Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among 2175 patients seen over the last three years in a non-specialized department of internal medicine with no intensive care unit, 100 had supranormal serum lactic dehydrogenase activities. These patients' case-reports have been analyzed. Nearly half the patients (47/100) had a malignant disease (cancer or hemopathy). Among the remaining patients, 19 had a hepatic disorder (alcohol hepatitis in 10, viral hepatitis in 8, and isoniazide hepatitis in 1), 7 had a heart disease (heart failure with hepatomegaly in 5, myocardial infarction in 2), and 27 had various other conditions (including hemolysis in 6 and polymyositis en 3). The value of serum LDH assay is obvious in situations other than acute conditions such as myocardial infarction of pulmonary embolism; these are better known and have not been studied here as their prevalence was low among the patients enlisted in our study. In comparison to other enzymes (alkaline phosphatase (AP), gamma-glutamyl transpeptidase (GGT), transaminases (GOT, GPT) that were also routinely assayed in our patients, abnormal serum LDH activities are much less common and their significance is quite different. An increase in serum and their significance is quite different. An increase in serum LDH activity indicates a serious condition, often with a fatal outcome. The "various other conditions" group includes patients with hemolysis, hepatitis and myositis; the other patients in this group either had severe infectious diseases or died suddenly in the first few days of their hospitalization before diagnosis had been established. Each etiologic group has been analyzed to asses the characteristics of patients with increased LDH activity according to each etiology. Analysis of coincident abnormalities of the other enzymes listed above shows marked differences between etiologic groups; diagnostic accuracy can thus be enhanced in certain conditions. Most patients with malignancies had poorly differentiated tumors, with metastases: 28 had an epithelial tumor, with hepatic and/or bone metastases in 23 cases, 5 had cancer of the liver, 10 had a malignant hemopathy (2 lymphomas, 5 myeloproliferative syndromes, 3 acute leukemias), and 4 had a sarcoma. Cancer of the lung is the most common malignancy (10 cases) and may be responsible for increased serum LDH activity even in patients without metastases. Serum LDH assay is of value for monitoring the course in patients with initially increased activities as it falls under effective therapy and rises during exacerbations.
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PMID:[Value and diagnostic significance of serum lactic dehydrogenase in internal medicine (author's transl)]. 628 24

Bridging hepatic necrosis has, in the past, been found to be of prognostic significance in patients with acute viral hepatitis. In two studies performed on a selected group of patients with acute viral hepatitis, one-third of the patients with bridging hepatic necrosis developed chronic liver disease. These patients differed from the average hepatitis patient in that they were more severely ill and a higher percentage of them had acute viral hepatitis Type B. As all army personnel in Israel who develop jaundice and are suspected of having acute viral hepatitis are hospitalized, regardless of their clinical state, they constitute a group of patients not preselected for severity of illness. Forty-eight soldiers diagnosed clinically and biochemically as having viral hepatitis were hospitalized during a 27-month period. After giving informed consent, 41 of them underwent a liver needle biopsy within a few days of hospitalization. Each histological specimen was coded, and was then examined for bridging hepatic necrosis by three independent observers. Fourteen patients (34%) were found to have bridging hepatic necrosis. Clinically, these patients could not be clearly separated from the group without bridging hepatic necrosis, although hepatomegaly was more frequent among them, and their mean leukocyte count and bilirubin and alkaline phosphatase levels were higher. During a follow-up of more than 1 year, patients in both groups recovered completely. Four patients, two in each group, consented to a second liver needle biopsy, which was found to be normal. We conclude that bridging hepatic necrosis seems to be more common than expected, and does not seem to have the severe prognostic significance attributed to it in the past.
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PMID:Bridging hepatic necrosis in acute viral hepatitis. 669 68

