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)

The causes of cholestasis in 276 patients with a total of 296 lesions were studied. Extrahepatic cholestasis was found in 58.4 percent of the patients, and 41.6 percent had intrahepatic cholestasis. Malignant disease was found in 34.8 percent of the patients (extrahepatic cholestasis in 20 and intrahepatic cholestasis in 70). Cholangiocarcinoma, especially the hilar intrahepatic type, seems to be the most prevalent in the medical literature. It is possible that the combination of opisthorchiasis and carcinogenic agents, such as nitrosamines, induce a precancerous stage at the hilar area. Some unknown factors, may be the immune system in immune surveillance that act as a catalyst leading to malignant transformation. Acute calculous cholecystitis, choledocholithiasis, and intrahepatic stones are more common in Thailand than in the western countries, and their causes have been discussed herein. The composition of stones is also different; pigment stones are found more often in Thailand. These differences between the western and oriental types of biliary calculi are significant in regard to diagnostic approach and management, and morbidity and mortality. In Thailand, Opisthorchiasis viverrini has significant influence in the development of several cholestatic diseases, such as hilar intrahepatic cholangiocarcinoma, biliary calculi, opisthorchiatic intrahepatic cysts, and aggregated dead opisthorchiatic worms blocking the biliary system. In tropical countries, infectious diseases such as virus B hepatitis; severe systemic infectious diseases such as salmonellosis; and amebiasis and tuberculosis were also important causes of intrahepatic cholestasis. In the category of congenital anomalies, the prevalence of choledochal cysts was higher than in the United States. The prevalence of other forms of congenital anomalies of the biliary system is unknown, but may be similar to the prevalence of choledochal cysts.
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PMID:Causes of cholestasis in Thailand. A study of 276 consecutive patients. 670 7

The objective of this overview is to assess the present situation with regards to gastrointestinal and hepatobiliary diseases prevailing in Thailand. In that context, special emphasis has been put on those forms of viral hepatitis prevalent in the region, namely, hepatitis A the frequency of which has undergone a change from hyper- to hypoendemic with a resulting decline in naturally acquired immunity; hepatitis B with its tendency to cause chronic liver disease mainly due to asymptomatic infections during early childhood and the impact of mass vaccination programs on its endemicity; hepatitis C which can also lead to chronicity; hepatitis D solely found as a coinfection with hepatitis B; hepatitis E acute cases of which can sporadically be found; hepatitis G encountered in healthy subjects at a prevalence similar to that seen in patients with chronic liver disease and rather more prevalent among people at risk for contracting blood borne agents; finally the novel hepatitis TT virus with a distribution comparable to that of hepatitis G virus and a similarly unclear role as to the etiology of serious liver disease. Particularly in connection with hepatitis B we have examined the situation regarding hepatocellular carcinoma which represents one of the most common malignancies among the Thai population. Cholangiocarcinoma caused by the liver fluke Opisthorchis viverrini is the most common form of liver cancer in the northeastern part of Thailand where an estimated 70% of the population are infested with the parasite. Peptic ulcer caused by Helicobacter pylori constitutes another common gastrointestinal affliction with the overall prevalence of antibodies to the agent amounting to 63 to 74% in patients exhibiting gastroduodenal symptoms. The final part of the paper deals with HIV-related gastrointestinal and liver disease and with amebic and pyogenic liver abscesses.
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PMID:Current status of infection-related gastrointestinal and hepatobiliary diseases in Thailand. 1069 96

