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 diagnostic specificity of a new method to detect obstructive jaundice by determination of lipoprotein X (LP-X) was tested in 144 patients with different kinds of hepatic diseases and compared with the usual chemical "obstructive jaundice specific" tests, such as bilirubin, SGOT, SGPT, alkaline phosphatase, LAP and gamma-GT. The LP-X test was performed by using all-in test kit LP-X Rapidophor" low-voltage electrophoresis of Immuno AG/Wien. The results were correlated with the histological classification of the liver biopsy specimen. In 82% of the histologically verified cases of obstructive jaundice the result of the LP-X test was positive, whilst in 98.5% of the histologically negative cases the result of the LP-X test was negative. Hence, this LP-X method proved superior to chemical methods in providing a clear-cut positive or negative answer to the presence of cholestasis. Furthermore, the LP-X test was suitable for long-term follow-up investigation of patients with obstructive jaundice.
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PMID:[The diagnosis of cholestasis: lipoprotein X (LP-X) (author's transl)]. 0 12

Percutaneous transhepatic drainage of the bile duct (PTCD) is a method that has few complications and can successfully relieve an obstructive jaundice. As a palliative drainage in malignancies of the liver and the porta of the liver it reduces the jaundice and prevents the accompanying troublesome pruritus, thus prolonging life. It reduces postoperative lethality and complications by reducing the jaundice preoperatively. Suppurative cholangitis with bile duct obstruction is quickly relieved by administration of antibiotics into the drainage.
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PMID:[Indications and results of percutaneous transhepatic bile-duct drainage]. 8 98

Total body opacification with high doses of a urographic contrast agent demonstrated dilated intrahepatic biliary ducts as branching or rounded lucencies in all of 18 patients with obstructive jaundice. Dilated extrahepatic ducts were seen as tubular lucencies in 11 of 16 patients with distal common bile duct obstruction. In seven patients with nonobstructive jaundice and in a control group of 25, the biliary ducts were either normal or not seen. Gallbladder size was also evaluated. The site of obstruction could be predicted by the size of the gallbladder and visualization of the biliary ducts.
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PMID:Infusion hepatotomography for evaluation of obstructive jaundice. 10 80

Cholestatic jaundice is one complication of nonhepatic gram-negative bacterial infection. The endotoxin of Escherichia coli has been reported to cause cholestasis by inhibiting the bile salt-independent fraction (BSIF) of bile in the perfused rat liver. Accordingly, the effects of lipopolysaccharides (LPS) of E. coli and Salmonella enteritidis on the Na+, K+-adenosinetriphosphatase (ATPase) in canalicular-enriched plasma membranes of rate liver were examined. At 20 microgram/ml, both endotoxins inhibited this enzyme by approximately 40%. Maximal inhibition (70%-80%) occurred at concentrations of greater than or equal to 120 microgram/ml. The LPS of neither organism exerted any effect on the activity of Mg++-ATPase or 5'-nucleotidase in the same preparations. Inhibition by the E. coli LPS appeared to be noncompetitive in nature, and the calculated Ki was 45 microgram/ml. Since the Na+, K+-ATPase may be responsible for the elaboration of BSIF, inhibition of this enzyme could be the underlying mechanism for the endotoxin-induced cholestasis.
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PMID:Inhibition of Na+, K+-adenosinetriphosphatase by endotoxin: a possible mechanism for endotoxin-induced cholestasis. 14 99

The abnormal lipoproteins of the density range 1.019-1.063g/cm3 occurring in the plasma of patients with obstructive jaundice were studied. Subfractionation of this density class by combined sodium phosphotungstate precipitation, ultracentrifugation, and column chromatography on hydroxyapatite and agarose gel yielded essentially three fractions: (1) lipoprotein-X, (2) A triglyceride-rich lipoprotein for which we propose the term lipoprotein-Y and (3) an abnormal lipoprotein, lipoprotein-B. Marked differences between these fractions with respect to electron-microscopic appearance, hydrated densities, chemical composition and immunochemical characteristics were observed. The protein moiety of lipoprotein-X consisted primarily of apolipoprotein-C and albumin. Lipoprotein-Y showed, in addition to apolipoprotein-C, the presence of apolipoprotein-B. The 'lipoprotein-B' fraction isolated from sera of these patients had higher triglyceride and free cholesterol contents than that of normal individuals and an unusually high content of apolipoprotein-C. The relative distribution of lipoprotein-X, lipoprotein-Y and 'lipoprotein-B' varied from patient to patient. The importance of considering the existence of lipoprotein-Y in screening patients for cholestasis by the lipoprotein-X test is discussed.
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PMID:Investigation of the abnormal low-density lipoproteins occurring in patients with obstructive jaundice. 18 49

Obstructive jaundice, pruritus, and malabsorption developed in twin brothers in infancy. Early liver biopsy specimens showed intracellular and canalicular cholestasis with normal bile ducts. By the age of 3 years, both had cirrhosis and portal hypertension. Each died during the teen years from hepatocellular carcinoma. These brothers represent the tenth reported family with familial cholestatic cirrhosis, and they are the first patients with this syndrome in whom hepatoma developed.
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PMID:Hepatoma in familial cholestatic cirrhosis of childhood: its occurrence in twin brothers. 21 1