A newly recognized clinical and morphologic pattern of acute alcoholic liver disease is described. Twenty-one patients, having the hepatic morphologic features of alcoholic foamy degeneration, were retrospectively analyzed. All patients had a significant history of chronic alcoholism. Jaundice and hepatomegaly were usually present. Hepatic encephalopathy, ascites, bleeding esophageal varices, or functional renal failure occurred in less than 10%. Usually this was the first episode of decompensation. Laboratory studies revealed a pattern of very transiently marked elevation of serum aminotransferase and more prolonged elevation of alkaline phosphatase activity and bilirubin levels. In the majority of cases, leukocytosis was absent, and serum cholesterol was elevated. The laboratory profile differed significantly from that of acute sclerosing hyaline necrosis. Serologic markers of acute viral hepatitis A and B were absent. Needle biopsy specimens of the liver revealed intact lobular architecture except for 1 case of cirrhosis. The perivenular hepatocytes revealed foamy fatty change characterized by striking cell swelling with massive accumulation of microvesicular fat, bile pigment deposition in the cytoplasm, and no displacement of the nucleus to the periphery of the cell. Megamitochondria were frequently identified. Multiple foci of hepatocyte dropout without significant parenchymal neutrophilic exudation and delicate intrasinusoidal collagen fibers were present in the perivenular area. Macrovesicular fatty change coexisted to a variable degree. The affected hepatocytes had extensive disorganization of the organelles by electron microscopy and decreased or absent functional activity by enzyme histochemical staining. These changes appear to be a purely degenerative process without inflammatory reaction. All patients in the present series showed a rapid recovery upon abstaining from alcohol.
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PMID:Alcoholic foamy degeneration--a pattern of acute alcoholic injury of the liver. 682 80

In order to assess the prevalence of venocclusive disease in autopsied recipients of bone marrow transplantation, we reviewed coded liver histology from 204 consecutive autopsied recipients transplanted for leukemia (142), other malignancies (5), or aplastic anemia (57). Twenty-seven patients with leukemia, 2 with carcinoma, and 3 with aplasia had venocclusive disease and survived 2-86 days post-transplant. Early lesions showed subintimal edema and hemorrhage within small central venules and centrilobular congestion with hepatocyte degeneration. Later lesions showed subtotal to complete fibrous obliteration of the central venule lumina and centrilobular sinusoidal fibrosis. Thirteen patients had a subclinical course, and 19 were symptomatic. Venocclusive disease was life-threatening or lethal in 13. Typical symptoms developed 1-3 wk post-transplant and consisted of sudden weight gain, hepatic enlargement, ascites, high bilirubin, and encephalopathy. Statistical analyses showed a significantly higher prevalence of venocclusive disease associated with transplantation for leukemia (P = 0.014), pretransplant conditioning with more rigorous chemoradiotherapy regimens (P < 0.001) and three- to fourfold increase of venocclusive disease in patients whose conditioning included dimethyl busulfan (P < 0.005). Abnormal liver tests before transplant were also more prevalent among patients with venocclusive disease. No factors predicted the clinical outcome of established venocclusive disease. Venocclusive disease showed no association with hepatic graft-versus-host disease even among prolonged cases with severe periportal hepatitis and cholestasis. Other centrilobular lesions (hepatocyte degeneration, sinusoidal fibrosis, and phlebosclerosis) were identified in 23 patients. These non-specific changes may occur with viral hepatitis, graft-versus-host disease or chemoradiotherapy effects.
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PMID:An analysis of hepatic venocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation. 700 4

Immunofluorescence (IF), indirect hemagglutination test (IHA), latex-agglutination test (LA), and immunofluorescence of activated sepharose particles (IFS) were used for early specific diagnosis of viral hepatitis A (VHA). The antisera used in the tests were those from convalescents after VHA collected at 25-30 days which had no HBs antigen or antibody to it. The IF and IHA tests were found to be most sensitive for examination of VHA patients. In VHA foci, positive IF tests were found in 22%-72% contacts (in relation to the number of manifest forms in a focus of infection) which in 84.6% cases correlated with enlarged liver. In parallel examination of contacts in one of VHA foci by IF and IHA tests similar results were obtained and the infection-rate in the group was 64.3% and 64% respectively.
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PMID:[Comparative evaluation of several methods of diagnosing hepatitis A]. 702 Feb 47

