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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A consecutive series of 1002 jaundiced adult patients covering 23 different causes of jaundice is presented. Patients were followed up for 2 to 7 years. The survival for the 784 patients included during their first episode of jaundice was calculated for each diagnostic category. Examples of decreased survival as compared with the general population were (figures indicate 3 months' and 5 years' survival, respectively): alcoholic cirrhosis 0.81, 0.35; cryptogenic cirrhosis 0.78, 0.32; pancreatic carcinoma 0.54, 0.04; cholangiocarcinoma 0.26, 0.00; and heart failure with liver congestion 0.47, 0.07. Ten of 172 patients with acute viral hepatitis died, 1 of fulminant hepatitis and 9 because of suicide or accidents. Of 105 patients with gallstones 37 died during the study period, but in only 9 of these could death be attributed to the gallstone disease. New diagnostic methods and types of treatment for jaundiced patients have been developed during recent years. To justify fully these diagnostic and therapeutic modalities, knowledge of the prognosis for the various causes of jaundice is essential.
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PMID:Survival after jaundice: a prospective study of 1000 consecutive cases. 399 72

Side effects and their relationship with the material used were analyzed in 748 plasma exchanges (PE) performed in 75 patients. The total incidence of acute and mild adverse effects (chills and/or fever, paraesthesias, allergic reactions, acute anaemia, vasovagal reactions, abdominal pain and hypotension) was 18.04%. Two patients developed an episode of left cardiac insufficiency. One patient in whom all PE were performed with fresh frozen plasma (FFP) developed metabolic alkalosis. Three patients developed sepsis during treatment with repeated PE and immunosuppressive drugs; in these three patients a permanent vascular inlet was used (shunt or catheter). All patients in whom only FFP was used as replacement solution developed non-A, non-B hepatitis. Neither haemorrhagic nor thrombotic episodes were observed in these patients. It is of the greatest importance to choose the most suitable material for each patient and to develop a careful technique in order to avoid these complications during treatment with PE.
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PMID:Adverse effects secondary to the treatment with plasma exchange. 403 Jan 33

The clinical syndrome of "shock liver," also known as ischemic hepatitis, is characterized by sudden elevation (to more than 20 times the upper limit of normal) of SGOT and SGPT in response to cellular anoxia, followed by resolution to near normal levels within seven to ten days. In our experience with ten cases, systemic hypotension was documented in only four, but processes characterized by decreased cellular perfusion were identified in all and included cardiac failure or arrhythmia, sepsis, cerebrovascular accidents, renal failure, and chronic obstructive pulmonary disease. We were also able to document the transient rise in serum bilirubin and alkaline phosphatase levels and prolonged prothrombin time that followed the transaminase elevations by 24 to 48 hours in most cases, followed by rapid resolution. In neither of the two cases in which tissue was available by biopsy after resolution of the biochemical abnormalities did we find the classic histologic picture of necrosis in zone 3 ("centrilobular necrosis"). The clinical picture of shock liver is so characteristic and resolves so rapidly that there should be no confusion with other causes of marked elevations of transaminase levels.
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PMID:Shock liver. 407 Nov 67

Amiodarone is a cardiac antiarrhythmic agent now undergoing clinical trials in the United States. Its most important side effect is pulmonary toxicity, which may present radiographically in two forms. One is similar to eosinophilic pneumonia with peripheral alveolar opacities but without any of the laboratory or pathologic findings. A second presentation is as a bilateral interstitial pattern resembling interstitial pulmonary edema. This is often mistaken for heart failure in the clinical and radiographic setting. Amiodarone also causes a phospholipidosis of the liver, which is usually asymptomatic but on occasion may present as hepatitis. On abdominal CT the liver will have an abnormally high attenuation (80-140 HU), which appears to be due to accumulation of an amiodarone metabolite in hepatocytes. This appearance is usually distinguishable from the other causes of increased hepatic attenuation by virtue of other CT criteria and clinical history. However, from a radiographic standpoint alone, the combination of acute congestive heart failure and an abnormally dense liver may result in at least an initial misdiagnosis of advanced primary hemochromatosis.
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PMID:Dense liver in a 72-year-old woman with congestive heart failure. 407 46

Among 2175 patients seen over the last three years in a non-specialized department of internal medicine with no intensive care unit, 100 had supranormal serum lactic dehydrogenase activities. These patients' case-reports have been analyzed. Nearly half the patients (47/100) had a malignant disease (cancer or hemopathy). Among the remaining patients, 19 had a hepatic disorder (alcohol hepatitis in 10, viral hepatitis in 8, and isoniazide hepatitis in 1), 7 had a heart disease (heart failure with hepatomegaly in 5, myocardial infarction in 2), and 27 had various other conditions (including hemolysis in 6 and polymyositis en 3). The value of serum LDH assay is obvious in situations other than acute conditions such as myocardial infarction of pulmonary embolism; these are better known and have not been studied here as their prevalence was low among the patients enlisted in our study. In comparison to other enzymes (alkaline phosphatase (AP), gamma-glutamyl transpeptidase (GGT), transaminases (GOT, GPT) that were also routinely assayed in our patients, abnormal serum LDH activities are much less common and their significance is quite different. An increase in serum and their significance is quite different. An increase in serum LDH activity indicates a serious condition, often with a fatal outcome. The "various other conditions" group includes patients with hemolysis, hepatitis and myositis; the other patients in this group either had severe infectious diseases or died suddenly in the first few days of their hospitalization before diagnosis had been established. Each etiologic group has been analyzed to asses the characteristics of patients with increased LDH activity according to each etiology. Analysis of coincident abnormalities of the other enzymes listed above shows marked differences between etiologic groups; diagnostic accuracy can thus be enhanced in certain conditions. Most patients with malignancies had poorly differentiated tumors, with metastases: 28 had an epithelial tumor, with hepatic and/or bone metastases in 23 cases, 5 had cancer of the liver, 10 had a malignant hemopathy (2 lymphomas, 5 myeloproliferative syndromes, 3 acute leukemias), and 4 had a sarcoma. Cancer of the lung is the most common malignancy (10 cases) and may be responsible for increased serum LDH activity even in patients without metastases. Serum LDH assay is of value for monitoring the course in patients with initially increased activities as it falls under effective therapy and rises during exacerbations.
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PMID:[Value and diagnostic significance of serum lactic dehydrogenase in internal medicine (author's transl)]. 628 24

