Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008370 (cholestasis)
 9,378 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The etiology of 72 episodes of liver disease that developed in 62 of 162 renal-transplant recipients was evaluated. Infection with hepatitis B virus was a minor problem, and none of our patients had evidence of infection with hepatitis A. Cytomegalovirus infection was ubiquitous in the population and probably accounted for many episodes of acute liver disease. This agent's role in causing chronic hepatitis is less secure. Infections with other viruses including Epstein-Barr virus, adenovirus, and the herpes viruses were only rarely associated with hepatic disease. Azathioprine was responsible for some episodes of acute cholestasis but could not be incriminated as a direct cause of chronic disease. A cause could be identified for the majority of episodes of acute hepatic dysfunction, but the cause of most of the chronic hepatitis remains undetermined. It is likely that infection with non-A, non-B hepatitis virus accounts for much of this serious, often fatal, complication of renal transplantation.
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PMID:Etiology of liver disease in renal-transplant patients. 22 42

A Teflon endoprosthesis for permanent bile drainage was inserted in 13 patients following percutaneous transhepatic puncture and catheterization of the bile duct system. Twelve patients had extrahepatic cholestasis because of a malignant tumor, whereas one patient had chronic inflammation involving the hepatoduodenal ligament (secondary to Crohn's disease) with obstruction of the extrahepatic bile ducts. The drainage periods varied from 1 week to 8 months. The endoprosthesis was regarded as partially effective in seven patients whereas in six cases the drainage through the endoprosthesis was insufficient and external bile drainage through a percutaneous transhepatic catheter was necessary. Infection of the bile duct system during the drainage period with a percutaneous transhepatic catheter and/or bile duct endoprosthesis occurred in 10 patients. Spontaneous dislocation of the endoprosthesis occurred in varying degrees in five patients. One patient developed an intrahepatic aneurysm adjacent to the puncture tract and died because of liver insufficiency following therapeutic embolization of the aneurysm and most of the hepatic arteries by injection of gelfoam particles into the common hepatic artery. Patients in whom palliative treatment by insertion of a permanent bile duct endoprosthesis may be suitable were defined.
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PMID:Percutaneous transhepatic insertion of a permanent endoprosthesis in obstructive lesions of the extrahepatic bile ducts. 51 Aug 75

Improved obstetrical and neonatal care has increased survival for many small premature infants. However, there remains a distinct group who die of complications later in infancy. The autopsy findings associated with these "postponed neonatal deaths" were the subject of our retrospective study of 18 premature infants (mean estimated gestational age, 28.6 +/- 0.6 weeks) who survived from 4 weeks to 4 months of age (mean, 70 +/- 11 days). All 18 infants required prolonged artificial ventilatory support and parenteral nutrition. The major findings at autopsy were similar in all cases and included bronchopulmonary dysplasia, hepatic cholestasis and fibrosis, abnormalities of endochondral ossification, and diffuse cerebral gliosis and infarction. Infection was the most common cause of death, and most of the infants died with acute bronchopneumonia. These postponed neonatal deaths, while they do not appear in standard neonatal mortality statistics, represent a problem of concern.
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PMID:Postponed neonatal death in the premature infant. 370 39

Based on autopsy findings in 301 adults who had died after intensive care, different patterns of single or multiple organ damage were identified. Signs of septicemia and/or exudative-to-fibrosing alveolitis (EFA) of the lungs, the prominent cause of the adult respiratory distress syndrome (ARDS), were recognized in 89 cases. Severe, progressive EFA, which appears to ensue mainly from continuing damage to alveolar walls, consequent fibroblast proliferation and so-called atelectatic induration (collapsed alveoli forming single thick septa), was registered only in individuals who had undergone long-term intensive care. The latter was necessitated in various severe conditions of which abdominal disease was the most important. Systemic disorders, such as hemorrhagic diathesis and multiple organ damage ("multiple organ failure"), showed a close correlation with septicemia. Infections with gram-negative bacteria appear to play a special role in such processes. Morphologically, these cases were characterized by multiple organ/system damage, e.g., in order of frequency, partial necrosis of renal proximal tubules, followed by signs of regeneration; jaundice; splenitis; lobular pneumonia; centrolobular-to-zonal liver necrosis, in part combined with cholestasis; petechial and/or extended hemorrhage; and others. This complex pattern contrasted strongly with findings in individuals who had been admitted to intensive care because of e.g. a cardiovascular incident: in this latter group (125 cases) intensive care was usually of short duration, progressive EFA was largely absent, signs of septicemia were exceptional, and multiple organ/system damage was rare. The group with polytraumatism (28 cases) exhibited a pattern of organ damage intermediate between (a) and (b).
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PMID:[Pathomorphologic findings following intensive therapy]. 372 1

The experience gained from 13 hepatic transplant operations is described, with particular reference to the findings in nine patients who survived the immediate operative period. A major problem was found to be infection. Fulminant pneumonia caused death in two adults, at a time when liver function was virtually normal. Infection related to bile fistula and sepsis may be overcome by an improved method of biliary drainage by cholecyst-dochostomy, which was carried out in the last two patients. Jaundice in the second week due to rejection was observed in several patients. The striking histological change was centrilobular cholestasis. The jaundice, which was not prevented by administration of antilymphocyte globulin, was rapidly controlled by temporarily increasing die dose of prednisone. One patient who survived for four and a half months and who had a poor tissue match subsequently developed chronic rejection with progressive cholestatic jaundice. Five of the patients were able to go home and at time of publication two are alive and well 14 and 20 weeks after treatment.
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PMID:Liver transplantation in man--3, Studies of liver function, histology, and immunosuppressive therapy. 430 54

