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

We examined clinical and laboratory data and the liver pathology of 48 patients in whom porphyria cutanea tarda was related to alcohol ingestion, estrogen use and pregnancy, or was idiopathic. Biochemical test results, when abnormal, tended to be mild in most cases, with less than two-fold elevations of serum aminotransferases and alkaline phosphatase and mild hyperbilirubinemia. Fatty change, liver cell and Kupffer cell hemosiderosis and glycogenation of hepatocyte nuclei were frequent histologic findings in the 58 liver specimens studied. Alcoholic hepatitis, chronic hepatitis and cirrhosis were uncommon. Granuloma-like lobular aggregates consisting of iron- and ceroid-laden Kupffer cells, chronic inflammatory cells and fat droplets ("lobular lesions of porphyria cutanea tarda") were found in nearly two-thirds of specimens and appeared to be the most characteristic form of parenchymal damage in this form of porphyria. These lesions may be associated with pericentral fibrosis in alcoholic as well as estrogen-treated patients and may remit following therapeutic phlebotomy.
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PMID:Hepatic pathology in porphyria cutanea tarda. 619 67

Hepatic tumors unassociated with cirrhosis were encountered in seven patients aged 10 to 19 years. Four patients had received androgens for aplastic anemia. Two patients had transfusional hemosiderosis. One patient had had a renal transplant 2 1/2 years ago. Two patients are alive at 2 3/4 and 2 1/2 years after surgical resections. Nodules were found at autopsy in the others. The tumors were well differentiated and, in the androgen-related cases, differed from the others in the following features: canalicular bile retention, mild nuclear atypia, and acinar formation. No mitoses, vascular invasion, or metastatic tumor were evident. The clinical setting was variable; different factors, including iron overload and androgen therapy, played a role in the development of tumor. Although the androgen-related cases showed mild cellular atypia, biologic evidence of malignancy was lacking as in most previous reports.
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PMID:Benign hepatocellular tumors in the young. A clinicopathologic spectrum. 632 Jul 60

A case report is given of a patient with liver cirrhosis caused by hemosiderosis, who developed liver carcinoma. In such patients liver carcinoma can only be excluded by means of peritoneoscopy. Sonography, computer tomography and laboratory findings will not allow to make the correct diagnosis, because of the particular nature of liver changes in hemosiderosis of the liver, as can be seen in our case. Thus none of the non-invasive procedures mentioned above are suited for early diagnosis of malignant liver disease because of the special morphological features in hemosiderosis of the liver.
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PMID:[Significance of laparoscopy in the diagnosis of hepatocellular carcinoma in siderocirrhosis]. 632 40

Hemochromatosis is a syndrome which, when fully expressed, is manifested by melanoderma , diabetes mellitus, and liver cirrhosis, with iron overload involving parenchymal and reticuloendothelial cells in many organ systems. This clinical presentation may arise as a consequence of either hereditary or acquired abnormalities of iron overload, although the mechanisms are quite different. In hereditary hemochromatosis (also known as primary, or idiopathic, hemochromatosis), increased intestinal iron absorption leads to excessive accumulations of iron, throughout the body, particularly in parenchymal cells. In secondary forms of iron overload including transfusional hemosiderosis, alcoholic cirrhosis, thalassemia, sideroblastic anemia, and porphyria cutanea tarda, iron accumulates in the reticuloendothelial system initially, but with increasing amounts of total body iron, excessive iron deposits eventually accumulate in parenchymal cells throughout the body producing a picture indistinguishable from hereditary hemochromatosis. In this article, the course, prognosis, and therapy of iron overload will be reviewed in detail. Clinical and experimental data concerning the pathogenesis of the different forms of iron overload will be examined critically. In particular, information relating to possible abnormalities of reticuloendothelial function, intestinal mucosal iron transport, and alterations in serum and tissue isoferritin patterns in hereditary hemochromatosis will be analyzed, and possible directions for future research will be suggested. The mode of inheritance and linkage with the major histocompatibility (HLA) complex will be discussed. Theories on the pathogenesis of tissue damage by excess iron will be evaluated. Methods for measuring the extent of iron overload in clinical practice will be described, including measurements of serum iron, serum ferritin, iron absorption, cobalt excretion, desferrioxamine excretion, liver biopsy and tissue iron determinations, and HLA typing. Finally, unresolved problems in the understanding of the disease process, diagnosis, and therapy will be delineated.
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PMID:Iron overload disorders: natural history, pathogenesis, diagnosis, and therapy. 637 41

