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)

One hundred and forty-eight patients with non-alcoholic cirrhosis or chronic aggressive hepatitis entered a prospective, unblinded, randomized trial on the effect of azathioprine versus prednisone. For all 148 patients, there were no differences in survival related to the two drugs. In 99 patients the disease was classified as autoimmune, in 23 as posthepatitic, and in 26 as cryptogenic. No significant differences were seen in survival between these three groups of patients and no differences in survival related to the two drugs were registered within any of the groups. The autoimmune group included the patients with the biochemically most active disease, and a statistically significant reduction in activity was obtained with prednisone as well as azathioprine. Most remarkably, the frequencies of the autoantibodies were reduced parallel to the biochemical improvement in these patients. Immunosuppressive treatment was found to be rather ineffective in posthepatic chronic liver disease of type B; however, no signs of activation of the hepatitis B virus were seen.
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PMID:Azathioprine versus prednisone in non-alcoholic chronic liver disease (CLD). Relation to a serological classification. 717 45

Serum IgE level was determined in patients with chronic and acute liver diseases. In the latter it was correlated with that of other immunoglobulin classes and with disease activity. IgE level was found to be within normal range in patients with chronic active hepatitis and in those with non-alcoholic cirrhosis, as well as in asymptomatic HBsAg carriers. In contrast, the prevalence of patients with high serum IgE level was significantly increased during the active stage of both type A an type B hepatitis. Serum concentration of IgE decreased to normal following complete recovery from the disease. The increase in serum IgE level during type A hepatitis was accompanied by a very marked increase in IgM level while that of IgG remained unchanged. The changes in the pattern of serum immunoglobulins during acute hepatitis might be attributed to selective depletion of suppressor T-cells.
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PMID:Serum IgE levels in patients with liver disease. 732 19

Circulating immune complexes have been described in viral hepatitis and primary biliary cirrhosis but their significance is unclear. Seventy-three patients with acute and chronic liver diseases were evaluated to determine the specificity of immune complex detection for a given liver disease. Immune complexes were measured by the fluid- and solid-phase Clq-binding assays. They were demonstrated frequently in all patients with liver disease, including those with viral hepatitis, alcoholic cirrhosis, chronic active and persistent hepatitis, drug-induced hepatitis and hepatic metastases. The presence of immune complexes was not specific for a given type of liver disease and did not correlate with hepatic dysfunction. We conclude that the detection of immune complexes is of no apparent diagnostic use in liver disease. Further evaluation of the antigen-antibody composition would be required to determine any pathogenic significance of the detected circulating immune complexes.
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PMID:Non-specificity of circulating immune complexes in patients with acute and chronic liver disease. 743 39

Caffeine elimination was studied in 419 patients with cirrhotic and noncirrhotic liver disease of different etiology (hepatitis B virus infection n = 79; hepatitis NANB virus infection n = 74; ethanol-induced liver damage n = 143; primary biliary cirrhosis I-IV n = 63; cryptogenic liver cirrhosis n = 60) following oral administration of 366 mg caffeine. Caffeine clearance in the control group was 69 +/- 33 ml/min (age-matched healthy volunteers and patients without liver disease). Caffeine clearance in acute hepatitis B (70 +/- 60 ml/min) chronic persistent hepatitis B (81 +/- 56 ml/min), chronic aggressive hepatitis B (107 +/- 66 ml/min), posthepatitic liver cirrhosis B (84 +/- 62 ml/min), acute hepatitis NANB (94 +/- 69 ml/min), chronic persistent hepatitis NANB (122 +/- 60 ml/min), chronic aggressive hepatitis NANB (87 +/- 52 ml/min) and posthepatitic cirrhosis NANB (59 +/- 26 ml/min) is not reduced in comparison with controls. In patients with alcoholic fatty liver (127 +/- 71 ml/min, p < 0.05) caffeine clearance is enhanced, in alcoholic hepatitis (57 +/- 72 ml/min) comparable to controls and in alcoholic cirrhosis reduced (36 +/- 44 ml/min, p < 0.05). In primary biliary cirrhosis I-IV caffeine clearance is higher than in controls (117 +/- 59 ml/min, p < 0.05). In cirrhotic liver disease of different origin caffeine clearance is inversely related to the serum bilirubin level. However, the absolute value is determined in addition by the underlying disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Caffeine elimination in cirrhotic and non-cirrhotic liver disease of different etiology. 748 16

A number of underlying diseases may recur after orthotopic liver transplantation. While the recurrence of cholestatic diseases such as primary biliary cirrhosis and primary sclerosing cholangitis is still debated, and occurs, if at all, rarely and late after transplantation, the chronic viral hepatitides and the liver tumors recur frequently and in general early after grafting. Except for hepatitis B and tumor recurrence, recurrent diseases have rarely an impact on survival and/or quality of life in medium terms. The frequency of the often fatal hepatitis-B reinfection can be minimized by passive immunoprophylaxis and appropriate patient selection, that of tumor recurrence by thorough patient selection. Relapses occur only rarely after transplantation for post-alcoholic cirrhosis, provided stringent selection criteria, including a period of documented sobriety > or = 6 month prior to transplantation, are applied. Thus, except for chronic hepatitis B with ongoing viral replication and most liver cancers, the possibility of recurrent disease is not a contraindication to liver transplantation.
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PMID:[Does the primary disease recur following liver transplantation?]. 750 61

