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)

A retrospective analysis of survival time and causes of death has been undertaken in 109 patients treated for multiple myeloma (MM) at the Hematologic Clinic of the Russian Research Institute of Hematology and Transfusiology in 1979-1995. Group I included cases of mono- and group II-polychemotherapy (PCT). Survival in patients with MM increased significantly (from 27 to 43 months) after PCT. The main causes of death in MM patients of group I were chronic renal failure and infectious complications, while in group II-intoxication syndrome including blood toxicity, toxic hepatitis, etc. In cases of this grave disease, the effectiveness of therapy appeared to depend on both main and supporting treatment. Of great importance was profuse hydration using diuretics, active rheologic preparations, plasmapheresis and other counter-complication means. Following the administration of immunity correction drugs (thymaline, tactivin, immunoglobulin), infectious complication incidence in group II dropped from 22 to 8.3%. It is suggested that the effectiveness of MM therapy is determined by stage-by-stage approach, course cycling of PCT and adequate evaluation of its criteria. PCT courses should be supplemented with infusion detoxication measures, particularly, in cases of highly aggressive PCT schemes, and procedures of immunity correction, hemo-component therapy and plasmapheresis.
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PMID:[Effect of various chemotherapy regimens on survival and cause of death in patients with multiple myeloma (retrospective study)]. 924 97

Anaemia is an almost invariable sign of chronic renal failure [1]. Although many factors have been implicated as causes of this anaemia, it seems probable that deficiency of erythropoietin is the main cause for most patients [2]. Institution of chronic dialysis can improve anaemia in end-stage kidney disease, continuous ambulatory peritoneal dialysis being reported as more successful [3]. The aim of this study was to investigate the influence of haemodialysis and continuous ambulatory peritoneal dialysis on anaemia during the first six months of treatment. We examined 21 persons (14 males and 7 females, aged from 18 to 78 years) on haemodialysis treatment and 13 persons (6 males and 7 females aged from 22 to 64 years) on continuous ambulatory peritoneal dialysis (Table 1). Standard procedures were used for measuring biochemical parameters. Urea and creatinine levels were high, almost incompatible with life, in all tested persons before dialysis treatment. During the first three months of both dialysis techniques urea and creatinine were significantly (p < 0.01) corrected, but remained above the normal ranges (Table 2). Patients on continuous ambulatory peritoneal dialysis have shown significantly (p < 0.01) lower urea and creatinine values compared to patients on haemodialysis (Graph 1). These data suggest better preservation of renal function and better control of the internal environment during continuous ambulatory peritoneal dialysis [6]. All tested patients were severely anaemic before the beginning of dialysis. During the first six months of haemodialysis erythrocyte count, haematocrit and haemoglobin levels were unchanged (Table 3). Transfusions and hepatitis episodes only temporary improved anaemia. Patients on continuous ambulatory peritoneal dialysis exhibited significant correction of anaemia already during the first three months of treatment (Graph 2). Though less significantly, haemoglobin values continued to rise even during the next three months. The reached haemoglobin levels were lower than normal, but significantly higher than values in patients on haemodialysis (p < 0.01), suggesting better control of anaemia during continuous ambulatory peritoneal dialysis. Transfusion requirement was irrelevant, and hepatitis was not noticed, so they cannot be held responsible for the improvement of anaemia. Greater iron consumption, illustrated by higher transferrin saturation, also confirmed increased erythopoitesis in patients undergoing continuous ambulatory peritoneal dialysis. They also had lower blood iron level than those on haemodialysis (who had) numerous blood transfusions. The improvement of anaemia during continuous ambulatory peritoneal dialysis may be the result of reduction in plasma volume [7] as well as an increase in red cell mass and a better clearance of middle molecules in comparison to patients on haemodialysis. The main cause is higher erythropoietin level [8]. All tested patients had low folic acid level. Patients who corrected anaemia showed fall in folat level. This was statistically remarkable during the first three months of continuous ambulatory peritoneal dialysis-from 3.64 ng/ml to 2.09 ng/ml. All these data suggest that both dialysis modalities are effective in the control of protein waste products level, but continuous ambulatory peritoneal dialysis has better influence on the improvement of anaemia that haemodialysis. This can be attributed to better removal of uremic toxins, improved protein metabolism, lower parathyroid hormone level and higher erythropoietin value due to peritoneal macrophage production.
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PMID:[The effect of hemodialysis and continuous ambulatory peritoneal dialysis on renal anemia]. 926 38

