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Symptom
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Target Concepts:
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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)
An unusual clinical presentation of
chronic active hepatitis
is the abrupt onset of symptoms and jaundice, suggesting acute viral hepatitis. In this report, six patients had the acute onset of a severe liver disease. Five of the patients were female and ranged in age from 13 to 64 years. Marked elevations in the total bilirubin (17.1 +/- 11.4 mg/dl), AST (1,346 +/- 352 mIU/ml), and
ALT
(1,043 +/- 213 mIU/ml) were present (mean +/- SD). Negative serologies for hepatitis A and B were found. Liver histology showed severe hepatocellular injury. A diagnosis of autoimmune
chronic active hepatitis
with acute features was made on the basis of high titers of antinuclear antibody and smooth muscle antibody and the presence of hypergammaglobulinemia. As immunosuppressive therapy is a beneficial treatment of autoimmune
chronic active hepatitis
, an acute presentation of this liver disease should be considered as an alternative diagnosis to acute non-A, non-B hepatitis in patients with these clinical characteristics.
...
PMID:Autoimmune chronic active hepatitis masquerading as acute hepatitis. 250 74
To evaluate the level of serum thyroxine-binding globulin (TBG) in various liver diseases, TBG and T4, T3, FT4 were measured by radioimmunoassay in 29 HBsAg carriers (C), 27 patients with acute hepatitis (AH), 18 patients with inactive chronic hepatitis, 70 patients with
chronic active hepatitis
(
CAH
), 31 patients with active cirrhosis (AC), 20 patients with inactive cirrhosis (IC), 38 patients with hepatocellular carcinoma (HCC), 12 patients with metastatic Ca to the liver (Met.) and in 81 normal controls. All the patients were clinically euthyroid. The TBG as well as T4 in patients with AH,
CAH
, AC HCC and, Met. were significantly higher than those in controls. The T3 level was significantly elevated in
CAH
and AC patients. The TBG level did not correlate with serum albumin or bilirubin levels, but did correlate significantly with
alanine transaminase
(
ALT
) (r = 0.54, p less than 0.01). However, the correlation was positive in
chronic active hepatitis
(r = 0.40, p less than 0.01) but negative in hepatocellular carcinoma (r = -0.32, p less than 0.05). The data suggested: (1) Significant TBG and T4 elevation was found in all active liver diseases and HCC. (2) In the presence of high T4 in patients with liver disease, normal FT4 excluded the diagnosis of hyperthyroidism. (3) The elevation of TBG levels in chronic hepatitis appeared to parallel the severity of hepatocytolysis, and therefore might be the result of hepatocytolysis; while the elevation of TBG in HCC might be due to increased synthesis by the malignant cells.
...
PMID:[Changes in thyroid hormone concentration in liver disease]. 250 36
We have retrospectively studied the clinical and histological features of 55 cases of acute post-transfusion non-A, non-B hepatitis. Histological findings in the liver biopsies taken in the acute stage covered the whole spectrum of acute and chronic hepatitis, the incidence of acute hepatitis or non-specific reactive hepatitis was 12.7% and 16/4%, respectively, while that of
chronic active hepatitis
was 56.4%. There was no correlation between histological features in acute stage and the mean peak levels in serum
alanine aminotransferase
(
ALT
). Post-transfusion hepatitis, non-A, non-B with histological signs of chronic hepatitis in acute stage frequently results in biochemical evidence of chronic liver disease during long-term follow-up periods. Therefore, our results suggest that the histological features of chronic hepatitis in the acute stage are indicative of long-term elevation in serum
ALT
level.
...
PMID:[Clinical and histological features of acute post-transfusion non-A, non-B hepatitis: histological diagnosis in acute stage and clinical outcome]. 251 63
Antipyrine (AP) clearance was determined in 23 cases with liver cirrhosis (LC), 12 with
chronic active hepatitis
(
CAH
), 12 with hepatocellular carcinoma (mcHCC), 20 with non-hepatic diseases and 70 healthy controls. ICG Clearance was performed simultaneously in 9 cases of them. The results showed that AP clearance was significantly decreased in patients with LC and moderately decreased in
CAH
and HCC, its diagnostic sensitivity in LC was significantly higher than that of
GPT
. The significant positive correlation between the AP and ICG clearance was noted and AP clearance also well correlated with serum albumin level and prothrombin time. It is suggested that AP clearance may be used as a quantitative test to determine the reserve capacity of liver and as a substitutive test for ICG clearance.