The growth in liver transplantations recorded by the Pitt-UNOS Liver Transplant Registry since October 1987 continues, and in 1993 the rate of increase was greater than it had been in recent years. This is in spite of the fact that the net growth of new centers was smaller in 1993 than in any previous year examined. Pediatric recipients in 1993 were compared with those in previous years, and no significant differences were found for sex, race, or age. In contrast to prior years, the majority of pediatric recipients in 1993 awaited transplantation at home. The most common indication for liver transplantation in children was biliary atresia, although the proportion of recipients with this primary liver disease decreased slightly in 1993. Significant increases were noted in the proportions of pediatric recipients with fulminant liver failure, and hepatoblastoma. Significantly fewer children received ABO-incompatible livers in 1993 compared with prior years, part of which may be a function of the increasing use of living-related donors. Many of the characteristics examined for adult recipients had different distributions in 1993 than in prior years. The proportion of White recipients declined in 1993, due to increases among Black and Hispanic recipients. The mean and median ages of adult recipients continued to increase because of the increasing proportion of recipients aged 60 and over. The proportion of adult recipients awaiting transplantation outside of the hospital continued to increase in 1993. The increase in the proportion of recipients with positive CMV serology is likely due to the increasing age of the recipients in 1993. A smaller proportion of multiorgan transplantations was performed in 1993, due to the elimination of procedures involving only the liver and pancreas. Alcoholic cirrhosis was replaced by hepatitis non-A, non-B, or C as the most common reason for LTX. The proportions of recipients with fulminant liver failure and malignancies, indications for poorest survival, declined significantly in 1993. The cumulative probability of surviving for 6 years after initial transplantation was 0.70 (without retransplantation = 0.58) for pediatric recipients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Liver transplantation in the United States: results from the National Pitt-UNOS Liver Transplant Registry. United Network for Organ Sharing. 754 39

To elucidate the appearance rates of hepatocellular carcinoma in cirrhosis and to assess the risk factors for hepatocellular carcinogenesis, we prospectively studied 795 consecutive patients with viral or alcoholic cirrhosis for 2 to 17 yr (median of 5.8 yr). During the observation period, hepatocellular carcinoma developed in 221 patients. Cumulative appearance rates of hepatocellular carcinoma were 19.4%, 44.3% and 58.2% at the end of the fifth, tenth and fifteenth years, respectively. When classified by the type of hepatitis virus infection, the appearance rates of hepatocellular carcinoma in 180 patients with only HBsAg and in 349 patients with only antibodies to hepatitis C virus were 14.2% and 21.5% at the fifth yr, 27.2% and 53.2% at the tenth yr and 27.2% and 75.2% at the fifteenth yr, respectively. Cox proportional hazard model identified that alpha-fetoprotein levels (p = 0.00001), age (p = 0.00067), positive hepatitis C virus antibodies (p = 0.00135), total alcohol intake (p = 0.00455) and indocyanine green retention rate (p = 0.04491) were independently associated with the appearance rates of hepatocellular carcinoma. Whereas age and indocyanine green retention rate were independent predictors for the appearance rate of liver tumor in the subgroup of HBsAg-positive patients, alpha-fetoprotein levels, age and past alcohol consumption were independent predictors in the group of hepatitis C virus antibody-positive patients. These epidemiological results suggest that some differences exist in the activity and modes of cancer promotion between hepatitis B virus infection and hepatitis C virus infection.
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PMID:A multivariate analysis of risk factors for hepatocellular carcinogenesis: a prospective observation of 795 patients with viral and alcoholic cirrhosis. 768 79

