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

In a prospective study 148 consecutive patients with biopsyproved acute viral hepatitis were observed serially and followed for 5 years. They were divided into three groups on the basis of being treated with high or low doses of gamma globulin and compared with a control group, not treated. As the efficacy of gamma globulin for the prophylaxis or modification of infectious hepatitis has been well documented by many investigators during the past 25 years, we were interested in evaluating the therapeutic effect of gamma globulin on the course of viral hepatitis. The purpose of the study was to determine the comparative efficacy of various doses of gamma globulin in preventing complications and in influencing the severity and the length of time of acute viral hepatitis and in preventing the development of chronic hepatitis and cirrhosis. For controlling the clinical, biochemical and histopathologic course 12 functional parameters were repeatedly measured under stable clinical conditions and 3--12 liver biopsies were performed in an individual patient using the Menghini needle with an intercostal approach. During the 5-year trial an overall of 825 liver biopsis were performed with this 148 patients. We conclude from this study, that in about 80% of patients with acute viral hepatitis recovery is complete, but takes several month's. A protracted course of 4 month's duration until recovery was found in 45 patients (30,4%), persistent hepatitis with recovery after 1--4 years duration occurred in 37 patients (25%), global liver necrosis with hepatic coma in 3 (2,3%), chronic hepatitis in 22 (14,8%), 8 of them as chronic aggressive hepatitis and cirrhosis in 3 (2,3%). The study demonstrated no therapeutic efficacy of gamma globulin in modifying the course or preventing complications of both AuAg+ and AuAg-neg. acute viral hepatitis in man. There was no striking difference in the groups treated with various doses of gamma globulin compared with a control group.
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PMID:[Gamma globulin therapy of acute viral hepatitis. Studies on the therapeutic effect of gamma globulin on the course and late prognosis of manifested acute viral hepatitis in man]. 5 14

Viral hepatitis has been known to occur among the Greenland population endemically as well as in smaller and larger epidemics. A large epidemic of acute hepatitis comprising around 9% of the entire population, viz. more than 4000 notified cases, swept through Greenland between October 1970 and December 1972. 996 verified cases were seen in the Godthaab district and subjected to more detailed studies. Most of the Godthaab cases were seen among children and adolescents, and no disease was observed in children less than one year of age. Out of 996 diagnosed cases 9 showed acute hepatic failure with coma. Two further cases of hepatic coma were referred for treatment from outside the district. Three of these 11 patients recovered spontaneously. Of the residual 8 cases 6 were treated with exchange transfusions and steroids. Four of these survived and recovered completely. No lasting sequelae had been registered in any of the surviving cases of the epidemic up to June 1975 (2 1/2 years after cessation of the epidemic). Prophylaxis with gamma-globulin was undertaken in a medium-sized settlement in which practically the entire population received gamma-globulin when the first case of hepatitis was diagnosed. In this settlement only 7 out of 297 inhabitants contracted hepatitis. By contrast, in a similar settlement where no gamma-globulin was given, more than 30% of the population developed icteric hepatitis. The clinical features and the prophylactic effect of gamma-globulin seem to indicate that the epidemic was caused by the hepatitis A virus. In accordance with this, transitory Australia-antigenaemia was demonstrated in the acute phase in only 2.6% of the cases, possibly inidicating a small admixture of acute hepatitis type B to the epidemic predominantly caused by hepatitis A virus.
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PMID:The 1971-72 epidemic of acute viral hepatitis in Godthaab, Greenland. 5 37

Alpha-fetoprotein levels were measured by radioimmunoassay in 40 cases of acute viral hepatitis, 5 cases of chronic persistent hepatitis, 15 cases of chronic aggressive hepatitis and 5 cases of hepatic coma from fulminant viral hepatitis. Serum concentrations were increased in 55% of patients with acute viral hepatitis and in about 33% of patients with chronic aggressive hepatitis. Levels resulted markedly raised among the patients with coma from fulminant viral hepatitis who survived. The high aplha-fetoprotein values may reflect liver cell regeneration after necrosis of a critical mass of hepatic tissue.
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PMID:Serum alpha-fetoprotein in viral hepatitis and its complications. 6 58

