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)

Liver enzymes were followed in 99 patients treated with D-penicillamine for rheumatoid arthritis. In six abnormalities were found which consisted of elevated levels of lactic dehydrogenase. ALAT/ASAT, alkaline phosphatases or combinations of these. The changes were reversible on stopping the drug with one possible exception. No evidence of biliary cirrhosis, chronic active hepatitis or HBag-associated hepatitis was found. Liver biopsy was performed in 4 cases--one was taken 2 months after the treatment was discontinued, and was normal. One biopsy showed mild inflammatory changes, whereas in two histologic evidence of toxic liver necrosis was present. Liver damage should be included among possible complications of D-PA treatment.
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PMID:Liver abnormalities in penicillamine treated rheumatoid arthritis. 28 88

During the last ten years, several clinical manifestations of Yersinia enterocolitica infection have been reported. Surgeons are especially aware of "the right iliac fossa syndrome", caused by mesenterial lymphadenitis and terminal ileitis. We suggest that Yersinia enterocolitica may also cause a clinical condition easily misinterpreted as cholecystitis, and accompanied by slightly elevated serum levels of ASAT, LD, AP and bilirubin. Apparently, this condition may run a chronic relapsing course. A report is given of two cases of liver affection associated wtih positive Y. ent. antibody titre. Case 1 would illustrate the chronic relapsing liver affection with stationary titre. In Case 2 an acute Au-negative hepatitis is accompanied by significant rise and fall in titre.
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PMID:Liver affection associated with Yersinia enterocolitica infection. 61 Feb 87

Four infants with Lues connata, three with the early stage of the disease (patients 1-3), are reported. Diagnosis was made after exclusion of other diseases. Initially an infectious disease was expected, since anemia, leucocytosis, thrombocytopenia, hepatomegaly and/or splenomegaly and a bad condition were found. In two patients bone structure was abnormal. Elevated serum concentrations of liver enzymes (ALAT, ASAT) were the indication for liver biopsy in one patient, in whom an accompanying hepatitis was diagnosed. Treatment was performed with penicillin, no JARISCH-HERXHEIMER reaction was observed. The Lues tests were negative during pregnancy but a displacental transfer of pathogenic agents could be assumed. Patient 4 was diagnosed at 9 months of age. Infection of the mother probably occurred in the last 6 weeks of pregnancy. It can not be decided if the baby has a connatal or acquired Lues. The titer decrease of the CMT-test after the end of the penicillin therapy is a marker for a successful treatment. If treatment was started at 2 years of age a total clinical recovery can be expected. The case reports demonstrate that negative Lues test during pregnancy do not exclude Lues connata in newborns. The Lues diagnosis should be considered if an infectious disease in a newborn can not be diagnosed. A general Lues serodiagnostic test is recommended in all newborns before they leave the obstetrics department.
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PMID:[Congenital syphilis]. 130 79

Triggered by a case of ischaemic hepatitis (shock liver) in a patient with severe respiratory insufficiency, we tried to gather information about clinical characteristics and incidence. To our surprise, this information could be found neither in major critical care, medical or gastroenterology textbooks nor in textbook indices or works on differential diagnosis. From Sept. 1989 to May 1990 we studied all possible cases of ischaemic hepatitis in a 390 bed general hospital, to establish incidence. Using computerised data from the clinical chemistry laboratory, all patients with grossly abnormal liver function tests were identified. In this nine-month period 27 adult patients had a peak ALAT level of > 500 U/l: 8 of these suffered from ischaemic hepatitis, using the criteria described by Gibson et al. In another 5 this diagnosis was suspected but could not be ascertained before death (30% and 18% of all cases). In all these cases ASAT, ALAT, LDH levels were 8-100 times normal, but bilirubin, alkaline phosphatase, gamma-glutamyl transferase and prothrombin time were only slightly abnormal. With correction of the underlying disorder enzyme levels returned to normal very rapidly, in 5-10 days. Ischaemic hepatitis could easily be distinguished from other causes such as alcoholic, viral or drug-induced hepatitis. Ischaemic hepatitis was the most frequent cause of severely elevated ASAT, ALAT and LDH in hospitalised patients. The diagnosis can easily be made on clinical characteristics and the typical biochemical pattern. An elaborate work-up or invasive procedure is redundant. Prognosis per se is excellent but depends on the underlying disorder.
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PMID:[Ischemic hepatitis]. 140 10

