Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
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.
 ...
PMID:Flucloxacillin induced delayed cholestatic hepatitis. 237 76

The study includes 108 patients with acute alcohol hepatitis, 45 patients with cholestasis and 124 healthy controls. In 14 patients (13%) cholestatic acute alcohol hepatitis was found. The patients with cholestatic acute alcohol hepatitis consumed considerably more alcohol than the other patients with acute alcohol hepatitis. The intensive jaundice led half of the patients with cholestatic acute alcohol hepatitis to the infectious diseases clinic and 32% of them to the surgical clinic. The course of the disease was heavy, with disturbed general condition, high temperature, pain in the right subcostal region but without itching. The patients showed higher levels of timol test, cholesterol, LDL-cholesterol, coefficient LDL/HDL-cholesterol, beta-lipoproteins, total lipids, gamma-GTP, ASAT and lower levels of leucocytes, bilirubin, SMC, alkaline phosphatase and LAP than the other patients with cholestasis. The patients with cholestatic acute alcohol hepatitis showed a higher level of total lipids and gamma-GTP than the other patients examined. The confirmation of the diagnosis implies the application of contemporary instrumental and invasive methods. The ultrasound examination is of special importance.
 ...
PMID:[The clinico-laboratory characteristics of the cholestatic form of acute alcoholic hepatitis]. 263 77

The occurrence of hepatobiliary disease with or without jaundice during pregnancy provides both the hepatologist and obstetrician with an interesting and urgent diagnostic challenge. Advances in our understanding and management of liver disorders unique to pregnancy and hepatobiliary disease in general have resulted in a significant improvement in the outcome for both mother and fetus. Certain disorders such as acute fatty liver of pregnancy and hepatic haemorrhage associated with toxaemia should be considered medical emergencies and delay in diagnosis of these conditions will probably adversely affect maternal and fetal outcome. A careful clinical history, physical examination, appropriate laboratory tests and radiological investigations should allow a diagnosis within 24-48 hours of presentation. Liver biopsy is rarely required. A careful history may provide important information. Does the patient have pre-existent liver disease? Has there been contact with hepatitis, intravenous drug abuse or any other factor predisposing to acute viral hepatitis? Does the patient have a family history of pruritus and/or jaundice to suggest intrahepatic cholestasis of pregnancy? Is the patient's alcohol consumption excessive? Has the patient received any hepatotoxic medications? Has there been abdominal pain and/or fever to suggest gallstones, hepatic bleeding or acute fatty liver of pregnancy? Laboratory investigations may give valuable diagnostic clues. Marked aminotransferase elevation would suggest acute viral or 'ischaemic' hepatitis. Haematological features of microangiopathic haemolysis would point towards toxaemia or AFLP. Hepatitis A and B serological tests may be helpful in viral liver disease. Radiological investigations may be indicated depending on the clinical context. Abdominal ultrasonography may be useful in the diagnosis of gallstones, biliary obstruction, liver tumours or intrahepatic bleeding. Fatty infiltration of the liver may be diagnosed by ultrasonography but computed tomography (CT) of the abdomen is probably more reliable for a diagnosis of acute fatty liver of pregnancy as it allows measurement of liver density which is typically reduced by fatty infiltration. CT scanning is also probably more valuable than ultrasound in assessing the extent of capsular rupture and haemorrhage into the liver and peritoneal cavity.
 ...
PMID:Jaundice in pregnancy. 265 65

A case of hepatitis is reported in a 38-year-old alcoholic woman taking disulfiram to aid in maintaining sobriety. She presented with anorexia, vomiting, fatigue, right upper-quadrant pain, pruritus, darkened urine, and jaundice after about two weeks of disulfiram 500 mg/d. The patient also had been taking enalapril 10 mg/d for one year. Hepatocellular enzymes, total bilirubin, and eosinophils were significantly elevated. Hepatitis B core antibody, hepatitis A antibody, hepatitis B surface antibody, and antinuclear antibody were negative. After discontinuation of disulfiram, the clinical and biochemical manifestations of hepatitis began to resolve and the patient was discharged in a much improved condition. Seventeen previous cases of disulfiram-induced hepatitis are reviewed. It has been suggested that the mechanism of hepatotoxicity is an allergic or hypersensitivity reaction. The findings in this case are consistent with the earlier descriptions of hypersensitivity hepatitis, and lend further support to the possibility that disulfiram may cause hepatitis.
 ...
PMID:Disulfiram-induced hepatitis: case report and review of the literature. 268 28

