Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 42 young adults with Gilbert's syndrome and in 9 patients with inactive, well-compensated liver cirrhosis the peroral nicotinic acid test was performed. Of the 13 parameters tested, the groups differed significantly in the sum of total and unconjugated serum bilirubin concentrations, respectively, during the test; in the difference between the maximal and initial concentrations of total and unconjugated bilirubin; in the retention of total bilirubin at the third, fourth and fifth hour of the test; and in the size of the area under the curve of unconjugated bilirubin increase. However, due to considerable overlap, no single parameter could reliably differentiate among all persons with Gilbert's syndrome and cirrhotics. The nicotinic acid test is neither necessary for the diagnosis of Gilbert's syndrome nor can it reliably differentiate between this condition and severe organic liver disease. Yet, it does supply valuable information about the readiness of the organism to develop or enhance hyperbilirubinemia following a defined stimulus.
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PMID:The nicotinic acid test in the evaluation of unconjugated hyperbilirubinemia. 258 38

In a 33 years old woman an orthotopic liver transplantation was performed because of an endstage posthepatic liver cirrhosis. Postoperatively the unconjugated bilirubin levels remained elevated although liver enzyme values were within normal range. Because hemolysis, rejection, infection or biliary obstruction could be excluded we suspected a Gilbert's Syndrome and were able to confirm this diagnosis by low caloric intake and nicotinic acid test. This case report therefore describes the first time the transplantation of a clinically harmless metabolic disorder but inborn error of metabolism by liver grafting into the recipient.
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PMID:[Manifestation of Gilbert syndrome (Meulengracht disease) following orthotopic liver transplantation: a rare cause of postoperative hyperbilirubinemia]. 285 Apr 4

Investigation of the uptake and metabolism of drugs by organs such as the liver may allow assessment of specific aspects of organ function. Rifampicin, when orally administered, is transported into the hepatocyte from portal blood and thence passes, with its deacetylated metabolite, into the systemic circulation and into bile. This paper reports an investigation of the pharmacokinetics of a sub-therapeutic oral dose of rifampicin in healthy subjects, in patients with cirrhosis and in subjects with Gilbert's syndrome. The areas under the plasma concentration curves (AUC) in patients with cirrhosis were significantly greater than in healthy subjects. Subjects with Gilbert's syndrome had decreased AUCs compared with healthy subjects and were clearly distinguished from patients with cirrhosis. Rifampicin concentration in serum was measured by HPLC using a novel direct injection technique.
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PMID:Drugs as probes of organ function: evaluation of the hepatobiliary axis using oral rifampicin and novel high performance liquid chromatography. 382 82

An attempt has been made to investigate drug elimination in patients with liver disease. Antipyrine was chosen as a model drug. The patients were divided into three groups depending upon clinical, biochemical, radiologic and histologic findings; (1) mild (Idiopathic portal hypertension, extrahepatic portal vein obstruction and Gilbert's syndrome); (2) moderate (Budd-Chiari syndrome and amoebic liver abscess); (3) severe (acute hepatitis, chronic active hepatitis and cirrhosis). A prolongation in antipyrine half-life (t1/2) was observed in 108 patients with liver disease (24.59 +/- 1.72 h) as compared to 12 controls (11.63 +/- 0.86 h). Similarly, metabolic clearance rate was decreased in all liver disorders. Among liver function tests, antipyrine t1/2 showed a significant correlation with serum albumin and prothrombin time index. After phenobarbitone administration, antipyrine clearance studied in 37 patients showed a significant decrease in t1/2 and an increase in MCR. Antipyrine t1/2 in 26 patients after recovery was comparable to those of controls.
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PMID:Impairment of drug elimination in patients with liver disease. 398 89

The pharmacokinetics of Josamycin was studied in 31 subjects (10 normals, 9 Gilbert's syndrome and 12 compensated liver cirrhosis) after the administration of Josamycin (1 g orally) and in 13 subjects (4 normals, 4 Gilbert's syndrome and 5 compensated liver cirrhosis) after 3-day Josamycin treatment (1 g orally every 12 hours). Josamycin pharmacokinetics was impaired in liver cirrhosis and, to a lesser extent, in Gilbert's syndrome. Moreover, in the three groups of individuals studied the drug accumulated after multiple dosing. These results suggest that a dosage adjustment of Josamycin is recommended when dealing with these patients.
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PMID:Pharmacokinetics of Josamycin in patients with liver cirrhosis and Gilbert's syndrome after repeated doses. 404 77