The authors report a case of toxic hepatitis in a woman of 22 years of age in the third trimester of her first pregnancy treated by methyldopa for hypertension of pregnancy which was diagnosed at 33 weeks of amenorrhoea. The prodromal symptoms were mild and consisted of nausea, vomiting and rise in temperature and this phase was associated with febrile jaundice without pruritus and it was only associated with coagulation disorders in the third stage of labour. This was a case of mixed cytolytic hepatitis (ASAT x 3N) and cholestasis (x 1.5N). The outcome was fatal. The patient died three days after delivery following haematemesis and renal failure as well as hepatic encephalopathy. The main diagnostic feature was acute hepatic stasis in spite of the absence of pruritus and the presence of a raised temperature after hematolytic, viral and obstructive causes had been eliminated. Histology confirmed that there was toxic hepatitis. This aetiology was suggested by the timing of the symptoms after MD (methyldopa) had been taken. Elkington described methyldopa hepato-toxicity in 1969. Fatal cases in the literature were in patients who were over 40 years of age. Methyldopa is used in pregnant women because of its safety as far as the fetus is concerned. Mechanism by which it causes toxic hepatitis is a combination of abnormal metabolism (the cytochrome P450 chain produces an antigen) and an immune reaction in response to this antigen and these explain why such severe and potentially fatal forms of the condition exist.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fatal toxic hepatitis in pregnancy. A discussion of the role of methyldopa]. 232 42

Data provided by 51 voluntary blood donors identified as asymptomatic HBsAg carriers five to ten years (mean = 7.5 years) before their inclusion in the study are analysed towards their long-term evolution. HBsAg clearance was estimated 2.5% yearly and 83.9% of those remaining positive showed the classical non-replicative serological pattern; another 12.9% were negative for both HBeAg-Anti HBe (seroconversion window?), one of them presenting raised ASAT-ALAT levels and enhanced histological activity (lobular chronic hepatitis). Neither alpha-fetoprotein seric levels (RIA) nor liver ultrasonography demonstrated hepatocellular carcinoma suspicion signs in 35 HBsAg positive cases to this methods; ASAT-ALAT levels raised over two fold the normal superior limit in only 11.4%, and neither aggressive chronic liver disease nor hepatocyte dysplasia was showed in 17 biopsied cases (70.6% normal; 23.6% chronic reactive or chronic persistent hepatitis; 5.8% chronic lobular hepatitis). One out of five patients biopsied with a seven years interval showed histologic worsening.
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PMID:[Long-term course in asymptomatic carriers of HBsAg in an area of low prevalence of hepatocarcinoma]. 248 74

Forty-seven Gabonese children with tuberculosis either limited to the lung or associated with other localizations were treated with isoniazid-rifampin (INH + RIF). They had liver tests done during the first 6 months of treatment. In 30 patients (63.8%) there was an increase in aminotransferase levels [over 100 UI/l in 14 (29.2%)]. The main factors increasing the risk of hepatic toxicity was a high dosage of INH and overall malnutrition. In fact, the weights of patients presenting with signs of hepatic toxicity were significantly lower than those in children who had no alterations of liver function. 68% of the severely malnourished (marasmus of kwashiorkor) presented with high ALAT or ASAT levels during treatment. The eventual role of the chronic HBV carrier state is discussed as 2 children presented with a chronic form of hepatitis at the time the treatment was initiated.
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PMID:[Hepatotoxicity of the combination of isoniazid-rifampicin in African children. Role of malnutrition and HB virus]. 260 23

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.
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PMID:[The clinico-laboratory characteristics of the cholestatic form of acute alcoholic hepatitis]. 263 77

We report 20 cases of alcoholic cirrhosis with superimposed episodes of acute viral hepatitis. Four had acute type B hepatitis and 16, presumed non A non B hepatitis. Before hepatitis, 17 patients had stopped drinking and only four had a complicated cirrhosis. Eighteen patients had received a blood transfusion within the 6 months before the occurrence of hepatitis (mean: 52 days). All patients developed jaundice, 7 encephalopathy, and 5 ascites. The ASAT/ALAT ratio was greater than 1 in 18 patients. Two patients died of hepatic failure. Follow-up was known in 17 of the 18 surviving patients: in all patients jaundice disappeared and transaminases returned to values less than 3 times the upper limits of normal. In our experience, the prognosis is good when viral hepatitis occurs in patients with non complicated alcoholic cirrhosis.
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PMID:[Prognosis of acute viral hepatitis in patients with alcoholic cirrhosis]. 360 35

The following recommendations are to be given for the basis diagnosis of hepatitis: --In the blood donation and blood transfusion institutions the control of the donors is performed by means of the combination ALAT and HBs-antigen (transmigration electrophoresis); depending on methods limits were established showing a high diagnostic specificity. Thus, no doubt, the diagnostic sensitivity is decreased, but the number of the examined persons with falsely positive findings probably diminishes. --For the diagnostics in the clinic the parameters ALAT, ASAT, bilirubin and the thymol turbidity test are at the disposal as criteria of the liver cell damage as well as AP (alkaline phosphatase), AAP and GGT as criteria of the cholostasis and the thymol turbidity test, serum protein including immunoglobulins as criteria of the mesenchymal reaction. The reference areas must be established method-specifically corresponding to the interrogation of the physician. --The isoenzymes of the ALD, the ASAT and the LDH represent an essential enrichment of the diagnostic and prognostic estimation of hepatitis. But at present it is not yet possible to determine these parameters in routine work. However, there gradual introduction into practice should be the aim.
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PMID:[Diagnosis of acute hepatitis]. 613 83


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