Histopathological findings in the liver in a series of autopsies on 110 patients suffering from leukaemia or lymphoma were reviewed. No treatment had been given to 23 patients, 50 had received chemotherapy alone, 23 chemo- and radiotherapy and 14 underwent bone marrow transplantation. The 23 untreated patients showed neoplastic infiltration in 10 (44%) and fibrosis in 16 cases (70%). The 14 bone marrow recipients showed mainly acute necrosis, zonal in six (43%) and focal in one (7%), and cholestasis in five (36%), together with marked siderosis in 11 (79%). Patients receiving chemotherapy or chemo-/radiotherapy showed similar changes consisting of neoplastic infiltration in 14 (28%) and in five (22%) cases respectively, and fibrosis in 31 (62%) and 17 (74%) cases respectively. Steatosis was seen in 70% of cases in the chemo-/radiotherapy group and in 50% of cases in the other groups. Infections were seen in all groups, particularly in the chemotherapy group (four fungal and two bacterial including one tuberculosis) and in the chemo-/radiotherapy group (one fungal and one bacterial). Cytomegalovirus infection was seen only in the bone marrow transplant group.
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PMID:Pathology of the liver in leukaemia and lymphoma. A study of 110 autopsies. 760 19

In this report the literature on all cases of documented measles with hepatobiliary disease was reviewed to describe the characteristics of measles associated hepatitis. We found 27 patients described. Their age ranged from 9 to 59 years. Male to female ratio excluding military facilities was 1:1. The clinical and laboratory presentation appeared to follow one of two patterns. The first was suggestive of hepatocellular dysfunction characterized by aminotransferase elevation. It was encountered in 24/27 cases, seven of them with atypical measles. This form of liver disease tended to be asymptomatic. It appeared early and resolved in a few days. The second pattern was characterized by cholestasis and jaundice. It was described in three cases. This type of hepatitis became apparent when measles began to recede and persisted for two weeks or longer. The variation in time of appearance of the two types of liver disease may imply distinct pathogenetic mechanisms.
Infection
PMID:Measles associated hepatobiliary disease: an overview. 849 19

The cause of extrahepatic biliary atresia (EHBA) remains unknown, and even an animal model is still lacking. Observations in a murine infectious model (newborn Balb/c mice infected with rhesus rotavirus group A [RRV]) reported extrahepatic biliary obstruction similar to findings in children who have EHBA. In the present study, this animal experiment was repeated, and the clinical and histomorphologic changes were observed over 3 weeks. Eighty-nine newborn mice were infected with RRV, and 67% showed signs of cholestasis and delayed growth. Eight of these animals recovered spontaneously whereas the others remained icteric. Fourty-six pups were prepared for microscopic examination following a 2-day interval. From the fifth day, the whole biliary tract showed edematous swelling with cellular infiltration. Ten days later, in the extrahepatic bile duct, a transformation took place in which concentric infiltration led to complete obstruction, sometimes with prestenotic dilatation. The intrahepatic changes showed reactive necrosis and proliferation of the small bile ducts. In one 19-day-old mouse, a ballooning dilatation was observed, similar to a developing choledochal cyst. Infection with RRV induces in newborn Balb/c mice a cholestatic clinical picture with different courses of the disease leading mostly to complete biliary obstruction and secondary hepatic changes similar to EHBA in children. This is the first animal model for EHBA with complete obstruction of the extrahepatic bile duct induced by infection. These findings present a new basis for further studies.
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PMID:New aspects in a murine model for extrahepatic biliary atresia. 926 68

Animal models for extrahepatic biliary atresia (EHBA) have failed to simulate the course of the disease. Until now only a few aspects of the entity could be investigated and no model was helpful in discovering the etiology of EHBA. Following the suspicion of a viral and hepatotropic infection, investigations in an infectious mouse model were continued. The results of previous and topical studies are summarized here. Infection of newborn Balb/c-mice with rhesus rotavirus (RRV) leads to cholestasis in 85% of the animals followed by a lethality of 90%. Preparation and histomorphological investigation of liver and ligamentum duodenale reveal EHBA of varying extent. Clinical course and morphological findings in mice are very similar to EHBA in newborn children and the results are presented in a chronological table. Hepatobiliary morbidity and lethality after RRV infection is higher in Balb/c-mice than in other mouse strains. This observation supports the suspicion that immunocompetence might be a determining factor in the etiology of EHBA. Initial therapeutic trials were made using this model by treating infected newborn mice with interferon-alpha (IFN). The prophylactic application of IFN protects the infected mice from cholestatic symptoms and appears to induce partial immunity. Their descendants are protected against the hepatotropic effect of RRV infection. Infected animals presenting with clinical signs of cholestasis can be treated successfully by IFN-therapy for one week. In the presented animal model. EHBA can be better induced and simulated than by any other method. As a first trial, a non-surgical and more etiologically orientated therapeutic method is tested in this model.
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PMID:Progress in developing animal models for biliary atresia. 967 94

Mirizzi syndrome is a very uncommon cause of extrahepatic bile duct obstruction. A stone impacts in the cystic duct or gallbladder neck and causes extrinsic compression and obstruction of the common hepatic duct, aided by a local inflammatory process. Preoperative diagnosis is very important because of the potential risk of bile duct injury during surgery and the local inflammatory process may suggest cholangiocarcinoma. Infection by specific coliform organisms may result in emphysematous cholecystitis in patients with diabetes or those who are immunosuppressed, with mural air being visible. Herein, we report an emphysematous cholecystitis associated with Mirizzi syndrome in a patient with diabetes mellitus.
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PMID:[Case report: Mirizzi syndrome in a patient with emphysematous cholecystitis: ultrasonographic and computed tomographic findings]. 1466 93


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