An attempt was made to find reliable indices for the early recognition of fatal cases of acute viral hepatitis, using the values of serum proteins with rapid turnover. Prealbumin and alpha2-HS-glycoprotein were measured in the sera of 44 cases by immunodiffusion method before the appearance of hepatic coma and/or gastrointestinal bleeding. The difference of the mean values of prealbumin between fatal and surviving cases of subacute form of fulminant hepatitis was not statistically significant. In contrast to this, there was statistically significant difference between both groups in the mean values of alpha2-HS-glycoprotein (p less than 0.05). The present results indicate the possibility of differentiating fatal cases from surviving ones at an early stage, using the reduction of alpha2-HS-glycoprotein by a simple and reproducible immunodiffusion method.
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PMID:The measurement of serum proteins with rapid turnover for early diagnosis of fatal hepatitis. 9 44

A consecutive series of 24 cases of primary carcinoma of the liver in Malawi has been investigated. Histologically, all were hepatocellular carcinomas (HCC). All patients were African Bantus, the average age was 42.7, and the sex ratio was men 3.5:women 1. The duration of symptoms attributable to HCC was about 5 months previous to admission to hospital and was in no case preceded by clinically manifest cirrhosis. The clinical picture was rather uniform with pain in the region of the liver, emaciation and nodular hepatomegaly as the most important features. One of the patients had repeated attacks of hypoglycaemic coma. Sera from 11 out of 13 patients contained alpha-feto-protein. Hepatitis-associated antigen and antibody in the serum were found in 7 and 6 out of 16 and 14 cases respectively. Serum B12 and serum unsaturated B12 binding capacity were moderately raised in most patients. The prognosis was poor, the average time of survival was 4.8 weeks after admission. The cause of death was most frequently hepatic coma. HCC in the African Bantu shows some different features from the same disease in the Western Hemisphere: The incidence is much higher; the patients are younger. The neoplasm commonly develops in a clinically latent cirrhosis. The latter is not caused by alcohol, but is presumably a sequel of hepatitis. It is possible that aflatoxin is the carcinogenic factor, acting more readily in a cirrhotic than in a normal liver.
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PMID:Primary carcinoma of the liver in Malawi: a review of 24 cases. 19 21

The chief causes of liver disease in Ethiopia are reviewed, considering hospital data on admissions for hepatitis, cirrhosis, ascites and hepatoma. Liver diseases account for 11.4% of all medical admissions in 3 medical wards in Addis Ababa. The causes are viral hepatitis, post- hepatic and post necrotic and mixed cirrhosis and hepatocellular carcinoma. Alcoholic cirrhosis is rare. Viral hepatitis with shivering, rigor and fever and elevated direct bilirubin levels are common in Ethiopians, especially in child-bearing women. The hepatitis B surface antigen (HBsAg) is often associated with hepatitis. The disease may be transmitted by several species of mosquitoes, placental transmission, or feces, urine, saliva or semen. Blood products are not screened for hepatitis B. Cirrhosis is common, and causes significant mortality, usually from esophageal varices and hepatic coma. Chronic active hepatitis patients may live for a time, especially if they are near a hospital and are treated with steroids. In Ethiopia presenting symptoms for hepatoma are anorexia, weight loss, persistent, burning, right upper quadrant pain, and a hard, nodular, tender RUQ mass. Over 5% of malignancies seen are primary hepatocellular carcinomas. 50% have HBsAG, compared to 3.8% of controls. 65% have alpha-fetoglobulins. It is suggested that some viral hepatitis cases progress to cirrhosis, of which some go on to hepatocellular carcinoma. Herbal medicines, aflatoxins and other toxins may also contribute to liver disease.
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PMID:Current views on liver diseases in Ethiopia. 20 62

