Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 80 industrial workers producing herbicides (2,4,5-trichlorphenoxyaceticacidsodium and sodiumpentachlorphenolate) in Czechoslovakia the following signs of intoxication caused by 2,3,6,7-tetrachlordibenzodioxin were found: Dermatological: Chloracne and Porphyria cutanea tarda. Internal: Disorders of the metabolism of porphyrins, fats, carbohydrates, plasmaproteins. Neurological: Mainly lesions of the peripheral neurone. Psychiatric: Neurasthenic syndrome and organic lesions. Differences from the usual course of chloracne were observed. Porphyria cutanea tarda acquisita was most obvious, one patient suffered and died from severe atherosclerosis, hypertension and diabetes. Many patients developed polyneuropathy, as verified both by EMG and autopsy. Two patients died from bronchogenic carcinoma.
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PMID:[Chloracne, porphyria cutanea tarda, and other poisonings due to the herbicides]. 13 6

Porphyria cutanea tarda is the most common disorder of porphyrin metabolism in the United States and Europe. This report presents the clinical, laboratory and pathologic features of 40 patients with porphyria cutanea tarda. Each patient was followed up for variable times during 1960-76 at the Clinical Research Center and the Dermatology Service of the Columbia-Presbyterian Medical Center; at the New York University Medical Center; or at the Rockefeller University Hospital. Earlier age at onset; diminution of alcohol ingestion as the major etiologic factor; and, an increased incidence in females indicate new environmental influences. The most frequently associated etiologic factor, aside from alcohol intake, was use of estrogens for contraception; postmenopausal syndrome; or treatment of prostatic carcinoma. Cutaneous findings in the patients included bullae (85%); increased skin fragility (75%); facial hypertrichosis (63%); hyperpigmentation (55%); sclerodermoid changes (18%); and, dystrophic calcification with ulceration (8%). Diabetes mellitus was found in 15%; systemic lupus erythematosus in 5%; elevated serum iron level in 62%; and, abnormal liver function test results in 60%. Histologic abnormalities were seen in liver biopsies of 34 patients. Phlebotomy is the treatment of choice. In 32 patients so treated, clinical remissions averaged 30.9 months. 31% (10 patients) had a relapse but additional phlebotomies resulted in 2nd remissions. Chloroquine and plasmaphoresis treatments were also briefly discussed.
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PMID:Porphyria cutanea tarda. Clinical features and laboratory findings in 40 patients. 46 34

Porphyria cutanea tarda (PCT) has a known increased incidence of diabetes mellitus and hepatic involvement. We investigated glucose tolerance and glucoregulatory hormone alterations in seven patients with PCT and correlated these results with hepatic histology by percutaneous liver biopsy. Abnormal glucose tolerance was observed in six of the seven patients (87%). Fasting serum insulin levels were normal range, and normal glucose and growth hormone responses to standard, exogenous intravenous insulin were observed. Fasting serum glucagon and urine free cortisol levels were normal in those patients in whom they were measured. While varying degrees of abnormalities were found on histopathologic exam of the liver biopsies, no patient met the criteria for cirrhosis, and none of the patients demonstrated abnormal levels of insulin counterregulatory hormones commonly seen in cirrhosis. Thus, liver disease may not be the sole cause of the observed glucose intolerance and hyperinsulinemia in PCT patients.
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PMID:Carbohydrate metabolism in porphyria cutanea tarda. 46 44

A screening test for urinary porphyrin excretion was performed amound 1433 diabetes patients (552 males and 881 females). In three patients (0.21)% the diagnosis of porphyria cutanea tarda was ascertained. In spite of the increasing usage of sulfonylurea antidiabetic drugs, previously reported as potential porphyria-inducing agents, the authors could not observe an increased number of porphyria cases among the diabetics compared to the proportions in similar groups examined 10-12 years ago. The sulfonylurea Oradian was the likely etiopathogenic factor in only one out of three patients. The above mentioned observations do not speak in favour of independent etiological porphyrinogenic influence of antidiabetic sulfonylurea drugs.
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PMID:[Porphyria cutanea tarda and blood-sugar-suppressing derivatives of sulfonylurea]. 120 44

Alcoholic liver disease includes steatosis, alcoholic hepatitis and cirrhosis. Other liver diseases of genetic origin, but with a curious association with alcohol intake, are hemochromatosis and porphyria cutanea tarda. The attribution of chronic hepatitis to alcohol intake remains speculative, and the association may reflect hepatitis C infection. Hepatic injury attributed to alcohol includes the changes reported in the fetal alcohol syndrome. Steatosis, the characteristic consequence of excess alcohol intake, is usually macrovesicular and rarely microvesicular. Acute intrahepatic cholestasis, which in rare instances accompanies steatosis, must be distinguished from other causes of intrahepatic cholestasis (e.g., drug-induced) and from mechanical obstruction of the intrahepatic bile ducts (e.g., pancreatitis, choledocholithiasis) before being accepted. Alcoholic hepatitis (steatonecrosis) is characterized by a constellation of lesions: steatosis, Mallory bodies (with or without a neutrophilic inflammatory response), megamitochondria, occlusive lesions of terminal hepatic venules, and a lattice-like pattern of pericellular fibrosis. All these lesions mainly affect zone 3 of the hepatic acinus. Other changes, observed at the ultrastructural level, are of importance in progression of the disease. They include widespread cytoplasmic shedding, and capillarization and defenestration of sinusoids. Progressive fibrosis complicating alcoholic hepatitis eventually leads to cirrhosis that is typically micronodular but can evolve to a mixed or macronodular pattern. Hepatocellular carcinoma occurs in 5 to 15% of patients with alcoholic liver disease. The clinical syndrome of alcoholic liver disease is the result of three factors--parenchymal insufficiency, portal hypertension and the clinical consequences of extrahepatic damage produced by alcohol. At the several phases of the life history of alcoholic liver disease, the individual factors play a different role. The clinical manifestations of alcoholic steatosis are mainly extrahepatic in origin. Those of alcoholic hepatitis reflect mainly parenchymal insufficiency and those of cirrhosis are mainly those of portal hypertension. Alcoholic liver injury appears to be generated by the effects of ethanol metabolism and the toxic effects of acetaldehyde, perhaps the immune responses to alcohol- or acetaldehyde-altered proteins, and questionably enhanced by viral hepatitis. Alcoholic hepatitis may be mimicked histologically, and to a varying degree clinically, by a number of conditions (obesity, diabetes, several drug-induced injuries, jejunoileal bypass, and related "shortcircuiting" of the bowel). Perhaps the most important facet of the hepatotoxicity of alcohol is its enhancement of the effects of a number of other hepatotoxic agents, among which acetaminophen is the prime example.
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PMID:Alcoholic liver disease: pathologic, pathogenetic and clinical aspects. 205 45