...
PMID:[Evaluation of antipyrine clearance in chronic liver diseases]. 255 53
All cases of liver tumor referred to the King Faisal Specialist Hospital and Research Centre in Saudi Arabia during 2.5 years were reviewed. Hepatocellular carcinoma, 104 cases, was considerably more common than metastatic carcinoma with unknown primary, 15 cases. Lymphoma presenting as liver tumor occurred in three cases and there were no cases of cholangiocarcinoma. There were only two cases of benign tumor, both hemangioma. Hepatocellular carcinoma was characterized by a male predominance of 6:1, positive hepatitis B surface antigen in 60%, presentation with an enlarged, hard liver in over 90%, a systolic-diastolic bruit over the mass in 45%, a single highly echogenic lesion in the right lobe on ultrasound in 80%, and rapid progression. The serum AST (aspartate aminotransferase, serumglutamic oxalacetic transaminase [SGOT]) was abnormal in 97% and was higher than the
alanine aminotransferase
(
ALT
) in 93% of cases compared with 17% in 100 consecutive cases of
chronic active hepatitis
. Sixty-six percent of patients with hepatocellular carcinoma had serum AFP greater than 200 ng/ml. Excluding five cases of germ cell tumor (none involving the liver), and pregnant patients, serum AFP was less than 200 ng/ml in all other patients in whom it was measured between 1979 and 1981. A practical approach to the diagnosis of hepatocellular carcinoma is outlined. Biopsy does not appear to be indicated in many cases of advanced hepatocellular carcinoma.
...
PMID:Hepatic tumors in Saudi Arabia. A practical approach to diagnosis. 257 17
The peptide which is encoded by the pre-S(2) region of hepatitis B virus DNA, the pre-S(2) antigen, was determined quantitatively by an enzyme immunoassay system employing monoclonal antibodies. The prevalence and titer of pre-S(2)Ag were 91.9% (91/99) and 10,356 +/- 19,053 units (mean +/- S.D., arbitrary units) for hepatitis B e antigen (HBeAg)-positive patients with acute and chronic HBV infection and 86.0% (74/86) and 952 +/- 1,565 units for HBeAg-negative subjects. In four patients with acute hepatitis B, pre-S(2)Ag titers changed in parallel with HBV DNA levels, and the disappearance of pre-S(2)Ag from serum was associated with a rapid fall of
ALT
levels into the normal range, whereas the fluctuation of pre-S(2)Ag titer correlated with persistence of
ALT
elevations. In all of the 19 episodes of acute exacerbation of hepatitis which occurred in nine patients with
chronic active hepatitis
B, a significant elevation of pre-S(2)Ag titer was observed, closely overlapping an increase or appearance of HBV DNA, and its peak preceded peaks of
ALT
by 1 to 11 weeks (mean +/- S.D. = 4.26 +/- 2.57 weeks). These observations suggest that quantitative measurement of pre-S(2)Ag would be useful for estimation of the magnitude of HBV replication and would help predict the prognosis of acute hepatitis B and of acute exacerbation in chronic hepatitis B.
...
PMID:Serum titers of pre-S(2) antigen in patients with acute and chronic type B hepatitis: relation to serum aminotransferase activity and other hepatitis B virus markers. 264 43
We investigated the expression of Pre-S2 antigen (Ag) and antibody (Ab) in sera quantitatively using ELISA. Four patients with acute hepatitis B and 87 chronic HBV carriers were included in this study. We also investigated the expression of Pre-S2Ag in the liver tissues obtained from 26 chronic HBV carriers by direct fluorescent antibody method. There was a significant correlation between Pre-S2Ag titers and HBsAg titers in sera. Pre-S2Ag titers were higher in sera positive for HBeAg, HBV-related DNA polymerase or HBV-DNA than in sera negative for those markers. The ratio of Pre-S2Ag titers to HBsAg titers, however, was constant irrespective of virus replicative markers. Pre-S2Ag in the liver had almost same intracellular localization with HBsAg in the liver. It was suggested that Pre-S2Ag was expressed with an intimate relation to the expression of HBsAg and was not useful as a virus replicative marker. Pre-S2Ag titers/HBsAg titers tended to be high in patients with
chronic active hepatitis
and high serum
GPT
levels compared to patients with chronic inactive hepatitis. This may be explained by the release of Pre-S2Ag in the liver. In addition, all patients positive for Pre-S2Ag on the membrane of hepatocytes had
chronic active hepatitis
. The overproduction of Pre-S2-containing surface proteins in the liver may have some implication related to cell injury via the immune response to Pre-S2Ag etc. Pre-S2Ab was detected only in few cases of chronic HBV infected patients. The lack of immune response to Pre-S2 region may play a role in the persistence of HBV infection.