Exchange transfusion (ET) were made twice on a 22 year old patient with fulminant hepatitis and hepatic coma. The influence of the ET on the plasma amino acids (PAA) was examined. The 1. ET reduced the concentration of the total PAA from 10,023 to 7,152 mugmol/l (about 28.6%) and the 2. ET from 11,770 to 9,706 mugmol/l (about 17.5%). Three hours after the 1. ET the concentration of the total PAA has passed over the prevalue and after the 2. ET has nearly reached it. The influence of both ET on the concentration of the individual PAA was very different (- 47.9% to + 71.2% after the 1. ET and - 32.9% to + 41.8% after the 2. ET respectively). Therefor the ET seems to be not a suitable method to reduce the pathologic concentration of the PAA in the hepatic coma.
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PMID:[Effect of exchange transfusion on the plasma amino acid concentration in hepatic coma]. 40 54

The clinical course and prognosis of hepatic coma were examined in 102 patients treated in the period from 1958 to 1975. The diagnoses included 9 fulminant hepatitis, 7 subacute hepatitis, 53 liver cirrhosis without liver carcinoma (40 cases of the acute type, 10 cases of the chronic type and 3 cases of another type, according to Sherlock's classification of hepatic coma) and 33 liver cirrhosis with primary liver carcinoma. Four of 9 fulminant hepatitis patients gained consciousness within 1 week and recovered completely. Seven subacute hepatitis patients died within 2 weeks after onset of hepatic coma. In the period from 1958 to 1969, 20% of liver cirrhosis patients with the acute type of coma recovered from coma, and in the period from 1970 to 1975, 45% of patients recovered. Seven of 10 patients with the chronic type of coma died between 4 months and 9 years after the onset of coma. Three other patients are presently still alive. The median survival time was 2.5 years. Nine primary liver carcinoma patients with coma were hospitalized from 1958 to 1969 and 24 from 1970 to 1975. Hepatorenal syndrome was present in 31 of 71 examined patients. Twenty-three patients with hepatorenal syndrome were in the period from 1970 to 1975.
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PMID:Clinical course and prognosis of one hundred and two patients with hepatic coma 1958 through 1975. 59 69

An attempt was made to find reliable indices for early diagnosis of fatal cases of acute viral hepatitis, using the values of serum proteins with rapid turnover. Of the subfractions of serum protein, prealbumin, alpha2-HS-glycoprotein and Normotest were measured simultaneously before the appearance of hepatic coma/or gastrointestinal bleeding in 78 cases of acute viral hepatitis, verified by biopsy or necropsy. The mean value of prealbumin with a very short half-life of one or two days, was 6.0 mg/dl in fatal cases, 7.4 mg/dl in surviving ones of subacute form of fulminant hepatitis. The difference between fatal and surviving cases was not statistically significant. In contrast to this, the values alpha2-HS-glycoprotein with a comparatively short halflife of four to six days, showed statistically significant difference between fatal (21.9 mg/dl) and surviving cases (37.4 mg/dl). Normotest was also depressed in fatal (10.7%) and surviving cases (45.3%). The difference was statistically significant. The present results indicate the possibility of differentiating fatal cases from surviving ones at an early stage, using the reduction of alpha2-HS-glycoprotein and the value of Normotest.
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PMID:Rapid turnover serum proteins in fulminant hepatitis. 60 67

Aliphatic mercaptans (aethanthiol, methanthiol, dimethylsulphide) can be measured in serum with a simple and rapid gaschromatographic method. The test takes 30 minutes. Aethantiol was found to be increased ten-fold (P less than 0.0001) in patients with acute hepatic failure (endogenous coma), while in exogenous hepatic coma it was always normal or decreased. Mild increase in aethanthiol concentration (two or threefold) was also found in chronic aggressive hepatitis, cirrhosis and obstructive jaundice. Methanthiol concentration was elevated in patients with endogenous and exogenous hepatic coma. Values for methanthiol are, however, of only limited use, because methionine is converted in small amounts to methanthiol during the test procedures. Dimethylsulphide is found in only very severe cases of endogenous or exogenous hepatic coma and can be considered to be a prognostically unfavourable sign. Determination of mercaptans makes it possible to differentiate exactly between endogenous and exogenous hepatic coma. Its value also lies in the recognition of the severity of endogenous intoxication and it is suitable for serial and control determination of the effectiveness of therapeutic measures.
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PMID:[The diagnostic value of determining serum-mercaptans in liver disease (author's transl)]. 71 Feb 90


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