The patient was a 59-year-old man who had been in hospital suffering from aplastic anemia with transfusion hemosiderosis. Sudden onset of weakness, shaking chills and headache was observed after his staying out overnight on July 25, 1981. His temperature was 39.3 degrees C and he complained of abdominal pain and abdominal distension. His blood pressure dropped to a dangerous level and tonic convulsions that had begun in the upper body gradually extended to the whole body and he died 23 hours after his return. V. vulnificus was isolated by the blood culture performed before death. During his stay away from the hospital, he had eaten raw cuttlefish, which was considered to be the source of infection. V. vulnificus is one of the halophilic marine vibrios and is isolated frequently in summertime from the sea foods and sea water near Japan. It has been disclosed that the presence of underlying diseases such as liver cirrhosis, hemochromatosis can predispose a person to fatal sepsis by V. vulnificus. In this case, besides leukocytopenia, the presence of hemosiderosis induced by many transfusions was considered to be a major cause leading to the fulminating course of the disease.
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PMID:[Fatal Vibrio vulnificus infection in a patient with aplastic anemia]. 667 24

3 cases of congenital dyserythropoietic anaemia (type I, case 3; type III, cases 1 and 2) are reported with a follow-up of 8-10 years. Conventional therapy with vitamins, steroids and/or anabolic hormones was ineffective. Regular blood transfusions were required to maintain the haemoglobin levels around 8 g/dl. Splenectomy, however, resulted in a sustained rise in haemoglobin without blood transfusions. During the follow-up period varying from 40 to 77 months after splenectomy, diabetes mellitus was detected in all 3 patients. Liver biopsy showed haemosiderosis in 2 patients with cirrhosis in one of them. It is suggested that splenectomy could be an effective mode of therapy to reduce the need for blood transfusion in congenital dyserythropoietic anaemias.
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PMID:Congenital dyserythropoietic anaemias: splenectomy as a mode of therapy. 679 78

During the past decade, 258 patients received 293 renal transplants at Hennepin County Medical Center Minneapolis, Minnesota. Twenty-three of these patients had a pretransplant liver biopsy. Thirty-six patients had liver biopsies done during the post-transplant period. Liver tissue at autopsy was available from 24 patients who died after receiving a kidney transplant. Systematic analysis of the biopsy and autopsy specimens with appropriate tissue stains showed significant iron deposition (3+ to 4+) within the hepatic parenchymal cells in 1 of the 23 (4%) pretransplant biopsies and 17 of the 60 (28%) post-transplant specimens (P = 0.02). Eight of the 17 (47%) patients with post-transplant hemosiderosis also exhibited histological features of liver cirrhosis. As hemosiderosis is reversible with intermittent phlebotomies, early recognition and adequate management are highly desirable. We suggest that the serum ferritin level, which is a reliable index of body iron stores, should be monitored in all patients at periodic intervals following renal transplantation.
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PMID:Hemosiderosis: an unrecognized complication in renal allograft recipients. 703 65

Revision of 167 bioptic cases of porphyria cutanea tarda failed to confirm porphyrin crystals in diseased hepatocytes. The only peculiar finding was a fine honey-comb microvacuolisation of hepatocytes corresponding to dilated sacs of degranulated endoplasmatic reticulum in electron microscopy. The lesion was closely connected with regressive changes of mitochondria which often were giant and sometimes unspecifically paracrystalline in their inner structure. Steatosis and haemosiderosis were frequent and taken for secondary as well as the hepatic proliferation in terminal fibrosis or cirrhosis. Any increase of hepatocytic lipopigment was not found.
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PMID:[Changes in the liver in porphyria cutanea tarda]. 717 88

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

In thirty-four patients with porphyria cutanea tarda treated with small doses of chloroquine, liver biopsies were performed before and after treatment. In seventeen cases (50%) the morphological patterns before treatment corresponded to unstabilized fibrosis, while in eleven (32.4%) there were non-specific changes in the form of focal fatty change, haemosiderosis, and mild fibrosis of the portal tracts. Active chronic hepatitis was found in three patients (8.8%), and cirrhosis also in three cases. Although in all patients a clinical and metabolic remission of porphyria cutanea tarda occurred during treatment, the morphological patterns in the liver parenchyma remained on the whole unchanged. Only in five cases was there an increase in the inflammatory changes, while in two patients these changes tended to disappear.
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PMID:Liver changes in porphyria cutanea tarda patients treated with chloroquine. 737 Jan 74


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