We report 81 of 107 cases of hemolytic uremic syndrome (HUS), admitted between July 1994 and February 1996, following an outbreak of Shigella dysenteriae type 1 dysentery in Kwazulu/Natal. All patients, excluding 1, were black with a mean age of 38 months (range 1-121); 50 (61.7%) were males. The mean duration of dysentery was 11.3 days (range 1-41) and HUS 15 days (range 1-91). Most patients had acute oliguric renal failure (90.1%), 42 (51.6%) required peritoneal dialysis. Complications included encephalopathy 30 (37.0%), convulsions 12 (14.8%) and hemiplegia 2 (2.3%), gastrointestinal perforation 8 (9.9%), protein losing enteropathy 26 (32.1%), toxic megacolon 4 (4.9%), rectal prolapse 5 (6.2%), hepatitis 11 (13.6%), myocarditis 5 (6.2%), congestive cardiac failure 3 (3.7%), cardiomyopathy 3 (3.7%), infective endocarditis 1 (1.2%), septicemia 15 (18.5%), disseminated intravascular coagulation 17 (21%). Leukemoid reactions were found in 74 (91.3%) patients, hyponatremia in 56 (69.1%), and hypoalbuminemia in 67 (82.7%). Stool culture for Shigella dysenteriae type I was positive in only 7 (8.6%) patients; Shiga toxin assays were not performed. Outcome was as follows: recovery 32 (39.5%), impaired renal function 8 (9.9%), chronic renal failure 26 (32.1%), end-stage renal disease 1 (1.2%), and death 14 (17.3%) patients.
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PMID:Post-dysenteric hemolytic uremic syndrome in children during an epidemic of Shigella dysentery in Kwazulu/Natal. 932 80

We have studied the relationship between T-cell receptor (TCR) density, genetic factors and the specific immune response in 153 end stage renal disease (ESRD) patients on haemodialysis immunised with HBsAg vaccine. One-hundred and nineteen patients raised a protective (> 10 U/ml) antibody response to hepatitis-B vaccination (responder, R), while 34 patients were found to be non-responders (NR). The density of the T-cell receptors was determined by flow cytometry. Proliferation of the T-cells induced by autologous monocytes presenting HBsAg was also measured and expressed as a stimulation index (SI). MHC class I, II and III alleles of the patients were also determined. The densities of TCR/CD3 receptors in NR patients were found to be significantly decreased as compared to the R patients (189 +/- 22 vs. 282 +/- 58 arbitrary units, P = 1.3 x 10(-7). TCR/CD3 receptor densities were found to be strongly associated (Spearman correlation coefficient: 0.84, P < 0.000001) with the SI values. Both parameters were found to be under dual genetic control: (a) very low density of the TCR/CD3 receptors and very low SI were found mainly in NR patients carrying HLA-A1, HLA-B8 and HLA-DR3 alleles; and (b) TCR/CD3 densities and function in R group were found to be significantly lower in carriers than in non-carriers of two MHC class III complement protein alleles: C4A*6, and Bf*F. Non-responsiveness to hepatitis-B vaccination was found to be associated with extremely increased neopterin levels. These findings indicate that both genetic and acquired factors contribute to the hepatitis-B vaccination failure in ESRD patients.
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PMID:Genetic regulation of the impaired immune response to hepatitis-B vaccine associated with low TCR density in end stage renal disease patients: contribution of complement C4 and factor B alleles. 933 52