In an effort to assess connective tissue biosynthetic activity in human liver disease, collagen proline hydroxylase (a key enzyme in collagen biosynthesis) and the uptake of (35)S sulphate (a precursor of sulphated mucopolysaccharides) were measured in hepatic tissue obtained mainly by percutaneous biopsy.A procedure is described for the quantitation of collagen proline hydroxylase in cryostat sections which allows for the simultaneous histopathological examination of the liver specimen. A three to eightfold increase in the activity of this enzyme was found in four cirrhotic livers compared with the mean value of four normal livers and two biopsies from patients with Gilbert's syndrome. Elevated hydroxylase levels were found also in five patients with hepatic dysfunction but without cirrhosis (four alcoholics and one patient with persistent hepatitis associated with serum smooth muscle antibody). It is suggested that the hepatic level of collagen proline hydroxylase may be a useful quantitative index of fibroblastic activity in human liver disease. Autoradiographic studies of radioactive sulphate uptake in biopsy specimens from patients with chronic liver disease showed an exaggerated incorporation of isotope not only at sites of established fibrogenesis but also in the walls of sinusoids throughout the liver.
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PMID:Collagen proline hydroxylase activity and 35S sulphate uptake in human liver biopsies. 436 10

A case of novobiocin-induced jaundice is described in which the main feature was elevated unconjugated bilirubin in the serum. No evidence of hemolysis or hepato-cellular failure was demonstrated.The effect of novobiocin on serum bilirubin was studied by administering 2 g. of the drug daily in four divided oral doses for two days. An increase in serum unconjugated bilirubin was nearly always observed in the normal subjects and in patients with cirrhosis of the liver. This rise was particularly significant in three patients with hemolytic anemia and in two patients with Gilbert's disease. After an oral dose of 500 mg. the BSP clearance was decreased after one hour and it was close to normal after three hours. Since hemolysis is not responsible for this elevation of serum unconjugated bilirubin, the novobiocin-induced hyperbilirubinemia appears to be due to a direct effect of the drug upon the liver.
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PMID:[Effects of novobiocin on liver function. Clinical study]. 495 70

Bilirubin mono- and diconjugates were determined by alkaline methanolysis and high-performance liquid chromatography (HPLC) in serum from patients with metastatic liver disease and liver cirrhosis. Conjugates could be detected and quantitated at normal or low total bilirubin levels. Comparison with serum alkaline phosphatase activity revealed that in cirrhosis bilirubin conjugates were sometimes detectable at normal or slightly elevated alkaline phosphatase activities. In patients with metastatic liver disease alkaline phosphatase activity was a more sensitive indicator. In normal controls and in patients with Gilbert's syndrome no bilirubin conjugates were detected whereas serum of patients with haemolysis contained conjugated bilirubin. Therefore HPLC appears to be an excellent method to diagnose Gilbert's syndrome. In liver cirrhosis HPLC is a useful liver function test.
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PMID:Quantitation of bilirubin conjugates with high-performance liquid chromatography in patients with low total serum bilirubin levels. 643 25

The total activity of lactatedehydrogenase (Merck tests) and its isoenzymes (electrophoretic fractionation by Helm) were studied in the blood sera of 202 patients with various hepato-biliary diseases (viral hepatitis, chronic persisting and chronic active hepatitis, cirrhosis of liver, chronic cholecystitis, benign cholestasis, malignant formations with and without cholestasis, Gilbert's syndrome and hemolytic jaundice). The referent limits are determined in the sera of 43 clinically healthy subjects (22 females and 21 males). The anaerobic fifth fraction of lactatedehydrogenase (LDH) was most increased in viral hepatitis (about 15 times), in the group with malignant formations with cholestasis (about 2 times) and in benign cholestasis (about 5 times). The determination of isoenzymes of LDH, is presumed, to be obligatorily included in the spectrum of modern enzyme constellation for hepatobiliary diseases.
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PMID:[Lactate dehydrogenase isoenzymes in the diagnosis of hepatobiliary diseases]. 653 74

Microcirculation was studied in liver biopsies of patients with viral hepatitis, Gilbert's syndrome, liver steatosis, chronic hepatitis, liver cirrhosis, obstructive jaundice and venous congestion. All these diseases were shown to be usually accompanied by morphologic changes of sinusoid, Disse's and intercellular spaces, cellular membranes of hepatocytes. Those changes causing microcirculation disturbances result in the functional insufficiency of the liver.
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PMID:[Microcirculation disturbances in liver diseases (author's transl)]. 741 40


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