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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although much is known about the neuropsychological functioning of cirrhotic individuals with Laennec's (alcohol associated) cirrhosis, little is known about the neuropsychological functioning of individuals with nonalcoholic cirrhosis. In the present investigation, we have determined that individuals suffering from chronic nonalcoholic cirrhosis, despite the absence of clinical signs of hepatic encephalopathy, are impaired on neuropsychological tests that measure visuopractic capacity, visual scanning, and perceptual-motor speed. In contrast, intellectual, language, memory, attentional, motor, and learning abilities are intact. In comparison with a chronically ill control group of patients suffering from Crohn's disease, individuals with advanced nonalcoholic cirrhosis exhibit less emotional disturbance, but are more impaired in their daily activities. These findings indicate that individuals with nonalcoholic cirrhosis, even in the absence of overt clinical signs of encephalopathy, manifest neuropsychological impairments and experience significant disruption in the routines of everyday living.
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PMID:Nonalcoholic cirrhosis associated with neuropsychological dysfunction in the absence of overt evidence of hepatic encephalopathy. 671 71

Endotoxins are constituents of the capsules of intestinal gram-negative Flora. Under pathological conditions with limited clarification function of the liver RES (alcoholic hepatitis, severe virus hepatitis, cholestasis, cirrhosis of the liver) they do reach the systemic circulation. If the colon is primarily diseased (ulcerative colitis, Crohn's disease) or secondarily damaged (edema of the colonic wall in acute pancreatitis) they pass through the wall into the peritoneal cavity and from there into the systemic circulation (endotoxemia). Attention to the endotoxemias can explain a number of systemic complications which often determine the clinical course of the diseases named. A basis is also created for seeking an effective form of therapy.
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PMID:[Endotoxins and the pathogenesis of gastrointestinal diseases (author's transl)]. 678 50

Serum cryoglobulins were detected in the majority of patients with liver disease, and in all patients with Crohn's disease and ulcerative colitis. Their incidence in acute hepatitis was similar to that in chronic active hepatitis or cirrhosis. All patients had serum cryoglobulins in the range of 5-76 micrograms/ml, except for a subgroup of patients with acute non-B hepatitis, who had much higher levels. The predominant immunoglobulin in the cryoprecipitates was IgMK. The significance of these results is discussed and possible mechanisms for the high prevalence of cryoglobulins in liver and inflammatory bowel diseases are suggested.
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PMID:Cryoglobulins in patients with acute hepatitis and inflammatory bowel disease. 715 58

Serum levels of sIgA were quantitated by a new radioimmunoassay in patients with a variety of diseases, lactating women and clinically healthy blood donors. Significantly elevated levels compared to controls were found in lactating women, patients with Crohn's disease and patients with cirrhosis, but not in patients with rheumatoid arthritis, IgA myeloma or neoplastic disease. Patients with inflammatory disease and serum IgA levels at least two-fold greater than the normal mean and patients with a variety of other diseases did not show elevated levels of sIgA. In the two latter groups, patients with hepatic disease were excluded. High levels of sIgA were found in four patients with liver metastases from extrahepatic neoplasms. The results indicate that the liver is important for the maintenance of normal serum levels of sIgA.
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PMID:Reassessment of levels of secretory IgA in pathological sera using a quantitative radioimmunoassay. 728 96

Experience using microaggregated human serum albumin for a Kupffer cell phagocytic capacity "stress test" in patients with liver and inflammatory bowel diseases is described. Each result has been related to a 1-hr BSP clearance in order to account for variations in liver blood flow. Kupffer cell clearances are reduced in proportion to BSP clearance in obstructive jaundice and in secondary biliary cirrhosis but are increased in patients with chronic hepatocellular inflmmation. Conversely Kupffer cell phagocytosis is often depressed in patients with alcoholic hepatitis. In Crohn's disease or ulcerative colitis RES function is normal unless patients are receiving corticosteroid suppression.
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PMID:Kupffer cell phagocytosis in relation to BSP clearance in liver and inflammatory bowel diseases. 737 74

