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)

We treated a case of drug-induced cholestatic jaundice in which the causative agent was pizotyline (Pizotifen), a phenothiazine-related drug. The patient's symptoms were compatible with either hepatitis or biliary obstruction. Diagnostic laboratory studies were performed to exclude both of these entities. The history of drug ingestion plus the clinical and histologic features established pizotyline as the causative agent.
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PMID:Pizotyline-induced cholestatic jaundice. 671 77

This paper presents a case of a patient who developed a severe illness with marked jaundice after 1 cycle of oral contraceptives (OCs). Although effects on liver physiology are a frequent but clinically insiginificant consequence of OC use, major hepatic dysfunction with clinically apparent jaundice occurs rarely. This patient's illness was manifest initially by pruritus and later was characterized by marked jaundice with mild to moderate transaminase and alkaline phosphatase elevations. Serologic studies for hepatitis and primary biliary cirrhosis were negative, and extrahepatic biliary obstruction was excluded by cholangiography. Liver biopsy revealed cholestasis without features of hepatitis. The patient, 22 years of age, has shown gradual resolution of jaundice and pruritus and normalization of liver tests over a 12-month period. OC-induced cholestasis appears to be associated primarily with the estrogen component of OCs, although the progeston component may enhance the cholestatic effects of the estrogen. This case demonstrates that, although typically benign, OC jaundice may occasionally be manifest by a severe and lengthy clinical illness. Since patients with prior jaundice of pregnancy often experience a recurrence of cholestatic symptoms if OC use is resumed, OC use should be avoided in such cases.
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PMID:Severe and prolonged oral contraceptive jaundice. 671 53

Alcoholics with abnormal liver function tests are generally assumed to have one of the recognised patterns of alcoholic liver injury. This report described a group of nine patients who were initially thought to have alcoholic liver disease but were found on liver biopsy to have a variety of liver disorders unrelated to alcohol. Liver biopsy showed granulomatous hepatitis in three, primary biliary cirrhosis in two, and cholestasis of unknown cause, large duct biliary obstruction, haemochromatosis with secondary carcinoma and Budd-Chiari syndrome in one each. The histological changes observed in liver biopsy samples are believed to represent a chance occurrence of liver disease due to some agent other than alcohol and illustrates that forms of hepatic disease that affect the population at large can and do occur in heavy alcohol consumers.
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PMID:Alcohol unrelated hepato-biliary disorders in the alcoholic: the role of liver biopsy in determining the aetiology of liver disease. 695 38

Plasma lipoproteins were studied in relation to liver histology in rabbits in the course of toxic hepatitis and compared to those after experimental biliary obstruction. The lipoprotein electrophoretic pattern became deeply abnormal during the acute phase of toxic hepatitis and correlated with the degree of liver injury, improving during recovery. Liver damage was more severe after carbon tetrachloride than after alcohol and milder after allylo-isopropyl-acetamide, a porphyrinogenic substance. Lipoprotein abnormalities were not followed by significantly reduced levels of cholesterol esters in the plasma. In comparison, animals with biliary obstruction developed milder liver damage presented gross abnormalities of plasma lipids and lipoproteins, followed by relative deficiency of cholesterol esterification. It is concluded that lipoprotein changes in acute liver injury, although non-specific, are a sensitive index of liver damage and recovery. Serious acute liver injury can exist without significant fall in cholesterol esters.
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PMID:Plasma lipoprotein pattern in relation to liver histology after toxic hepatitis and experimental biliary obstruction in rabbits. 709 Nov 41

Neonatal hepatitis and biliary atresia are disorders of early infancy that represent variable expressions of one entity. Clinical and extensive laboratory evaluation are unsatisfactory in distinguishing between the two diseases. The usefulness of hepatobiliary ultrasonography in the evaluation of neonatal jaundice is described in four infants. Ultrasonic diagnosis was substantiated by laparotomy, liver biopsy or autopsy. The performance of hepatobiliary ultrasonography is recommended in all cases of neonatal jaundice in order to differentiate between extrahepatic biliary obstruction and neonatal hepatitis.
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PMID:Hepatobiliary ultrasonography as a diagnostic aid in neonatal jaundice. 714 55

The existence of hepatic involvement in systemic lupus erythematosus (SLE) is still contested in the literature. We report a patient with SLE and deranged liver function tests, especially marked elevation of alkaline phosphatase levels, an association not hitherto described. These changes have persisted for 3 1/2 years with no evidence of chronic active hepatitis (CAH) on liver biopsy or biliary obstruction. Current concepts of liver involvement in SLE, 'lupoid' hepatitis and aspirin hepatotoxicity are reviewed.
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PMID:Hepatic involvement in systemic lupus erythematosus. A case report. 722 99