CT can clearly demonstrate dilation of intra- and extra-hepatic bile ducts due to mechanical obstruction. Note is made that the intrahepatic bile must not necessarily participate in dilation in obstructive jaundice. The cause in 27 cases observed in our institutions was as follows: 16 pancreatic tumors; 1 stone; 2 extrahepatic bile duct obstructions; 4 liver lesions (tumor and cirrhosis) and 4 with cause unknown. Furthermore, CT is helpful in the evaluation of hepatogenic non-obstructive jaundice such as due to primary liver cell carcinoma (hepatoma), metastases to the liver and advanced cirrhosis of the liver. The value of CT in the evaluation of different types of cholestasis is demonstrated by several exemplary cases; and the problems of differential diagnosis are pointed out.
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PMID:[Computerized tomography in the evaluation (author's transl)]. 22 56

To study the effects of acute and chronic cholestasis on vitamin D metabolism we investigated six cases of acute extrahepatic obstructive jaundice and eight cases of primary biliary cirrhosis (PBC) (three supplemented with vitamin D). Plasma 25-hydroxyvitamin D (25OHD) was low in the patients with PBC unsupplemented with vitamin D but normal in obstructive jaundice. None of the patients with PBC showed radiological or histological evidence of osteomalacia. In PBC, dietary intake of vitamin D was low but response to ultra-violet irradiation of the skin was normal even in those with a considerably raised serum bilirubin. Patients with PBC or obstructive jaundice had low levels of 25 hydroxyvitamin D binding protein which correlated with the serum albumin. The half-life of intravenously injected (3)H vitamin D(3) ((3)HD(3)) and the subsequent production of (3)H 25OHD were normal in all the patients with obstructive jaundice and in most with PBC. The two patients with PBC who produced less (3)H 25OHD than expected were receiving vitamin D supplements. The urinary tritium ((3)H) excretion after the injection of (3)HD(3) correlated with the serum bilirubin. After the injection of (3)H 25OHD(3) the urinary excretion of (3)H was minimal and did not correlate with the serum bilirubin, suggesting that the radioactivity appearing in the urine after the (3)H vitamin D(3) injection was associated with vitamin D metabolites other than 25OHD. Factors contributing to the low plasma 25OHD in primary biliary cirrhosis may be a low dietary intake of vitamin D, inadequate exposure to ultra-violet light, and a tendency to urinary wastage of vitamin D metabolites.
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PMID:Vitamin D metabolism in acute and chronic cholestasis. 23 Jan 29

Grey-scale ultrasound tomography was used to examine the liver and biliary tree of 100 consecutive unselected jaundiced patients in a prospective study. It was successful in differentiating between hepato-cellular and obstructive jaundice in 94%. It precisely localised the site of obstruction in 75% of those patients with enlargement of the head of the pancreas from either carcinoma or gall-stones impacted in the Ampulla of Vater. This figure was reduced to 60% when all cases of obstruction were considered. Cirrhosis and chronic active hepatitis were found to be associated with an abnormal pattern of echoes within the liver. These echoes were stronger and more numerous than normal. This association was not apparent with drug-induced cholestasis or acute viral hepatitis. Grey-scale ultrasound tomography is quick, safe and completely non-invasive. It should be the initial investigation of choice in the differential diagnosis of jaundice. When precise localisation of an obstruction is not possible after a repeat attempt, then percutaneous transhepatic cholangiography should be considered.
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PMID:Ultrasound tomography of the liver: Non-invasive method of choice for the differential diagnosis of jaundice. 28 82

Lipoprotein-X is an abnormal lipoprotein that appears in the sera of patients with obstructive jaundice, and thus is a sensitive indicator of cholestasis. In patients with familial plasma lecithin, Cholesterol acyltransferase (LCAT) deficiency, there is an inverse relationship between plasma Lp-X levels and LCAT activity. Ultracentrifugation procedures utilized for isolation of Lp-X have shown that it is associated with the low density lipoprotein fraction. Lp-X can be visualized by electrophoresis on either Agar or Agarose. The purity of Lp-X preparations has been documented by immunochemical procedures. The availability of highly purified antisera to Lp-X has served as a basis of one of the assay procedures for this lipoprotein. It's chemical composition has been established. Phospholipids and unesterified cholesterol constitute the bulk of the Lp-X molecule. Electron microscopic studies have demonstrated that Lp-X is a spherical particle which has strong aggregating properties. Membrane bound enzymes have been shown to aggregate with Lp-X. The fact that bile lipoprotein can be converted to Lp-X by the addition of albumin and that Lp-X can be converted to bile lipoprotein by the addition of bile salts offers a possible explanation for the origins of Lp-X. Phospholipases of plasma might play a role in the catabolism of Lp-X. The value and limitations of Lp-X determinations will also be addressed in this review.
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PMID:Lipoprotein-X. 38 51


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