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Query: UMLS:C0019209 (
hepatomegaly
)
5,798
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Liver biopsies were done on 20 patients with histiocytosis X (HX) as part of pretreatment evaluation prior to entry on two Childrens Cancer Study Group protocols. Seventeen patients had
hepatomegaly
, and seven had one or more abnormal laboratory parameters using Lahey's criteria for liver dysfunction. Nineteen of 20 specimens showed various abnormalities of the portal triads. A single biopsy revealed normal liver. Among the changes were triaditis, bile duct proliferation, variable fibrosis with histiocytic infiltrates, and cirrhosis. One patient had typical granulomas of HX within the liver parenchyma in addition to portal triaditis. Patients with larger livers and dysfunction tended to show more marked histologic abnormalities in the portal triads. However, correlations among liver size, function, and pathology showed considerable overlap. Early death among these patients was more likely to be associated with progressive HX in other sites and/or infection. Death from cirrhosis and liver failure per se occurred in one patient 4 years after initial biopsy, but five other children had evidence of cirrhosis on biopsy or at autopsy. The majority of patients with triaditis initially did not have clinical evidence of progressive
liver disease
although four expired with other manifestations of HX or infection. Conversely, patients showing fibrohistiocytic changes or cirrhosis initially were likely to have continuing or progressive
liver disease
. Although the liver histology was not diagnostic of HX, the types of portal changes usually predicted the subsequent course of
liver disease
.
...
PMID:Pretreatment liver biopsy in 20 children with histiocytosis X: a clinicopathologic correlation. 240 53
This review article is mainly concerned with the incidence and pathogenesis of alcohol-induced liver diseases. Clinically the most relevant symptom is a
hepatomegaly
. During the course of the disease there is to state progression to alcoholic hepatitis with increasing jaundice. The laboratory values show different patterns; severe courses develop progression to a fulminant hepatitis. The diagnostic approach includes exact patient's medical history, clinical and laboratory investigations, followed by a step-wise diagnostic procedure including histology. Therapeutically the main approach is a diet, in case of malnutrition substitution of vitamins and only rarely the need of corticosteroids and/or anabolic steroids. Prognosis and long-term course of alcoholic-induced
liver disease
depend mainly on the severity of the disease and the consequent alcohol-free diet.
...
PMID:[Alcohol-induced liver diseases]. 265 33
Liver injury may develop in some people who consume alcohol. The pathogenesis of liver damage in such subjects remains obscure. Major histopathologic features of alcohol-associated liver injury include steatosis, steatonecrosis, and cirrhosis. The clinical manifestations of alcoholic
liver disease
are nonspecific and range from asymptomatic
hepatomegaly
to stigmata of portal hypertension with advanced parenchymal failure. The severity of the clinical presentation and the degree of aminotransferase elevation correlate poorly with the liver histopathology, particularly in patients who continue to drink alcohol. Short-term mortality of such patients is best predicted by a composite of clinical and laboratory parameters that are influenced by alcohol consumption as well as by
liver disease
. Long-term prognosis is determined by residual damage to vital organs (that is, whether or not cirrhosis has developed) and whether or not the patient continues to drink. Current therapy of alcoholic
liver disease
includes abstinence and correction of nutritional deficiencies. Other therapies are experimental and are best utilized in the setting of controlled clinical trials.
...
PMID:Alcoholic liver disease. 265 64
The liver tissue of 26 children with biliary atresia was compared to that of 20 adults with autoimmune chronic active hepatitis, 20 adults with chronic hepatitis due to hepatitis B infection, and 5 children with alpha 1-antitrypsin deficiency in terms of the number and type of mononuclear cells in portal and lobular areas of each using a panel of specific monoclonal antibodies that recognize different cell surface epitopes. All of the tissues studied were obtained at time of liver transplantation. In addition the livers of 5 adults biopsied for
hepatomegaly
but found to have no histologic
liver disease
were used as normal controls for this study. The results demonstrate that liver tissue obtained from children with end-stage biliary atresia is more like normal liver in terms of the number and type of mononuclear cells present than in either of the two types of adult liver diseases. Moreover although the liver of children with end-stage alpha 1-antitrypsin deficiency is more like that of normal liver than either of the two adult liver diseases studied in terms of the number and type of mononuclear cells within the liver, it is less similar to that of normal adult liver than is liver tissue obtained from children with biliary atresia. These findings suggest that as a morphologic basis biliary atresia is unlikely to be due to either a viral or an autoimmune attack upon the liver.