...
PMID:[Expression of Pre-S2 antigen and antibody in patients with hepatitis B virus infection]. 268 90
The efficacy of Shosaiko-to (SST) on 222 patients with
chronic active hepatitis
was studied in a double-blind multicenter clinical study. One hundred and sixteen patients received SST in a daily oral dose of 5.4 g for 12 weeks, followed by the same dose for a further 12 weeks. One hundred and six patients received a placebo containing 0.5 g of SST for 12 weeks, followed by a cross-over to SST for a further 12 weeks. Among the liver tests, serum AST and
ALT
values decreased significantly with the administration of SST. The difference of the mean value between the SST group and the placebo group was significant after 12 weeks. In patients with chronic active type B hepatitis, a tendency towards a decrease of HBeAg and an increase of Anti-HBe antibodies was also observed. No remarkable side effects were noticed.
...
PMID:A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. 269 17
Superinfection by hepatitis delta virus (HDV) in hepatitis B virus chronic carriers is normally associated with a progressive liver injury. For this reason, the aim of the present study was to determine the efficacy of recombinant interferon alpha (rIFN-alpha) treatment of chronic delta hepatitis, by giving high doses of rIFN-alpha 2c during a prolonged period. A total of 20 HBsAg, anti-HD carriers with a
chronic active hepatitis
were randomly allocated in two groups: (I) n = 10, control and (II) n = 10, treated with 10 MU/m2 body surface of rIFN-alpha, twice weekly, intramuscularly (im) during 6 months. Basally, all patients presented HDAg in the liver and serum IgM anti-HD. Serum HDV-RNA was positive in 8 and 7 patients from groups I and II, respectively. The interferon therapy was well tolerated and all patients finished the treatment period. During the first 6 months, a decrease in
ALT
levels among treated patients (255 +/- 98 vs. 193 +/- 117) was observed. In addition, a transient drop in HDV-RNA levels was also observed. No changes in anti-HD titer, IgM anti-HD and HBsAg concentration were detected. At the end of the follow-up period (15 months) two treated patients had lost IgM anti-HD. In addition, another two patients were HDV-RNA negative. In conclusion, no permanent antiviral effects of rIFN-alpha 2c in chronic delta hepatitis, using this schedule, was achieved.
...
PMID:Treatment of chronic delta infection with recombinant human interferon alpha 2c at high doses. 269 69
The purpose of this study was to evaluate the clinical diagnostic value of serum total bile acid (STBA) in hepatobiliary diseases. Fasting STBA was measured using the enzymatic colorimetric method in 44 normal control cases and 153 cases of hepatobiliary disease, and then abnormal rates were compared to other conventional liver function tests. These 153 cases of hepatobiliary diseases included acute viral hepatitis (10 cases), chronic persistent hepatitis (32 cases),
chronic active hepatitis
(16 cases), liver cirrhosis (15 cases), alcoholic hepatitis (11 cases), alcoholic fatty liver (23 cases), alcoholic cirrhosis (17 cases), chronic liver diseases with slight fatty changes (10 cases) and hepatocellular carcinoma (6 cases). Except for 8 cases of acute viral hepatitis, the above cases were verified by liver biopsy. There were also 13 cases of biliary tract diseases. Fasting STBA and other conventional liver function tests were used in the above hepatobiliary diseases during the acute, exacerbated or decompensated stage, and the stable or compensated stage, and their abnormal rates compared. The results of this study revealed that the concentration of STBA is raised in various hepatobiliary diseases, which is related to the degree of hepatic cell injury and the various stages of liver. The concentration of STBA was higher in the acute, exacerbated or decompensated stage than in the convalescent, stable or compensated stage of liver diseases. When the abnormal rates of STBA were compared to other conventional liver function tests, the abnormal rates of STBA were not inferior to r-GT, GOT and
GPT
, and were more accurate than the other liver function tests.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Diagnostic value of serum total bile acid in hepatobiliary diseases]. 275 25
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