A case report is presented of a 43-year-old woman with generalized peliosis hepatitis that developed during longterm use of oral contraceptives (OCs). The patient had been in good health until the last 2 years when she began to experience vague epigastric pains and a feeling of abdominal distension. Several months prior to admission, she had started to complain of itching and fatigue. There was no history of dark urine, white stools, or hepatitis. On physical examination, no jaundice or cutaneous stigmata of chronic liver disease were observed. Laboratory studies showed a normal erythrocyte sedimentation rate and hematological blood count. A radionuclide study of the liver showed hepatomegaly; especially the left lobe was enlarged. A computerized tomographic scan of the liver showed multiple areas of decreased density in both of the enlarged lobes. There was no evidence of a tumor. Selective transfemoral angiography of the celiac artery also showed hepatic enlargement but no signs of a space-occupying lesion. At laparoscopy, the liver was grossly enlarged and had a lumpy appearance, but again there were no signs of a tumor. No evidence of veno-occlusive disease or hepatocellular adenoma was found. The diagnosis was peliosis hepatitis. The OCs were withdrawn, and the patient was discharged. Regular follow-up in the outpatient department showed no decrease in the size of the liver. The alkaline phosphatase level rose. The fatigue became worse, and cholestyramine was prescribed for progressive itching. In September 1980, the patient was admitted for reevaluation. A repeated CT scan and angiography of the liver again yielded no evidence of a tumor. Esophagoscopy showed the presence of varices grade 2. The liver at laparoscopy had the same appearance as it had in 1976. Histological examination of a biopsy specimen showed occasional dilated sinusoids and locally marked periportal and intralobular fibrosis. No regeneration nodules were found. The diagnosis was liver fibrosis. The patient's condition deteriorated gradually in the following years. She experienced increasing fatigue. Steatorrhea developed, and the patient lost weight. She needed increasing doses of cholestyramine and oral supplementation of vitamins A, D, and K. She was admitted for a 3rd time in February 1985. Esophagoscopy revealed varices grade 4. A CT scan of the liver showed no change. The patient successfully underwent an orthotopic liver transplantation in January 1987. The diagnosis of peliosis hepatis was well documented in this patient.
 ...
PMID:Generalized peliosis hepatis and cirrhosis after long-term use of oral contraceptives. 312 33

Serum 3 beta-hydroxy-5-cholenoic acid (3 beta-OH-delta 5) was analyzed in 100 cases (90 patients with hepatobiliary diseases, 10 normal subjects) and its clinical significance investigated. The measurement of 3 beta-OH-delta 5 was performed by high performance liquid chromatography (HPLC) with immobilized 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) as the enzyme column. Esterified 3 beta-OH-delta 5 was measured after enzymatic hydrolysis with sulfatase and beta-glucuronidase. 3 beta-OH-delta 5 was hardly detected in normal cases. On the other hand, serum 3 beta-OH-delta 5 levels were remarkably high in cholestatic cases and also high in other cases with high bilirubin levels. The ratio of glycine- to taurine-conjugates (G/T ratio) was effective in discriminating cholestasis from hepatocellular damage such as in cases of acute hepatitis or fulminant hepatitis. More than 90% of the 3 beta-OH-delta 5, which is toxic, was sulfated or glucuronidated, suggesting detoxification by esterified bile acids. Significant increases of taurine-conjugated 3 beta-OH-delta 5 were observed in cases with pruritus, and a relationship between taurine-conjugated and pruritus was presumed. Therefore, analysis of 3 beta-OH-delta 5 is considered to be effective in clarifying the pathogenesis of hepatobiliary diseases.
 ...
PMID:Clinical evaluation of serum 3 beta-hydroxy-5-cholenoic acid in hepatobiliary diseases. 347 20