...
PMID:Phenotypic characterization of mononuclear infiltrate present in liver of biliary atresia. 267 28
Over a 15-year period we observed seven children (four girls, three boys) who presented within the first months of life with severe renal failure and acidosis, associated with hypertension in five patients and polyuria in four. In addition, one patient had a severe cholestatic
liver disease
. In two families, a similarly affected sibling had died previously. Four patients were referred with the clinical diagnosis of polycystic kidney disease because of moderate enlargement of kidneys, but renal imaging (intravenous pyelography and ultrasonography) did not confirm this diagnosis. A renal biopsy, performed in all patients, showed similar features characterized by a diffuse chronic tubulo-interstitial nephritis (TIN) and particularly by the presence of microcystic dilatation of proximal tubules and Bowman's space. Liver pathology was normal in two patients, including one with
hepatomegaly
. However, in the patient with cholestasis there was inflammatory portal fibrosis with mild duct proliferation. Progression of the renal disease was extremely rapid and all patients reached end-stage renal failure (ESRF) before the age of 2 years (11-22 months). Two children had successful renal transplants. Although this chronic TIN shares some features with nephronophthisis, we suggest that it represents a distinct entity both on clinical and morphological grounds. The specific clinical features of this disease are its early onset and rapid progression to ESRF. Pathologically, it differs from nephronophthisis by the absence of medullary cysts and thickened tubular basement membranes and by the presence of cortical microcysts.
...
PMID:Infantile chronic tubulo-interstitial nephritis with cortical microcysts: variant of nephronophthisis or new disease entity? 270 88
Predictive factors for the first digestive tract hemorrhage and for death in cirrhotic patients have been partially studied in prophylactic shunt trials and never prospectively according to multivariate analysis method. We prospectively followed 106 cirrhotic patients (88 p. 100 with alcohol abuse) with large esophageal varices without past history of bleeding during a mean period of 13.3 +/- 6.1 months. Of 23 clinical and biochemical variables recorded at entry as well as alcohol withdrawal evaluated during the course of the study, we looked for those which had independent prognostic value for the risks of bleeding and death according to a multiple regression analysis (Cox's model). At the end of the study, 30 patients had bled and 40 were dead. The cumulative one-year percentages of patients were 72 p. 100 free of bleeding and 65 p. 100 surviving (95 p. 100 confidence limits: 62 and 81, 54 and 73, respectively). The bleeding risk was positively correlated with variceal size, plasma creatinine and negatively correlated with age and mean arterial pressure. The bleeding risk varied according to variceal size: medium: 23 p. 100, large: 44 p. 100 (p less than 0.05). An increase in Child-Pugh score, plasma creatinine and mean corpuscular volume as well as
hepatomegaly
were independent predictive factors for death. The death rate was (according to Child-Pugh grade): A: 14 p. 100, B: 33 p. 100, C: 50 p. 100 (p less than 0.01). We conclude that bleeding risk is maximum in young patients with large varices and the death rate is dependent on severity of
liver disease
.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Predictive factors of the first digestive hemorrhage and death in cirrhotic patients with esophageal varices]. 278 97
From October 1982 to June 1985 158 hospitalized patients in the National Hospital of Niamey, Republic of Niger, were selected whenever one of the following signs was found:
hepatomegaly
, jaundice, ascites, oesophageal varices, abdominal venous pattern, or splenomegaly. Investigations included hepatic echography (158/158), needle liver biopsy (68/158), radioimmunoassays for serum hepatitis B surface antigen (HBsAg; 158/158), anti-HBs (152/158), anti-HBc (129/158) and anti-delta antibody (anti-HD; 158/158). 112 patients with liver diseases comprised 28 with chronic hepatitis, 55 with non-alcoholic hepatic cirrhosis, and 29 with hepatocellular carcinoma (HCC). 46 patients with other diagnoses were used as controls. 71/112
liver disease
patients were positive for HBsAg in serum compared with 1/46 controls (P less than 10(-9)). Prevalences of delta superinfection in patients with serum HBsAg (+) and anti-HD (+) were 45/112 (40.2%) in
liver disease
patients versus 1/46 (2.2%) in controls (P less than 10(-9)). Delta superinfection was very frequent in chronic hepatitis (8/28), non-alcoholic cirrhosis (24/55) and HCC (14/29). In chronic hepatitis, delta superinfection was more frequent in the chronic active form than in the chronic persistent type (not significant). Cirrhosis patients with delta superinfection were younger (10 years in males, 11 years in females) than those without (P less than 0.05).