After 6 months on hemodialysis, a 58-year-old male patient with diabetes developed photosensitive bullous dermatosis on his hands and face. There was no evidence of liver diseases although the patient had a history of excessive alcohol consumption. He was suspected to have iron overload in the liver. Analysis of porphyrins in plasma, hemofiltrate, urine and feces by high performance liquid chromatography revealed significantly high levels in these samples with a porphyrin profiles which is consistent with porphyria cutanea tarda. The fluorometric assays of plasma also disclosed an elevated plasma porphyrin level. And it seemed that there were correlation between the fluctuation of vesicle formation, serum ferritin level and plasma porphyrin level. Small volume plasma exchange temporarily reduced the plasma porphyrin level and prevented vesicle formation.
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PMID:[Porphyria cutanea tarda in a chronic hemodialysis patient]. 239 21

It has been reported that patients with porphyria cutanea tarda (PCT) develop carbohydrate (CHO) intolerance and manifest diabetes melitus (DM) more frequently than the normal population. In order to verify whether this is due to insulin resistance we studied 5 patients with PCT and 5 normal subjects matched for age, sex and weight. In all the patients an evaluation consisted of the glycemic curve and insulin response to an iv glucose tolerance test (IVGTT: 0.33 g/kg) as well as of an evaluation of the circulating monocyte insulin receptors. Blood samples were drawn in the basal state to measure plasma levels of NEFA, glycerol, and intermediate metabolites. The patients with PCT showed normal glucose tolerance which was obtained, however, at the expense of the elevated insulin levels: therefore a condition of insulin resistance was demonstrated in these subjects. An involvement of the lipid metabolism, observed by the raised levels of plasma NEFA and glycerol, was also evident. The insulin binding to circulating monocytes was reduced but not enough to justify the degree of insulin resistance observed. Therefore, it could be hypothesized, in agreement with similar studies, that a postreceptor defect is responsible for the insulin-resistance observed in patients with PCT and that the reduction of insulin receptors is determined by the down regulation in response to elevated insulinemic levels. An alteration of the porphyrin metabolism might be responsible for this disorder.
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PMID:Insulin resistance in porphyria cutanea tarda. 267 Nov 11

Glucose tolerance test was done in 61 patients with liver disease, 54 with porphyria cutanea tarda and 62 controls. The results showed that 45 patients (73.8%) from the liver disease group, 19 (35.2%) from the porphyria cutanea tarda (PCT) group and only 7 individuals (11.3%) from the control group had an abnormal glucose tolerance test. The differences were significant. Although nutritional state is known to influence the glucose tolerance test, we did not find any significant difference in the mean body mass index between those with an abnormal glucose tolerance test and those without in both groups of patients. Furthermore, the prevalence of an abnormal glucose tolerance test in those above and below 40 years in each group of patients was not significantly different, indicating that age probably played no significant role in this study. Therefore, glucose intolerance is common among Ethiopian patients with liver disease and PCT. As some patients with an abnormal glucose tolerance test may be expected to develop asymptomatic diabetes, we recommend that periodic blood glucose determinations should be part of the management.
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PMID:Glucose tolerance in adult Ethiopian patients with liver disease and porphyria cutanea tarda. 275 29

The clinical recognition of dioxin-associated illness can be extremely difficult for the physician. After analyzing the relative sensitivity and specificity of reported manifestations of exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD), we suggest criteria for the diagnosis of dioxin toxicity. Exposure to higher doses of 2,3,7,8-TCDD may lead to the appearance of chloracne and the increased excretion of porphyrins and porphyria cutanea tarda. Liver function abnormalities, peripheral neuropathy, hyperlipidemia, and evidence of weakness and depression may occur following exposure; however, these findings are less specific since diseases such as diabetes or alcoholism could cause several of these problems. The long-term effects of exposure to low-dose TCDD are currently uncertain.
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PMID:The diagnosis of dioxin-associated illness. 296 9

A patient with alcoholic liver cirrhosis, diabetes mellitus and porphyria cutanea tarda (PCT) is described, who subsequently died of hepatocellular carcinoma. The literature relating PCT to the incidence of primary hepatoma is reviewed, and the mechanisms underlying this possible association are discussed.
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PMID:Is porphyria cutanea tarda a risk factor in the development of hepatocellular carcinoma? A case report and review of the literature. 298 17


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