Whether heterozygotes with alpha-1-antitrypsin (AAT) deficiency type PiZ bear an increased risk for chronic liver disease is controversial. On the basis of liver tissue from 1,030 autopsies (autopsy series), 1,847 biopsies (biopsy series) and 317 primary liver carcinomas (tumor series), we analysed the effect of heterozygous state PiZ for the development of liver diseases. The PiZ status was screened immunohistochemically and verified in selected cases by SSCP analysis and by sequencing DNA extracted from paraffin embedded tissue. The PiZ frequency in the biopsy series (3.4%) and tumor series (5.99%) was significantly higher than in the autopsy series (1.8%). Hepatic PiZ deposits in heterozygotes sometimes were as extensive as in homozygotes. The amount of PiZ deposits correlated positively with the inflammatory activity and stage of fibrosis, as well as with the age of patients. Patients with concurrent liver disease such as hepatitis and alcoholic liver disease showed significantly higher scores of inflammatory activity, stage of fibrosis and amount of PiZ deposits than those without additional liver disease. Cholangiocarcinomas and combined hepato-cholangiocarcinomas were seen significantly more frequently in patients with PiZ-associated liver carcinoma than in genetic healthy individuals (p = 0.004). Three out of 19 PiZ-associated liver carcinomas had developed in cirrhotic liver tissue. Heterozygotes of type PiZ have an enhanced risk for chronic liver disease including primary liver carcinoma. PiZ-associated liver diseases will become clinically manifest in middle or old aged adults. Rarely this genetic defect causes liver cirrhosis even without concurrent liver disease. PiZ-associated liver carcinomas are frequently characterized by cholangiocellular differentiation and may develop often in non-cirrhotic liver tissue. Immunohistochemistry is a specific method to detect hepatic PiZ deposits.
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PMID:[Liver changes in heterozygote alpha 1-antitrypsin deficiency PiZ]. 1114 23

Cholangiocarcinoma is a malignancy of the biliary duct system. Presently, these malignant biliary tract diseases are common among the people in Southeast Asia, with the world's highest prevalence in northeastern Thailand and Laos. This carcinoma tends to grow slowly and to infiltrate the walls of the ducts, dissecting along tissue planes and leading to biliary tract obstruction. Recently, hepatitis virus-associated chronic hepatitis or cirrhosis has been suggested to be involved in the pathogenesis of cholangiocarcinoma. Here, we report the prevalence of hepatitis B seropositivity among Thai patients with cholangiocarcinoma. A total of 55 patients with cholangiocarcinoma, who were admitted to King Chulalongkorn Memorial Hospital, Thailand, during 1992-2001, with known hepatitis B serology was selected for further prevalence study. Of the 55 cases (32 males and 22 females), hepatitis B seropositivity was found in five cases (three males and two females), giving a total prevalence rate equal to 9.1% (9.4% for male and 9.2% for females). Since hepatitis B infection is believed to be a risk factor in the development of cholangiocarcinoma, and both cholangiocarcinoma and hepatitis B infection are common in Thailand, screening and vaccination for hepatitis B may be a useful strategy to decrease the high rate of cholangiocarcinoma in Thailand. Further long-term study to study the relation of hepatitis B infection and cholangiocarcinoma is recommended.
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PMID:The prevalence of hepatitis B seropositivity among patients with cholangiocarcinoma. 1251 80

Cholangiocarcinoma occurs with a varying frequency in different areas of the world. Some of the variations in incidence rates can be explained by the distribution of risk factors in different geographic regions and ethnic groups. Several accepted risk factors for cholangiocarcinoma include infestation with liver flukes, primary sclerosing cholangitis, hepatolithiasis, choledochal cysts, cirrhosis, and infusion of certain chemical agents. Approximately, 90% of patients diagnosed with cholangiocarcinoma do not have a recognized risk factor for the malignancy. The study by Ahrens et al. [16] finds that obesity and gallstones are risk factors for developing extrahepatic cholangiocarcinoma in men patients. Obesity was found to have a 'dose-effect' relationship with the strength of statistical association. No significant association was reported for tobacco or alcohol use, hepatitis, cirrhosis, diabetes, or inflammatory bowel disease. Although the author's definition of extrahepatic cholangiocarcinoma was unusual, the association of obesity with the risk of developing cholangiocarcinoma persisted for all anatomic subsites.
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PMID:Risk factors for cholangiocarcinoma. 1762 30

Cholangiocarcinoma is a predominantly fatal cancer, which can be difficult to treat. We report a 73-year-old man who developed cholangiocarcinoma with cholangiohepatitis and diabetes. Administration of pioglitazone, peroxisome proliferator-activated receptor gamma (PPARgamma). agonist, improved not only diabetic control, but also the tumor-induced cholangiohepatitis, and improved the patient's quality of life. Although he finally died of obstructive jaundice, thiazolidinedione should be considered for treatment of tumor-induced hepatitis in the presence of diabetes, unless severe side effects occur.
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PMID:Beneficial effects of pioglitazone on cholangiohepatitis induced by bile duct carcinoma. 1793 28