The prevalence of GBV-C infection in voluntary blood donors and in groups at high risk for parenteral exposure to infectious agents was studied. The high risk groups included chronic renal failure patients on haemodialysis, renal transplant patients and haemophiliacs from Gauteng. The presence of GBV-C RNA in these populations was determined using reverse transcription polymerase chain reaction (RT-PCR) in the 5' non-coding region (NCR) of the virus. Of the blood donors, 11.1% (95% CI 7.6, 15.8) were positive, whereas 23.8% (95% CI 12.6, 40.2) of haemodialysis patients and 23.5% (95% CI 15.9, 33.3) of the haemophiliacs were infected with GBV-C. The highest proportion of infection was in the renal transplant patients, where 41.2% (95% CI 35.1, 47.7) were found to have circulating GBV-C RNA. Serological markers for hepatitis B (HBV) and hepatitis C viruses (HCV) were also measured as indicators of other hepatitis viruses with important parenteral transmission routes. Of the GBV-C positive blood donors, 3.6% were also HBsAg positive and none were positive for HCV. The GBV-C positive patients on haemodialysis were not positive for either HBsAg or antibodies to HCV, but had evidence of past infection with HBV since 40% were anti-HBc positive. The greatest proportion of HCV positives was in the haemophiliac group, 91.3%, none of these were HBsAg positive but 39.1% had anti-HBc. In the GBV-C positive renal transplant patients, 4% had HBsAg, 13.3% had anti-HBc and 2.1% had antibodies to HCV. This is the first report describing the prevalence of GBV-C in South African populations.
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PMID:GB virus C prevalence in blood donors and high risk groups for parenterally transmitted agents from Gauteng, South Africa. 959 29

Ischemic hepatitis, a relatively infrequent disorder occurring in 0.16% to 0.50% of patients admitted to medical intensive care units, often follows episodes of hypotension or acute heart failure. Investigating the clinical characteristics of patients with ischemic hepatitis may add to our understanding of the pathogenesis and significance of this syndrome. We therefore conducted a retrospective analysis of 34 patients to examine the possible contribution of the various baseline characteristics to the severity of the hepatic damage. In all patients liver disease was unexpected and in some, liver dysfunction dominated the clinical picture. All patients had high serum glutamic pyruvic transaminase (SGPT) and lactic dehydrogenase (LDH) levels (mean +/- SE, 2073 +/- 255 international units and 6085 +/- 748 international units, respectively). The mean SGPT/LDH ratio was 0.34. Most patients had coagulopathy with a prolonged prothrombin time (mean +/- SE, 5.86 +/- 1.37 international normalized ratio [INR]). The most common diagnosis on admission was respiratory distress secondary to various causes. Before the development of the hepatic dysfunction, respiratory failure and hypoxemia were observed in 68% of the patients, whereas hypotension was observed in only 38%. More than 90% of the patients had three or more associated comorbid conditions. The most frequent of these were left heart failure (88.2%), right heart failure (67.6%), chronic obstructive lung disease (58.8%), and chronic renal failure (55.9%). During the acute episode, more than 90% of the patients had transient deterioration of their renal functions. Hypoglycemia was noted in 11 patients (32.4%), and the glucose level was inversely correlated with the SGPT level (r = -0.43, p = 0.01). Stepwise multiple regression analysis showed that left heart failure, systolic blood pressure lower than 90 mm Hg, and female gender, together, accounted for 34% of the variance of the peak SGPT levels (p = 0.002). Fourteen (41.2%) patients died during the 3-month follow-up period, but none from the hepatic injury. None of the clinical or laboratory parameters measured predicted mortality. Clearly, ischemic hepatitis is associated with a high risk of death. The characteristic patients are those with multiple underlying systemic diseases and conditions, especially those with left heart failure. Liver function test results and levels of liver enzymes should be monitored in these patients, particularly when they are admitted for respiratory deterioration and episodes of hypotension.
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PMID:Ischemic hepatitis: clinical and laboratory observations of 34 patients. 960 Mar 66

A 43-year-old man underwent living related-donor renal transplantation because of chronic renal failure in 1991. During the transplant period, both donor and recipient were seronegative for hepatitis B surface antigen (HBsAg). The donor was seropositive for antibody to hepatitis B surface antigen (anti-HBs) due to hepatitis B virus (HBV) vaccination. After transplantation, FK506 and methylprednisolone had been administered to the patient as immunosuppressants. In 1993, HBsAg appeared in his serum. His alanine aminotransferase level elevated gradually during 1995 and then in 1996, general fatigue, ascites and jaundice developed. At this time his serum was positive for hepatitis B e antibody, contained more than 100000 Meq/mL HBV-DNA and 100% precore mutant. Despite subsequent intensive therapy, liver dysfunction progressed and this patient died of hepatic failure 2 months following admission. At autopsy, the liver exhibited cholestasis, fibrosis extending from the portal tracts, mild inflammation and hepatocytes with a ground-glass appearance. In addition, HBsAg and hepatitis B core antigens had accumulated in the hepatocytes. Consequently, the final diagnosis was fibrosing cholestatic hepatitis (FCH) due to precore mutant HBV infection contracted after renal transplantation. It is unclear when and where the recipient liver became HBV infected. Nevertheless, after renal transplantation, while receiving immunosuppressive drugs, HBV appeared to have the potential to cause hepatic failure and FCH may have been a fatal complication for the recipient.
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PMID:Fibrosing cholestatic hepatitis after living related-donor renal transplantation. 987 Aug 1