Excretory liver function was analyzed in 10 healthy volunteers and 28 subjects with acute or chronic liver injury following intravenous administration of 99mtechnetium p-isopropyl iminodiacetic acid. Hepatobiliary transit of this agent was quantitated at 5-min intervals for a total of 60 min. Indices of total liver activity, liver cell uptake, liver parenchymal clearance, and bile duct clearance of 99mtechnetium p-isopropyl iminodiacetic acid were calculated from time--activity curves over heart, liver, extrahepatic bile ducts, and gallbladder. Seven subjects with acute viral hepatitis, 15 with extrahepatic biliary obstruction, and 6 with intrahepatic cholestasis were evaluated. Compared with healthy volunteers, a significant (p less than 0.0001) reduction in total liver activity and liver parenchymal clearance was demonstrated in all patient groups. Major resolution in all liver-derived indices, particularly total liver activity, occurred during convalescence from hepatitis and after biliary drainage. Nonmeasurable bile duct clearance always indicated a diagnosis of extrahepatic obstruction in cholestatic subjects, and this index normalized in subjects following biliary drainage. Whereas visual assessment of 99mtechnetium p-isopropyl iminodiacetic acid scans provided limited, useful information about the functional status of the liver, quantitative temporal analysis proved to be a much more effective technique.
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PMID:Quantitative temporal analysis of 99mTechnetium p-isopropyl-iminodiacetic acid (PIPIDA) as a measure of hepatic function in health and disease. 728 82

Based on the assumption that faecal and urinary coproporphyrin excretion is closely dependent on biliary function, coproporphyrin excretion was investigated in severe cholestatic diseases in infants and adults. The following subjects were investigated: biliary atresia (5), neonatal hepatitis (3), normal infants (11), adults with biliary obstruction (5) and normal adults (18). Urinary and faecal coproporphyrin concentrations were determined by solvent partition methods, and the isomers (I and III) were separated by thin-layer chromatography with direct spectrofluorometric scanning. The results showed a significant increase in urinary coproporphyrin in biliary atresia and neonatal hepatitis and in adults with biliary obstruction. All the cholestatic diseases showed the same marked increase in urinary isomer I. In biliary atresia and neonatal hepatitis there was a significant decrease in faecal coproporphyrin and a concomitant increase in isomer III (of bacterial origin) which was related to the extent of the biliary defect. Determination of urinary and faecal coproporphyrin, and particularly of the isomer distribution, may be a sensitive tool for diagnosis.
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PMID:Faecal and urinary coproporphyrin isomers in biliary atresia and neonatal hepatitis. 742 94

The finding of epithelioid cell granulomas within liver biopsies is a not uncommon occurrence. We undertook this study to investigate the underlying conditions responsible for a diagnosis of granulomatous hepatitis in Northern Ireland during the thirteen year period 1980-1992. One hundred and sixty-three patients with hepatic granulomas were identified, accounting for 4% of all liver biopsies undertaken during the period of the study. In 145 cases (89%) a definite clinical diagnosis was established. The most common clinical diagnoses were primary biliary cirrhosis which accounted for 90 cases (55%) and sarcoidosis which accounted for 30 cases (18%). Other less common conditions associated with hepatic granulomas included tuberculosis (3 cases), Crohn's disease (3 cases), chronic active hepatitis (2 cases), drug hypersensitivity (2 cases) and extra-hepatic biliary obstruction (2 cases). Six patients were identified with a clinical diagnosis of psoriasis. Other miscellaneous conditions accounting for single examples of granulomatous inflammation were schistosomiasis, gout, Hodgkin's disease, secondary adenocarcinoma, collapse and necrosis of tumour following radiotherapy and chemotherapy, granulomatous inflammation within the wall of an abscess cavity and idiopathic cirrhosis. Only eighteen cases (11%) remained idiopathic with no definite diagnosis established after detailed investigation. The findings confirm the wide range of clinical conditions which can result in hepatic epithelioid cell granulomas. This has been emphasised in several previous major studies which are reviewed in this paper.
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PMID:Hepatic granulomas in Northern Ireland: a thirteen year review. 782 89

A 7-year-old child had unusual manifestation of cryptococcosis; liver and lymph node involvement predominated. There was evidence of cryptococcal hepatitis, extrahepatic biliary obstruction, and subsequent cirrhosis of the liver. Despite widespread dissemination, underlying immune disturbance was not evident. The patient was treated with two courses of amphotericin and 5-flucytosine.
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PMID:Hepatic involvement culminating in cirrhosis in a child with disseminated cryptococcosis. 788 81


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