Cholangiocarcinoma is a predominantly fatal cancer, which can be difficult to treat. It has been reported that the administration of pioglitazone temporarily improved not only diabetic control, but also bile duct carcinoma-induced cholangiohepatitis. Pioglitazone is considered to have both direct and indirect mechanisms of action on the tumor-related hepatitis. Several molecules induced by thiazolidinedione, including Smad pathway-related molecules, adipokines, and other lipid metabolism-related proteins, may directly or indirectly suppress tumor development and/or tumor-induced cholangiohepatitis. Although the most frequent and critical side effect of thiazolidinedione is drug-induced hepatitis, it can probably be avoided by careful monitoring of serum hepatic enzyme levels. Thiazolidinedione should be considered for management of tumor-induced hepatitis in the presence of diabetes unless severe side effects occur.
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PMID:Do PPARgamma Ligands Suppress the Growth of Cholangiocarcinoma or the Cholangiohepatitis Induced by the Tumor? 1861 98

Cholangiocarcinoma is the second most common primary malignant tumor in the liver. It is a tumor that is characteristically composed of cells resembling those from the bile duct. The disease is difficult to diagnose and is usually fatal due to its late clinical presentation, lack of effective non-operative therapy, and rapid turnover. Most patients have unresectable tumors at the time of presentation and die within 12 months once diagnosis has been made. Prognosis of intrahepatic cholangiocarcinoma (ICC) remains very poor. Currently, there is no established therapy once diagnosis is made. In this report, we provide a case of a patient who presented with ICC and positive history of hepatitis C virus (HCV). The patient also had a strong family history of cancer. Finally, we attempt to review some of the important developments in the study of ICC, with particular attention to recent studies linking hepatitis with the disease.
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PMID:Intrahepatic cholangiocarcinoma and hepatitis: case study and literature review. 1966 41

Primary sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation with fibrosis and obliteration of the intra- and extrahepatic bile ducts. This disease is usually associated with ulcerative colitis. The process of chronic cholestasis eventually leads to biliary cirrhosis. The prevalence of primary sclerosing cholangitis is low in southern Europe but is especially high in Scandinavian countries. The etiopathogenesis is unknown but immune disorders, potential toxic agents or intestinal infections, ischemic injury to the bile ducts, and possibly alterations in hepatobiliary transporters are known to play a role. The disease manifests at the age of approximately 40 years, mainly in men with clinical and laboratory features of cholestasis but may also be asymptomatic. There are specific forms in which the small intrahepatic bile ducts are involved, mainly affecting children, as well as overlap syndromes with autoimmune hepatitis. A form characterized by an increase in IgG4 has been described, which is usually associated with autoimmune pancreatitis. The key diagnostic procedure is endoscopic retrograde cholangiography, although magnetic resonance cholangiography is the first diagnostic procedure that should be used since it is equally informative and non-invasive. Liver biopsy is not essential for diagnosis. Primary sclerosing cholangitis is a progressive disease with a probability of transplant-free survival of 18 years in asymptomatic forms and of 8.5 years in symptomatic forms. Cholangiocarcinoma can result from the disease and confers a poor prognosis. There is no specific treatment although ursodeoxycholic acid improves the biochemical alterations of cholestasis. Liver transplantation is the last therapeutic resort with good results in terms of survival although the disease can recur in the transplanted liver.
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PMID:[Primary sclerosing cholangitis: diagnosis, prognosis and treatment]. 2043 77

Cholangiocarcinoma (CCA), a cancer originating from the neoplastic transformation of the biliary epithelium, is characterized by a progressive increase in incidence and prevalence. A number of risk factors have been identified including primary sclerosing cholangitis, liver fluke infestation, and hepatolithiasis. More recently, hepatitis viruses (HCV, HBV) have been taken into consideration as risk factors for the intrahepatic CCA and this could explain the increased incidence seen in the last two decades. All these risk factors induce chronic inflammation in the biliary epithelium together with partial bile obstruction. These two conditions are considered the background (chronic inflammation) favouring the cancer development. The only effective treatment is the radical surgical resection but, this is applicable in less than 40% of the patients since CCA is mostly diagnosed at an advanced stage. This mainly occurs because, in the majority of the cases, CCA is clinically silent, with symptoms only developing at an advanced stage but also for the lack of effective biomarkers to be used for a screening purpose. A number of serum and bile biomarkers have been recently proposed for the diagnosis of CCA but, their impact on the early diagnosis is still under the evaluation.
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PMID:Cholangiocarcinoma: risk factors and clinical presentation. 2049 49


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