Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report four cases of severe delayed cholestatic hepatitis induced by flucloxacillin. All patients presented with deep jaundice and pruritus which developed soon after ceasing flucloxacillin. Liver function tests were abnormal in all patients with markedly elevated serum bilirubin concentration, alkaline phosphatase and aspartate transaminase levels. Extrahepatic biliary obstruction and infective hepatitis were excluded in all cases. Liver biopsies showed centrilobular cholestasis with portal and lobular inflammation and eosinophil infiltration. Although symptoms resolved within six weeks in all patients, cholestatic liver function tests have persisted in two patients for more than six months. With the increasing usage of this drug and the delayed presentation of cholestasis, flucloxacillin needs to be considered in the differential diagnosis of all patients presenting with cholestatic jaundice.
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PMID:Flucloxacillin induced delayed cholestatic hepatitis. 237 76

Acute, drug-induced hepatocellular cholestasis (either pure or cholestatic hepatitis) is a common manifestation of drug-induced hepatic injury. The drugs most frequently responsible are hormonal steroids and psychopharmacological agents (in particular phenothiazines and some antidepressants). Cholestasis usually subsides without sequelae in less than six months. Acute, drug-induced ductular cholestasis is uncommon and can resemble biliary tract obstruction. Complete recovery occurs promptly after the withdrawal of the causative drug in most cases. The pathogenetic mechanism may be immunoallergic. Prolonged ductular or ductal cholestasis can follow drug-induced acute hepatitis despite prompt withdrawal of the offending drug. This syndrome, observed mainly with chlorpromazine and uncommonly with twenty other drugs, is characterized by the progressive disappearance of small bile ducts and by manifestations mimicking primary biliary cirrhosis. However, its prognosis appears to be better than that of primary biliary cirrhosis, the condition being reversible in the majority of cases or even subsiding completely. The mechanism is still unknown, but several features suggest some form of autoimmunity. Extrahepatic cholestasis related to sclerosing cholangitis is a frequent and long-term complication of intra-arterial infusion of floxuridine in patients treated for hepatic metastases from colorectal carcinoma. Although it may be reversible, floxuridine-induced sclerosing cholangitis has a poor prognosis and can lead to death in a few patients. The mechanism is probably related to the vascular supply of the common hepatic duct and its relationship to the perfusion territory of floxuridine.
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PMID:Drug-induced cholestasis. 304 69

The causes of cholestasis in 276 patients with a total of 296 lesions were studied. Extrahepatic cholestasis was found in 58.4 percent of the patients, and 41.6 percent had intrahepatic cholestasis. Malignant disease was found in 34.8 percent of the patients (extrahepatic cholestasis in 20 and intrahepatic cholestasis in 70). Cholangiocarcinoma, especially the hilar intrahepatic type, seems to be the most prevalent in the medical literature. It is possible that the combination of opisthorchiasis and carcinogenic agents, such as nitrosamines, induce a precancerous stage at the hilar area. Some unknown factors, may be the immune system in immune surveillance that act as a catalyst leading to malignant transformation. Acute calculous cholecystitis, choledocholithiasis, and intrahepatic stones are more common in Thailand than in the western countries, and their causes have been discussed herein. The composition of stones is also different; pigment stones are found more often in Thailand. These differences between the western and oriental types of biliary calculi are significant in regard to diagnostic approach and management, and morbidity and mortality. In Thailand, Opisthorchiasis viverrini has significant influence in the development of several cholestatic diseases, such as hilar intrahepatic cholangiocarcinoma, biliary calculi, opisthorchiatic intrahepatic cysts, and aggregated dead opisthorchiatic worms blocking the biliary system. In tropical countries, infectious diseases such as virus B hepatitis; severe systemic infectious diseases such as salmonellosis; and amebiasis and tuberculosis were also important causes of intrahepatic cholestasis. In the category of congenital anomalies, the prevalence of choledochal cysts was higher than in the United States. The prevalence of other forms of congenital anomalies of the biliary system is unknown, but may be similar to the prevalence of choledochal cysts.
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PMID:Causes of cholestasis in Thailand. A study of 276 consecutive patients. 670 7

Cytologic criteria were evaluated for their diagnostic value in liver disease in dogs. Therefore, histopathologic and cytologic examination was performed on liver biopsy samples of 73 dogs with liver diseases and 28 healthy dogs. Logistic regression analysis was used to select the measured parameters to be included in a multistep approach. With the logistic regression method, different characteristic cytologic parameters could be defined for each histopathologic diagnosis. In malignant lymphoma of the liver, the presence of large numbers of lymphoblasts with a minimum of 5% of all cells was found. Clusters of epithelial cells with several cytologic characteristics of malignancy intermixed with normal hepatocytes were indicative of metastatic carcinoma or cholangiocellular carcinoma. Liver cells in hepatocellular carcinoma were characterized by a high nucleus/cytoplasm ratio, large cell diameters, increased numbers of nucleoli per nuclei, small numbers of cytoplasmic vacuoles, and frequently, small numbers of lymphocytes. Extrahepatic cholestasis was characterized by excessive extracellular bile pigment in the form of biliary casts, an increased number of nucleoli within hepatocytes, decreased hepatic cell size, and low numbers of lymphocytes. In destructive cholangiolitis, increased numbers of neutrophils and a small mean nuclear size within hepatocytes were seen. Acute and nonspecific reactive hepatitis are diagnosed based on the presence of moderate reactive nuclear patterns, including more pronounced chromatin, prominent nucleoli, increased numbers of inflammatory cells, excluding lymphocytes, and the absence of increased numbers of bile duct cell clusters. Increased number of mast cells also was indicative of nonspecific reactive hepatitis. Important cytologic criteria for the diagnosis of liver cirrhosis, in addition to chronic hepatitis, are intracellular bile accumulation and increased numbers of bile duct cell clusters. In summary, the stepwise approach based on logistic regression presented in this study might be helpful in the objective cytologic diagnosis of hepatic diseases.
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PMID:A multistep approach in the cytologic evaluation of liver biopsy samples of dogs with hepatic diseases. 1534 18

The scope of this article precludes an 'in depth' description of all liver problems and I will limit this review to anaesthesia for biliary atresia - a common hepatic problem in the very young - and partial hepatectomy in older children. I will not be discussing the problems of anaesthetising children with hepatitis, cirrhosis, congenital storage diseases or liver failure. Extrahepatic biliary obstruction is an obliterative cholangiopathy of infancy which is fatal if untreated. Diagnosis involves exclusion of other causes of neonatal jaundice and treatment involves a hepatico portoenterostomy carried out at the earliest. This is a review of current concepts in anaesthesia and postoperative management of neonates with extrahepatic biliary atresia. Anaesthesia for hepatic resection has seen great changes in recent times with the improvement in surgical techniques, technology and a better understanding of the underlying physiology. These are reviewed along with the problems of postoperative pain management.
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PMID:Anaesthesia for biliary atresia and hepatectomy in paediatrics. 2329 87