Twenty-nine patients with primary sclerosing cholangitis were reviewed. Males predominated (2:1). Seventy-six per cent presented with cholestasis and cholangitis, 17% with cirrhosis and portal hypertension, and 7% were asymptomatic, presenting with a raised serum alkaline phosphatase. The serum immunoglobulin IgM concentration was raised in 45% of the patients, but no patient had serum mitochondrial antibody present. Seventy-two per cent had ulcerative proctocolitis. There was no relationship between either duration or severity of ulcerative proctocolitis and the development of primary sclerosing cholangitis. Four patients were not benefited by colectomy. None of the patients ahd Crohn's disease. The prognosis was variable. Corticosteriods and azathioprine were ineffective. Eleven patients (38%) had died with a mean survival time of seven years from diagnosis. Three patients with ulcerative proctocolitis developed bile duct carcinoma. The cholangiograms and liver biopsies were reported without reference to clinical information together with 41 patients with other biliary diseases. Cholangiography was diagnostic in 18/22 (82%). Hepatic histology was diagnostic in 8/22 (36%). Ten showed features of large bile duct disease and three were misdiagnosed as primary biliary cirrhosis. Reduced numbers of bile ducts, ductular proliferation, portal inflammation, and substantial copper deposition, in combination with piecemeal necrosis, are commonly seen in primary sclerosing cholangitis and indicate the need for cholangiography.
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PMID:Primary sclerosing cholangitis: a review of its clinical features, cholangiography, and hepatic histology. 743 7

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

We report the case of a patient suffering from acquired immunodeficiency syndrome and hepatitis B and D virus-related cirrhosis of the liver who was diagnosed as subclinical Crohn's disease. We attribute this clinical course to abnormality of intestinal immune system induced by the human immunodeficiency virus. Concomitant hepatitis B and D virus infection may have contributed. This observation supports the hypothesis of helper-inducer T cells (CD4 T cells) having a critical role in the immunopathogenesis of Crohn's disease and its clinical expression.
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PMID:[Subclinical Crohn disease in acquired immunodeficiency syndrome]. 812 96

Three patients with primary sclerosing cholangitis and Hodgkin's disease, a previously unrecognized association, are reported. All three patients were men, and one patient had Crohn's disease of the colon. Primary sclerosing cholangitis was diagnosed 2, 11 and 17 yr before diagnosis of Hodgkin's disease in the three patients, and all three had advanced biliary cirrhosis prompting referral for liver transplantation. The symptoms of Hodgkin's disease were often masked by similar manifestations of primary sclerosing cholangitis, particularly symptoms of recurrent biliary sepsis. Hodgkin's disease is another disorder that may occur in patients with primary sclerosing cholangitis, particularly in the setting of advanced disease, and may be masked by the underlying hepatobiliary disease.
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PMID:Primary sclerosing cholangitis and Hodgkin's disease. 822 18

A new photometric assay for factor XIII was evaluated for its analytical performance and clinical usefulness. The test showed good performance characteristics: intra-assay coefficients of variation between 0.83 and 2.68%, inter-assay coefficients of variation from 3.4 to 4.5%. The test can be conducted rapidly on an automated analyser such as the Cobas Bio. The reference values (mean +/- 2 SD) ranged from 67 to 147% and there was no gender difference. The comparability of the photometric test with a clot lysis factor XIII test showed an acceptable coefficient of correlation r = 0.87 (p < 0.0001). The diagnostic conformity of both tests was 76.7%. Factor XIII concentrations were assessed in seven patient groups. In liver cirrhosis, M. Crohn and during pregnancy noticeable percentages of lowered values were found: i.e. 18.2%, 11.8% and 10.0% respectively. Elevated values were seen in hypertensive patients (16%) and in the small group of patients with carcinoma of the ovarium (22.2%). These results show that the incidence of acquired factor XIII deficiencies is relative low. The clinical meaning of reduced or enhanced factor XIII needs to be clarified by more extensive patient studies.
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PMID:Analytical and clinical utility of a photometric assay for blood coagulation factor XIII. 839 88


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