Severe congestive cardiac failure developed in a few weeks in a 44 year old man who had undergone porto-caval anastamosis for post-hepatitis cirrhosis one year previously and then treated for anaemia by repeated blood transfusion and chronic daily oral iron therapy. Infiltrative, congestive and restrictive cardiomyopathy was diagnosed in the presence of global cardiomegaly, electrocardiographic changes (microvoltage, diffuse ST-T wave changes), echocardiographic appearances (dilatation of the left ventricle, with hypertrophic and hypokinetic walls), and hemodynamic signs of adiastole with equalisation of filling pressures at 15 mmHg and a cardiac index of 1,88 l/min/m2. Cardiac haemochromatosis was confirmed by the laboratory (serum iron: 35 mumol/l; siderophilin saturation: 100 p. 100; serum ferritin: 1854 ng/ml; induced siderouria: 51 mg/24 hours) and histological findings (endomyocardial biopsy showing pigment overload). The absence of a family history, of homozygote A3 antigen, of diabetes, of iron overload on hepatic biopsy one year previously, excluded the diagnosis of familial idiopathic haemochromatosis. A secondary form of the disease was diagnosed on a possible genetic predisposition (heterozygote A3 antigen) and on environmental factors (blood transfusions, iron therapy, cirrhosis, alcoholism and perhaps the porto-caval anastamosis. Cardiac haemochromatosis was cured in this case by iron chelating therapy comprising daily subcutaneous infusions of 2 g of desferrioxamine for 2 months. The cure was confirmed by regression of the signs of clinical cardiac failure and of cardiomegaly, the increase in QRS voltages and the near normalisation of the hemodynamic and laboratory findings.
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PMID:[Adiastole caused by a secondary cardiac hemochromatosis. Successful treatment with an iron chelating agent]. 641 3

175 patients with histological evidence of chronic diffuse liver disease, 67 patients with heart failure, diabetes and atherosclerosis, and 118 healthy adults under 30 years of age engaged in sports were studied for the prevalence of hepatitis A virus antibody (anti-HAV) by radioimmunoassay using a HAVAB (Abbott)-kit. Infection with hepatitis-A virus is highly prevalent in Hungary, anti-HAV having been demonstrated in a very high proportion of controls as well as of patients. Over the age of 40 the incidence is 100% in controls and 98% in patients with chronic liver disease. Infection with hepatitis-A virus must have been asymptomatic in the majority, since no more than 11.4% of the subjects had a history of acute hepatitis. The prevalence of acquired anti-HAV increases with age until it attains 100% in advanced age. The present results lend no support to the possibility that hepatitis-A virus infection might be involved in the production of chronic diffuse liver disease.
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PMID:Hepatitis a virus antibody in chronic diffuse liver disease. 666 44

Jaundice is often the first and also most prominent sign of liver disease. A knowledge of liver involvement in systemic and extrahepatic disease is of practical significance for a precise diagnosis and specific therapy. Since this syndrome is complex with multifactorial causes, the following classification has been employed. Jaundice in heart failure, drug-induced jaundice, jaundice resulting from infection, postoperative jaundice. In the discussion the following points have been emphasized. A pattern of jaundice similar to hepatitis can be observed even in isolated left heart failure. Tetracyclines are able to cause an acute fatty liver with jaundice. Clostridia infections should always be considered in the case of raised indirect bilirubin postoperatively. Cautious waiting is indicated initially in the case of "benign postoperative cholestasis".
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PMID:[Icterus - in intensive care]. 669 62

Twenty cases of sonographically visualized thickening of the gallbladder wall were reviewed and the clinical diagnoses compiled. In only eight of these patients was cholecystitis considered responsible for the finding. The rest had hepatitis, alcoholic liver disease with hypoproteinemia, heart failure, renal disease, and multiple myeloma; however, all lacked clinical evidence of gallbladder disease. Because of these findings, caution is urged in making the diagnosis of cholecystitis on the basis of wall thickening alone.
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PMID:Sonography of the thickened gallbladder wall: a nonspecific finding. 678 Dec 56

Two patients abruptly developed congestive heart failure and elevation in serum transaminase levels when given disopyramide phosphate; enzyme abnormalities and hemodynamic status corrected upon withdrawal of the drug. Both patients had underlying ischemic cardiomyopathy. Myocardial infarction, pulmonary embolism, and viral hepatitis were ruled out in both patients. One patient had a liver biopsy documenting central hepatic necrosis with congestion, consistent with hepatic ischemia and not toxic hepatitis. In the other patient, cardiac decompensation and hepatocellular enzyme elevation were reproduced on rechallenge with the drug. Disopyramide should be used with caution in patients with heart failure.
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PMID:Acute cardiac failure and hepatic ischemia induced by disopyramide phosphate. 722 41


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