In the period from 1991 to 1993, 18 patients with the acute viral hepatitis type C were treated and followed up--13 men and 5 women, the average age of 42 years. The group of 6 patients (4 men and two women) with the "old" proven liver cirrhosis, whose etiology was unknown for 20 years, was analyzed. The investigations showed that the acute viral hepatitis type C usually began with the mild subjective disorders. The half of the patients did not have either jaundice or hepatomegaly, only half of them recover, and the first cases of cirrhosis could have been expected almost as early as a year after the beginning of illness. The developed liver cirrhoses remained compensated for years. About 58% of patients got infected parenterally, and the rest of them could have gotten infected in other manner. ELISA test showed great reliability in proving the antibodies against the viral hepatitis type C in the confirming the diagnosis of illness.
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PMID:[Viral hepatitis C. Personal experience with diagnostic, monitoring and epidemiologic studies]. 757 22

Glycyrrhizin (GL) has an inhibitory effect on several viruses including human immunodeficiency virus type 1 (HIV-1) and varicella-zoster virus (VZV). In addition, some therapeutic and prophylactic effects on chronic active viral hepatitis have been claimed for GL. In this study, 0.2% GL dissolved in saline (2 mg/ml GL), supplemented with 2% glycine and 0.1% cysteine (Stronger Neo-Minophagen C, SNMC) was administered intravenously in a dose of 50 ml/day for a period of more than one week to three infants with cytomegalovirus (CMV) infection who exhibited abnormal liver function or hepatomegaly. Liver function had become normal at the end of the course of SNMC. These findings suggest that GL might have therapeutic effects on liver dysfunction associated with CMV infections.
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PMID:Effect of glycyrrhizin in children with liver dysfunction associated with cytomegalovirus infection. 807 26

Early appearance of clinical jaundice is rare presentation in enteric fever. Although abnormal biochemical tests suggestive of hepatic involvement has already been suggested in 23-60 per cent of cases. The early hepatic changes have been attributed to generalised bacteraemia, persistence of hepatomegaly and hepatic lesion during pyrexial stage. But the typhoid hepatitis has been ignored as a clinical entity. In this report the importance of typhoid hepatitis and its clinical significance for the diagnosis of enteric fever is highlighted, particularly at places where viral hepatitis and hepatic amoebiasis are usually common and enteric fever is endemic.
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PMID:Typhoid hepatitis: report of two cases. 882 55

Typhoid Hepatitis is a rare presentation of typhoid fever, clinically suspected in patients with persistent fever hepatomegaly and jaundice and especially in cases where the liver function tests show predominantly conjugated hyperbilirubinemia, modest elevation of liver enzymes and negative serology for viral hepatitis. From January, 1989 to December, 1994, 476 cases were included in this study, 204 with typhoid fever admitted in JPMC Karachi and 272 in Civil Hospital, Quetta. Eleven percent cases had typhoid hepatitis. Nineteen (4%) cases were initially diagnosed as viral hepatitis and 33 (7%) developed jaundice later on. As typhoid is prevalent in Pakistan and typhoid hepatitis is a challenging problem, accurate and simple methods are required for diagnosis in all febrile cases. It should particularly be considered as a differential diagnosis for cases with fever, jaundice and hepatomegaly.
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PMID:Typhoid hepatitis. 892 May 99

To study prevalence of cytomegalovirus (CMV) infection in patients with viral hepatitis and its clinical characteristics, serum anti-CMV-IgM was detected in 6411 hospitalized hepatitis cases, and clinical symptoms, signs and liver function in 115 cases with CMV infection were compared with 192 cases of non-CMV infection. Results showed a CMV infection rate of 1.79% in them with an average age of 33.6 years, a sex ratio of 2.13, and dual superinfection with CMV and hepatitis accounting for 44.74%, and triple and quadruple superinfection for 47.37% and 7.89%, respectively. Proportion of those with fever, digestive symptoms, hepatomegaly, changes of gallbladder in ultra sound scan, rising activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (gamma-GT) were more, and duration of hospitalization longer in the cases with CMV infection. It suggests that CMV can be found in the cases with viral hepatitis, most in a form of dual or multiple infection, and it can aggravate hepatitis.
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PMID:[An analysis of CMV infection in 115 cases with viral hepatitis]. 920 27


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