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)

Twelve patients with liver disease related to methyldopa were seen between 1967 and 1977. Illness occurred within 1--9 weeks of commencement of therapy in 9 patients, the remaining 3 patients having received the drug for 13 months, 15 months and 7 years before experiencing symptoms. Jaundice with tender hepatomegaly, usually preceded by symptoms of malaise, anorexia, nausea and vomiting, and associated with upper abdominal pain, was an invariable finding in all patients. Biochemical liver function tests indicated hepatocellular necrosis and correlated with histopathological evidence of hepatic injury, the spectrum of which ranged from fatty change and focal hepatocellular necrosis to massive hepatic necrosis. Most patients showed moderate to severe acute hepatitis or chronic active hepatitis with associated cholestasis. The drug was withdrawn on presentation to hospital in 11 patients, with rapid clinical improvement in 9. One patient died, having presented in hepatic failure, and another, who had been taking methyldopa for 7 years, showed slower clinical and biochemical resolution over a period of several months. The remaining patient in the series developed fulminant hepatitis when the drug was accidentally recommenced 1 year after a prior episode of methyldopa-induced hepatitis. In this latter patient, and in 2 others, the causal relationship between methyldopa and hepatic dysfunction was proved with the recurrence of hepatitis within 2 weeks of re-exposure to the drug.
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PMID:Patterns of hepatic injury induced by methyldopa. 42 37

Liver function tests were performed in 165 hospitalized patients suffering from P. falciparum malaria with complications. Serum bilirubin was found increased in 33 patients, and 22 of them had unconjugated hyperbilirubinaemia. Serum alanine aminotransferase was increased in 5 patients, but only to mild to moderate levels. Serum alkaline phosphatase was increased in 11 patients, gamma-glutamyl transpeptidase in 3 patients. Serum total protein and albumin were significantly decreased but these were considered more as indicator of acute phase response. Liver cell necrosis was observed in one patient, and oedema and mononuclear cell infiltration in two patients. Though hepatomegaly and mild elevation of enzymes can be observed in a significant proportion of patients, involvement of liver leading to acute hepatitis or liver cell necrosis is a relatively uncommon complication in P. falciparum malaria.
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PMID:Hepatic changes in P. falciparum malaria. 128 32

Authors have performed an anatomo-clinico-biological comparison of two groups of hepatitis with lobular inflammation: group I with a simple lobular inflammation, called lobular hepatitis, and group II with a lobular inflammation associated with portal and periportal hepatitis, called chronic active hepatitis (CHA) with lobular hepatitis. Furthermore, a comparative study of these forms with a group of CHA without lobular inflammation was performed. Both forms of lobular inflammation appeared in young patients, the large majority of whom were infected with the hepatitis B virus; in 5 cases of CHA with lobular hepatitis the presence of the delta agent in the liver, possibly responsible of the lobular inflammation, was detected. The two forms of lobular hepatitis are differentiated by: the fivefold increase of ALAT over the normal value, with usually normal gamma-globulins and albumin, in the first group; in the lobular hepatitis, HBsAg was present in 33% of cases in the first group and in none of the patients of the second group, suggesting the integration of HBsAg within the hepatocytic genome; the clinical picture was generally asymptomatic in the first group and noisier, with hepatomegaly, in the second group; the period elapsed since the acute hepatitis was shorter in the first group (4-11 months) in 8 of 15 patients and longer in the second group. The clinical course of these forms of hepatitis if unforeseeable and the diagnosis is established on the basis of the morphological examination.
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PMID:[The significance of lobular inflammation in chronic active hepatitis]. 134 56

