than 10 days in 3 patients and 30 days in 2 patients. In all cases with non-A, non-B hepatitis, the illness was symptomatic, but mild. Serum alanine aminotransferase returned to normal within 4 mo in 2 patients, but in 3 patients serum alanine aminotransferase persisted longer than 6 mo. One patient developed an acute B hepatitis 40 wk after non-A, non-B hepatitis. Thus, infection with the hepatitis B virus still remains prevalent as a cause of acute hepatitis in hemophiliacs receiving commercial factor concentrates, and accounts for chronic liver dysfunction in patients with persistent HBs antigenemia. In addition, acute non-A, non-B hepatitis, appears to be relatively common in hemophiliacs, and non-A, non-B virus may account for many cases of persistent liver dysfunction in these patients.
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PMID:Prevalence of type B and non-A, non-B hepatitis in hemophilia: relationship to chronic liver disease. 677 32

One hundred and thirty six patients receiving haemodialysis in a HB antigen-free unit were prospectively studied over a period of 29 months for evidence of hepatitis. Twelve/one hundred and eleven patients who were dialysed in this unit for at least one month developed elevation of ALT which proved to be related to neither toxic hepatitis nor hepatitis due to any of the following viruses: hepatitis B virus (HBV), hepatitis A virus (HAV), cytomegalovirus (CMV) or Epstein-Barr virus (EBV). Therefore these cases were considered to be non-A non-B (NANB) hepatitis. In 5 patients the liver disease was of short duration, whereas in 7 others hepatitis had a chronic course with ALT remaining elevated for more than 6 months. During the same period, one/sixty staff members who were working for at least one month in this unit also developed presumed non-A non-B hepatitis. Serological markers of NANB infection tested by double immunodiffusion were present in 10/12 patients and in the one staff member.
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PMID:A non-A non-B hepatitis epidemic in a HB antigen-free haemodialysis unit. Demonstration of serological markers of non-A non-B virus. 678 82

Most episodes of acute rejection will resolve after steroid therapy without detrimental consequences on the liver allograft. However, steroid-resistant acute rejection may induce irreversible lesions of the graft and is associated with an increased risk of chronic rejection. The aim of this study was to determine whether there were predictive factors for steroid-resistant acute rejection after liver transplantation. A total of 108 adult liver recipients with a follow-up of at least 2 years have been analyzed; sixty-two (57%) patients had at least one episode of acute rejection. The rates of steroid resistance were 35%, 52% and 83% after a first (n = 62), second (n = 25), or third (n = 7) episode of acute rejection, respectively. Steroid resistance of acute rejection was significantly associated with a past history of pretransplant steroid therapy (P = 0.004). High levels of ALT (P = 0.03) and serum bilirubin (P = 0.002) were also predictive of steroid-resistant acute rejection. Eight (7%) patients eventually developed chronic rejection. Predictive factors for chronic rejection included steroid-resistant acute rejection (P = 0.01), recurrent acute rejection (P = 0.03), and CMV infection (P = 0.01). In conclusion, this study suggests that pretransplant steroid administration or high levels of ALT and bilirubin in rejecting patients are risk factors for steroid resistance and should lead to aggressive antirejection therapy without delay.
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PMID:Enhanced risk of steroid-resistant acute rejection following pretransplant steroid therapy in liver graft recipients. 748 16

Canada has not introduced the non-A, non-B (NANB) surrogate marker tests (antibodies to hepatitis B core antigen and alanine aminotransferase) to screen donated blood. We evaluated the effect of NANB surrogate markers in reducing post-transfusion hepatitis in a prospective randomised intervention study. From 1988 to 1992, 4588 subjects were enrolled into two study groups that received allogeneic blood from which units positive for NANB surrogate markers were either withheld (n = 2311) or not withheld (n = 2277). We also assessed a simultaneous non-randomised cohort (n = 650) of subjects who received only syngeneic blood. All subjects were followed up for 6 months and assessed for the presence of post-transfusion hepatitis due to hepatitis A, B, C, non ABC, Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Withholding of blood containing NANB surrogate positive units reduced the overall post-transfusion hepatitis rate by 40% (p = 0.065) and the hepatitis C rate by 70% (p = 0.05). Most of the benefit of NANB surrogate testing was due to reduced frequency of hepatitis C virus after transfusion before all donor blood was screened for anti-HCV. During this time the overall post-transfusion hepatitis rate per 1000 transfusion recipients was 20.2 in the no-withhold group compared with 5.0 in the withhold group (p = 0.05), and the HCV hepatitis rate was 12.6 and 0 respectively (p = 0.06). After the introduction of HCV screening, the overall post-transfusion hepatitis rates were 8.6 and 6.8 per 1000 (p = 0.55) respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Post-transfusion hepatitis: impact of non-A, non-B hepatitis surrogate tests. Canadian Post-Transfusion Hepatitis Prevention Study Group. 763 69


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