A total of 238 sera samples from cases of hepatitis, renal failure, thalassaemia, healthy health care workers (HCWs) & asymptomatic HBsAG carriers coming from central India from July 1992 to June 1998, were screened for anti-delta antibodies. Among 238 subjects, 206 were reactive for hepatitis B surface antigen (HBsAg) while 32 were HBsAg non-reactive. The prevalence of anti-delta antibodies was low (1.9%) among 54 patients of acute viral hepatitis (AVH) while it was higher (5.7%) among 52 patients of chronic liver disease (CLD). The anti-delta antibodies positivity among 34 patients with hepatic failure was around 15% and all of them were FHF patients. Among multitransfused subjects such as chronic renal failure (CRF) the prevalence of anti-delta antibodies was low (2.3%). None of the apparently healthy HBsAg reactive HCWs and asymptomatic HBV carriers were reactive for anti-delta antibodies. Similarly anti-delta antibodies could not be detected in HBsAg negative viral hepatitis patients. There is a wide variation in the prevalence of anti-delta antibodies in different parts of India. However, overall prevalence of anti-delta antibodies appears to be lower in the Indian population in comparision to western countries.
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PMID:Prevalence of anti-delta antibodies in central India. 1046 45

India is amidst a demographic transition showing an ageing trend. This will increase non-communicable diseases including diabetes which is already showing an increasing trend. With scanty literature existing on elderly diabetics (> 60 years of age), it was decided to study the clinico-laboratory and complication profile of this group of patients. Fifty consecutive elderly diabetics were studied and evaluated for ECG, chest x-ray, blood sugar, urea, creatinine, lipid profile, proteinuria, motor nerve conduction velocity and autonomic neuropathy. Duration of diabetes varied from one month to 28 years. Fifty-six per cent of the patients presented with classical symptoms of polyuria, polyphagia and polydipsia. Hypertension was present in 40% and cataract in 54% of the patients. Eighteen per cent were obese, 52% had evidence of peripheral neuropathy while 56% had autonomic neuropathy. Background diabetic retinopathy was present in 56%, pre-proliferative retinopathy and maculopathy in 4% each; hypertensive retinopathy in 10% of patients; 44% had microproteinuria and 8% had chronic renal failure. Hypercholesterolaemia was present in 64% and hypertriglyceridaemia in 42% of the patients with 26% having coronary artery disease. Sixty per cent were harbouring infections--20% had foot infections, 14% had tuberculosis and 10% had urinary tract infections. Ninety-two per cent of the patients were aware of their disease but 62% were not aware of the complications and of the need for strict dietary and drug compliance. There was a high prevalence of associated diseases viz, osteoarthritis, cataract, hypertension, hepatitis and parkinsonism. Therefore, this study brings out the need to have a holistic and multidisciplinary approach for management of elderly diabetics who constitute a heterogeneous group with distinct health care problems.
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PMID:Clinical and laboratory profile of diabetes in elderly. 1065 95

Porphyria cutanea tarda (PCT) is frequently described among patients with chronic renal failure undergoing hemodialysis. One patient who was receiving peritoneal dialysis and had PCT develop has been described in the literature. However, it was later determined that the patient's PCT was related to the hepatotoxic drug she was receiving rather than her peritoneal dialysis. Our patient is the first reported case, to our knowledge, of a patient with end-stage renal disease with negative hepatitis serology who was not receiving a hepatotoxic drug, or on hemodialysis, who had PCT develop while receiving peritoneal dialysis.
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PMID:Treatment of porphyria cutanea tarda with phlebotomy in a patient on peritoneal dialysis. 1117 9


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