A 49-year-old man was admitted to Mitsui Memorial Hospital because of fever of unknown origin. Since one year ago, he had often used intravenous narcotic drugs. Ten months before his admission, he had his first experience of fever and a chill. Four months later, he was admitted to a hospital under the diagnosis of pneumonia and he was treated successfully. After his discharge, he began to use drugs again, which resulted in the repetition of fever and chills during four months prior to his admission to our hospital. On admission, physical findings concerning the patient were unremarkable, except for mild hepatomegaly. ECG and chest X-ray were normal. Laboratory data revealed marked inflammatory changes and severe liver injury. Blood culture disclosed Campylobacter fetus and two dimensional echocardiography showed a large vegetation on the anterior tricuspid valve. He was diagnosed as isolated tricuspid infective endocarditis accompanied with acute hepatitis due to drug abuse. Moreover pulmonary perfusion scintigraphy showed decreased perfusion in the right lower lung field, which suggested that pneumonia of six months ago was due to septic pulmonary emboli from the infected tricuspid valve. The combined antibiotics therapy was successful. By the follow-up echocardiographic studies, the size of vegetation was observed to decrease progressively.
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PMID:[A case of right-sided infective endocarditis in a drug addict]. 233 Apr 63

The presence of IgM antibodies for the HVA and HBc antigens in 90 children of 15 or less years with acute hepatitis were investigated, finding that 62% (58) were positive for HVA, 8.9% (8) for HBc and 27.8% (25) did not show antibodies for HVA or HBc (non-A non-B hepatitis); comments are made on some clinical and epidemiological findings such as a higher frequency of blood transfusions in HNANB, more males in HB and HNANB, and more hepatomegaly and liver sensitivity in HNANB.
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PMID:[Hepatic markers (Ac-HVA-IgM and AcHBc-IgM) in cases of infectious hepatitis in Dominican children]. 271 55

Eleven patients of Chinese origin experienced spontaneous reactivation of chronic active hepatitis B. Eight HBsAg-positive patients were followed for an average of 15 months prior to, while three others presented during reactivation. Fatigue, hepatomegaly and jaundice were frequent findings. Elevation of both serum ALT (average = 1,212 units per liter) and hepatitis B virus DNA levels were noted in all patients, and reactivation lasted an average of 4.4 months. During resolution, clinical symptoms abated, serum ALT levels reverted toward normal, and in nine patients, the hepatitis B virus DNA values became undetectable. All patients lacked evidence for acute hepatitis A, Epstein-Barr Virus, cytomegalovirus or hepatitis delta virus infection. Histologic findings of liver tissue from eight patients showed piecemeal necrosis and fibrosis. Within the parenchyma, varying degrees of hepatocytolysis with cuffing, perivenular necrosis and acidophilic bodies were noted. Ground-glass cells and regenerative changes also were observed. Cirrhosis was not present in any of the liver biopsies. These findings suggest that spontaneous reactivation of hepatitis B occurs in heterosexual patients with chronic active hepatitis B and contributes to chronic inflammation and to the progression of their liver disease.
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PMID:Spontaneous reactivation of hepatitis B in Chinese patients with HBsAg-positive chronic active hepatitis. 361 49

In the past 10 years we have examined 20 children with inflammatory liver disease associated with high serum titers of anti-liver-kidney microsome antibody (anti-LKM). The first hepatic symptoms were progressive fatigue and jaundice, the fortuitous finding of hepatomegaly or splenomegaly with raised transaminase activity, or an acute hepatitis-like illness. At the time of diagnosis, hepatomegaly was present in 18 children, splenomegaly in 16, jaundice in nine, and ascites in two. Serum alanine transferase activities were elevated in all but two, who had already received steroids. Serum total gammaglobulin values were greater than 2.0 gm/dl in 16 children, prothrombin activity less than or equal to 60% in six, and serum titer of anti-LKM between 1:100 and 1:100,000. All children but one had cirrhosis, and histologic signs of aggressivity were present in 14. In 11 children one or more extrahepatic diseases were present, including type 1 diabetes, vitiligo, glomerulonephritis, autoimmune hemolytic anemia, hypoglycemia with hyperinsulinism, autoimmune thyroiditis, chronic mucocutaneous candidiasis with hypoparathyroidism, and multiple cutaneous and visceral telangiectasias. Treatment with prednisone and azathioprine improved the liver condition in 16 of the 18 patients given treatment. In eight of them discontinuation of treatment resulted in rapid relapse; 14 are still receiving treatment and have stable hepatic function with follow-up from 8 months to 6 1/2 years. Only two are free of treatment. Four children died, two in spite of immunosuppressive therapy, one during a relapse, and one of extrahepatic disease. These results indicate that this autoimmune inflammatory liver disease may have onset early in life, with several clinical patterns; is frequently associated with certain types of extrahepatic manifestations of autoimmune origin; and is a potentially fatal disease for which immunosuppressive treatment must be started early.
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PMID:Liver disease associated with anti-liver-kidney microsome antibody in children. 395 Aug 19