We report the case of a patient in whom troleandomycin-induced hepatitis was followed by prolonged anicteric cholestasis. Jaundice occurred after administration of troleandomycin for 7 days and was associated with hypereosinophilia. Jaundice disappeared within 3 months but was followed by prolonged anicteric cholestasis marked by pruritus and high levels of alkaline phosphatase and gammaglutamyltransferase activities. Finally, pruritus disappeared within 19 months, and liver tests returned to normal 27 months after the onset of hepatitis. This observation demonstrates that prolonged cholestasis can follow troleandomycin-induced acute hepatitis.
 ...
PMID:Prolonged cholestasis after troleandomycin-induced acute hepatitis. 349 78

A case of phenytoin-induced hepatitis with mononucleosis is reported, and syndromes associated with phenytoin hypersensitivity reactions are discussed. A 23-year-old black woman with a two-month history of seizure disorder was admitted to a hospital with nausea, vomiting, fever, lymphadenopathy, diffuse maculopapular rash, left-upper-quadrant tenderness, and hepatomegaly. She was receiving phenytoin sodium 300 mg/day; carbamazepine 200 mg four times daily had been discontinued four days before admission because of leukopenia. Phenytoin was discontinued after admission; however, phenytoin 1 g i.v. was given for a tonic-clonic seizure two days after admission, after which swelling of the face and legs and pruritus developed. Over the next few days, signs and symptoms of hepatotoxicity progressed, and she became comatose. Seizures were treated with diazepam. She began to recover after 10 days of supportive therapy and was discharged several weeks later on primidone therapy. Serious phenytoin hypersensitivity reactions may appear as dermatologic, lymphoid, or hepatic syndromes. Fever, rash, and lymphadenopathy often accompany hepatic injury. Encephalopathy and death may occur. Proposed mechanisms for phenytoin hypersensitivity include antigen-antibody reactions, alteration of lymphocyte function, and an enzyme abnormality causing the production of toxic metabolites. Treatment is supportive; phenobarbital and carbamazepine may be used with caution as alternate anticonvulsant therapy. The possibility of phenytoin hypersensitivity reactions should be considered when patients receiving phenytoin have unusual symptoms, particularly fever, rash, and lymphadenopathy.
 ...
PMID:Phenytoin-induced hypersensitivity reactions. 367 71

A relapsing papulo-vesicular rash with or without pruritus was observed in 54 out of 148 patients (36%) with posttransfusion or sporadic, acute or chronic, non-A, non-B (NANB) hepatitis. The predominant location was the trunk and the anterior surfaces of the upper extremities. The face was affected less often. The eruptive phase was accompanied by general symptoms and increases in aminotransferases and gamma-GT values. The nature of the eruption was consistent with cutaneous reactions as frequently seen in enterovirus infections. No predominance was found for special groups of patients when the skin lesions were correlated to either sex, mode of infection or pattern of transaminase elevation (i.e. monophasic or bi-, and multi-phasic).
 ...
PMID:Cutaneous papulo-vesicular eruptions in non-A, non-B hepatitis. 392 44

Microval, a low dose progestin oral contraceptive (OC) containing .03 mg levonorgestrel, provides contraception through 3 mechanisms: rendering the cervical mucus impermeable to sperm, slowing the descent of the egg through the fallopian tube, and causing endometrial atrophy unfavorable to nidation. The Pearl index is about 1%. Formal contraindications to Microval include suspicion of pregnancy, recent history of hepatitis or hepatic insufficiency, and breast or uterine cancer, while relative contraindications include ovarian dystrophy, mastopathy, and history of extrauterine pregnancy, jaundice, or pruritus of pregnancy. As with any other OC, a complete physical examination should be done before prescription to rule out contraindications, and follow-up examinations should be given twice yearly. Irregular cycles, spotting, amenorrhea, edema, and breast discomfort are not unusual at the beginning of treatment. Rifampicine, barbiturates, phenylbutazone, and the hydantoin group of drugs render Microval ineffective. The pill should be taken every day without exception at the same hour, and it is advisable to use another method of contraception during the 1st month of Microval use. A single pill taken 12 hours late can bring a risk of pregnancy. Low dose progestins are of interest for patients with contraindications to synthetic estrogens who desire an OC, but they can induce a relative hyperestrogenism with ovarian dystrophy and other symptoms, and they can cause menstrual irregularity.
 ...
PMID:[Microval]. 392 36


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>