...
PMID:Delta superinfection in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma in a Sahelian area. Study of 112 cases versus 46 controls. 284 9
Peripheral blood cholyglycine and procollagen-III-peptide were measured in 22 Zairean patients with
hepatomegaly
caused by S. mansoni before and after treatment with praziquantel. Circulating T-cell subsets and cutaneous in vivo delayed type hypersensitivity were assessed; serum neopterin and beta 2-microglobulin served as indicators for macrophage/lymphocyte activation. The results were compared to age and sex matched patients with S. mansoni infection limited to the intestinal tract and schistosomiasis free controls with equal socioeconomic background. Abnormal serum cholyglycine and neopterin levels and alterations of circulating T-cell subset frequencies were associated with
hepatomegaly
in schistosomiasis. Normalization of these parameters reflected a regression of egg-induced immunopathology as early as two months after specific chemotherapy. Serum procollagen-III-peptide concentrations rose significantly after treatment, suggesting release of propeptide previously incorporated without cleavage into tissue collagen. The combination of these biochemical and immunological parameters may allow assessment of the pathophysiological mechanisms responsible for
liver disease
in individual patients.
...
PMID:Liver involvement in human schistosomiasis mansoni. Regression of immunological and biochemical disease markers after specific treatment. 290 28
Liver disease
, although usually asymptomatic, is a frequent accompaniment of AIDS.
Hepatomegaly
and macrosteatosis are prevalent but non-specific findings. Evidence of remote hepatitis B virus infection is extremely common; however, the HBsAg carrier state, chronic active hepatitis, or cirrhosis occur no more frequently in AIDS patients than in the general population. Opportunistic intrahepatic infections (such as MAI, fungi, and CMV) or neoplasms (such as lymphoma or KS) usually reflect a disseminated process; liver involvement generally does not directly cause morbidity or result in death. Although biochemical liver tests are commonly elevated in the AIDS population, alkaline phosphatase has proved to be the most specific enzyme for infiltrative processes. Percutaneous liver biopsy has a high diagnostic yield, although the treatment options are currently limited. Acalculous cholecystitis and biliary tract obstruction have been recently described and probably result from CMV and/or cryptosporidial infection. Radiologic features of papillary stenosis and/or sclerosing cholangitis have been demonstrated. In contrast to hepatic parenchymal disease, these entities may be amenable to surgical or endoscopic therapeutic maneuvers.
...
PMID:Hepatobiliary abnormalities of AIDS. 304 66
We studied the risk of posttransfusion hepatitis in recipients of blood collected from volunteer donors who tested negative for HBsAg and had serum ALT levels less than 1.5 times the upper limit of the normal range. Between October, 1983 and September, 1984, 676 consecutive patients who needed blood or plasma transfusions during or after elective surgery, who had no history of
liver disease
and had never received blood previously, were studied. The patients were given a total of 4,813 (mean = 7) units. Ninety-six patients developed posttransfusion hepatitis, which yielded a hepatic incidence of 20 cases per 1,000 units of transfused blood. Ninety-two patients had non-A, non-B hepatitis, 3 had hepatitis B and 1 had cytomegalovirus infection. The incubation periods for non-A, non-B hepatitis ranged from 2 to 26 (mean = 9.5 +/- 4) weeks. In 68 (73%) patients, the hepatitis was completely asymptomatic; only 24 (27%) patients developed symptoms, including jaundice and
hepatomegaly
. There were no cases of fulminant hepatitis. Sixty per cent of the patients still had elevated serum ALT levels 1 year after the onset of hepatitis. The 96 patients with hepatitis had received a mean of 9.6 blood units, as compared to a mean of 6.7 units for the unaffected patients (p less than 0.001). This study demonstrated that non-A, non-B hepatitis remains a common and important complication of blood transfusion despite screening of blood donors for HBsAg and elevated serum ALT levels.
...
PMID:A multicenter, prospective study of posttransfusion hepatitis in Milan. 311 67
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