Eight hundred Jordanians with liver enlargement were studied: 369 (46%) were males and 431 (54%) females. Ages ranged between 13 and 85 years, with a mean of 47.4%: 766 cases demonstrated a single pathological process while 34 cases showed two or more processes. The most significant findings were: congestion secondary to cardiac failure in 323 cases (38.5%); inflammatory and parasitic processes in 192 cases (22.9%), including acute hepatitis (81 cases), hydatid cyst (63 cases), chronic hepatitis (27 cases), liver abscess (19 cases), brucellosis (one case) and malaria (one case); malignancy in 164 cases (19.6%); liver cirrhosis in 80 cases (9.5%); fatty metamorphosis in 47 cases (5.6%); metabolic and genetic disease in 11 cases (1.3%); miscellaneous conditions in nine cases (1.1%); and 15 apparently normal individuals (1.8%). Cardiac failure was the most frequent cause of hepatomegaly in this sample of Jordanians. Inflammatory processes were the second major cause, followed by malignancy and cirrhosis of the liver.
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PMID:Patterns of hepatomegaly in Jordanians: a prospective study of 800 cases. 407 96

A case report is presented of a young woman in whom symptomatic porphyria cutanea tarda (PCT) developed during copper chelation therapy for Wilson's disease. The 22 year old white woman was seen in the summer of 1978 because of development of blisters on the dorsa of the hands associated with focal atrophic hypopigmentation, generalized hyperpigmentation of the skin, and hpertrichosis of the lateral forehead and face. A sibling had died in childhood with Wilson's disease. When the patient developed hepatomegaly, ascites, and an acute hepatitis syndrome at the age of 11, penicillamine therapy was empirically started, with gradual symptomatic improvement. When evaluated at the age of 22, abnormal laboratory values included a total bilirubin of 1.2 mg%; alkaline phosphatase, 96 U; serum glutamic oxaloacetic transaminase (SGOT), 175 U; serum glutamic pyruvic transaminase (SGPT), 122 U; gamma glutamyl trans peptidase (GGTP), 64 U; and Bromsulphalein (BSP) retention, 21% at 45 minutes. Skin biopsy from the hand revealed a noninflammatory subepidermal bulla with prominently PAS positive vessel walls in the festooned dermal papillae at the base of the blister. A fragmented liver biopsy failed to reveal evidence of active hepatitis or cirrhosis, but considerable stainable iron was present in both hepatocytes and Kupffer cells. A rubeanic acid stain for copper was negative. The patient was diagnosed as having Wilson's disease, hepatic hemosiderosis, and PCT. Cessation of all ethanol consumption and discontinuation of the oral contraceptives which she had been taking for 6 years, was recommended. On examination 9 and 22 months after these modifications were instituted, the patient felt asymptomatic and was without evidence of any new blisters or scars of her skin. The hyperpigmentation and hypertrichosis persisted, but she rigidly adhered to a program of penicillamine, topical sunscreen application, and abnegation of alcohol. Liver function studies were normal, and urinary porphyrin levels returned toward normal values. The clinical onset of this patient's blistering disease was temporally associated with ethanol and exogenous estrogen medication.
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PMID:Porphyria cutanea tarda complicating Wilson's disease. 720 91

The results of clinical, biochemical and histological studies in 26 children with chronic hepatitis B are reported. Most cases were detected when diagnostic procedures were arranged because of non specific abdominal complaints, by routing tests after acute hepatitis or multiple transfusions, and by examination of family members. Hepatomegaly was found in half of the cases, splenomegaly in a quarter. Other clinical signs were rarely seen. Among the biochemical findings, elevated serum transaminase activities were the most reliable indicators of chronic hepatitis. There was a significant difference of the mean transaminase activities between patients with CPH and CAH. In 15 children CPH was diagnosed histologically. 9 children had CAH, 2 children showed signs of MinH.
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PMID:Chronic viral hepatitis B in childhood. I. Clinical , Biochemical and histological results. 744 99


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