Although the growth in liver transplantations (LTX) recorded by the Pitt-UNOS Liver Transplant Registry since October 1987 continues, the rate of increase has been declining in recent years. Among children, the number of procedures reached a peak in 1990 and declined each year thereafter. The number of centers performing LTX continued to increase. However, in 1992, compared with previous years, the greatest proportion of centers had a decreased volume of procedures, and the fewest number of new centers were opened. Upon examining characteristics of pediatric recipients from 1987 through 1992, no significant trends were noted for sex, race, age, or nationality. The distribution of functional status in 1992 was similar to that prior to 1991. Compared with recipients in the other 2 time periods, recipients in 1991 were more likely to be in the best functional status and least likely to be in the ICU. The most common indication for LTX in children was biliary atresia, though the proportion of recipients with this primary liver disease decreased significantly over the study period. Significant increases were noted in the proportions of pediatric recipients with autoimmune disease (though this remains a relatively uncommon indication) and fulminant liver failure. There have been trends in many of the characteristics examined for adult recipients. The proportion of male recipients grew significantly between 1987 and 1992. Decreasing proportions of White recipients and increases among Hispanics and Asians were found. The mean and median ages of adult recipients peaked in 1990, with a slight decrease in 1992 reflecting a slight rise in the proportion of the youngest age group and a slight decline for the oldest age group. Adult recipients had better functional status in 1991 than earlier recipients, and the distribution in 1992 was very similar to that in 1991. The trend in the proportion of recipients with positive CMV serology followed very closely the pattern in age distribution, peaking in 1991 and dropping slightly in 1992. The proportions of multiorgan recipients were similar in all 3 time periods. However, in 1992, contrasting with previous years, most multiorgan procedures involved only a kidney. Alcoholic cirrhosis continued to be the most common reason for LTX, though the combination of non-A, non-B hepatitis and hepatitis C accounted for only 20 fewer recipients. The proportions of recipients with hepatitis B and malignancies (the indications with the poorest survival) declined significantly. The cumulative probability of patient (retransplantation-free) survival 5 years after initial transplantation was 0.7 (0.58) for pediatric recipients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Trends in liver transplantation in the United States. 791 52

To aid understanding of markers of disease and predictors of outcome in alcohol-exposed systems, we undertook a literature survey of more than 700 articles to view the morphological characteristics and the clinical and experimental epidemiology of the Mallory body. Mallory bodies are filaments of intermediate diameter that contain intermediate filament components (e.g., cytokeratins) observable by conventional light microscopy or immunohistochemical methods, identical in structure regardless of initiating factors or putative pathogenesis. Although three morphological types can be identified under electron microscopy (with fibrillar structure parallel, random or absent), they remain stereotypical manifestations of hepatocyte injury. A summary of the conditions associated with Mallory bodies in the literature and their validity and potential etiological relationships is presented and discussed, including estimates on the combined light microscopic and immunohistochemical prevalences and kinetics. Emphasis is placed on proper confounder control (in particular, alcohol history), which is highly essential but often inadequate. These conditions include (mean prevalence of Mallory bodies in parentheses): Indian childhood cirrhosis (73%), alcoholic hepatitis (65%), alcoholic cirrhosis (51%), Wilson's disease (25%), primary biliary cirrhosis (24%), nonalcoholic cirrhosis (24%), hepatocellular carcinoma (23%), morbid obesity (8%) and intestinal bypass surgery (6%). Studies in alcoholic hepatitis strongly suggest a hit-and-run effect of alcohol, whereas other chronic liver diseases show evidence of gradual increase in prevalence of Mallory bodies with severity of hepatic pathology. Mallory bodies in cirrhosis do not imply alcoholic pathogenesis. Obesity, however, is associated with alcoholism and diabetes, and Mallory bodies are only present in diabetic patients if alcoholism or obesity complicates the condition. In addition, case studies on diseases in which Mallory bodies have been identified, along with pharmacological side effects and experimental induction of Mallory bodies by various antimitotic and oncogenic chemicals, are presented. Mallory bodies occur only sporadically in abetalipoproteinemia, von Gierke's disease and focal nodular hyperplasia and during hepatitis due to calcium antagonists or perhexiline maleate. Other conditions and clinical drug side effects are still putative. Finally, a variety of experimental drugs have been developed that cause Mallory body formation, but markedly different cell dynamics and metabolic pathways may raise questions about the relevance of such animal models for human Mallory body formation. In conclusion, the Mallory body is indicative but not pathognomonic of alcohol involvement. A discussion on theories of development and pathological significance transcending the clinical frameworks will be presented in a future paper.
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PMID:The Mallory body: morphological, clinical and experimental studies (Part 1 of a literature survey). 792 9

One hundred and sixty-five patients with cirrhosis were prospectively investigated, by regular ultrasonographic follow up, to assess the incidence of gallstones. The mean length of follow up was 33 months (range 12 to 108). Cholelithiasis was diagnosed in 31 patients (18.8%), with a cumulative incidence over 84 months of 38.3% (4.7% yearly incidence). The risk of gallstones was similar in males (38%) and females (38.3%), although the final cumulative incidence was reached at 72 months in males. The percentage of patients with new stones was higher in alcoholic cirrhosis (28.9%) (with a cumulative incidence of 48.8% at 84 months) and lower in hepatitis-related cirrhosis (1.9%) (only one new case at 96 months of follow up) (p < 0.001). The cumulative incidence of gallstones in the Child's C group reached 49.3% at 48 months versus 24% in Child's B and 6.4% in Child's A (p < 0.0001). At multivariate analysis, Child's C and alcoholic cirrhosis were shown to be the independent variables significantly associated with a high risk of development of cholelithiasis. This study confirms that cirrhosis represents a high risk factor for gallstones. The risk is greater for alcoholic cirrhosis and increases with the severity of the disease.
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PMID:Incidence of gallstones in a population of patients with cirrhosis. 793 Apr 81


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