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)

Glomerular lesions were studied in 41 patients with hepatic cirrhosis (32 cases) or steatosis (9 cases) by optical microscopy (38 cases) and immunofluorescence (22 cases) examinations of biopsy samples. The most frequently observed lesion on optical microscopy was a glomerulosclerosis (16 cases), arteriolar lesions being present in 15 cases, two-thirds of which had associated glomerular lesions. Immunofluorescence revealed the presence of immunoglobulin deposits in 17 cases, these possessing two main characteristics: the prevalence of IgA (14 cases), alone or in association with other immunoglobulins; and the predilection for the mesangium alone, or in association with parietal deposits. The glomerular nephropathy in the cirrhotic patients was completely latent in 3 out of 4 cases, renal signs, when they existed, being of mild intensity. Renal lesion can occur in the absence of severe hepatopathy, particularly in the presence of steatosis. IgA deposits in the mesangium, a fundamental feature of hepatic glomerulopathy, can be related to the presence of IgA deposits in the liver sinusoids, suggesting the development of IgA deposits in several organs during these affections. Their pathogenesis is still obscure but two hypotheses have been suggested: an immune disease with deposits of circulating immune complexes in the kidney; a non-immune disease, IgA deposits being a secondary and not a primary feature.
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PMID:[Glomerular nephropathies in hepatic cirrhosis (author's transl)]. 702 64

Lead, cadmium, mercury and arsenic are widely dispersed in the environment. Adults are primarily exposed to these contaminants in the workplace. Children may be exposed to toxic metals from numerous sources, including contaminated air, water, soil and food. The chronic toxic effects of lead include anemia, neuropathy, chronic renal disease and reproductive impairment. Lead is a carcinogen in three animal species. Cadmium causes emphysema, chronic renal disease, cancer of the prostate and possibly of the lung. Inorganic mercury causes gingivitis, stomatitis, neurologic impairment and nephrosis, while organic mercurials cause sensory neuropathy, ataxia, dysarthria and blindness. Arsenic causes dermatitis, skin cancer, sensory neuropathy, cirrhosis, angiosarcoma of the liver, lung cancer and possibly lymphatic cancer.
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PMID:Occupational and community exposures to toxic metals: lead, cadmium, mercury and arsenic. 716 33

In the years between 1967 and 1978, Billroth I-type antrectomy and truncal vagotomy were performed in 44, and primary gastric resection in 19 cases of perforated duodenal ulcer. It was found that in the case of perforated ulcer causing extensive scarring, stenosis or penetration, antrectomy is not more complicated than pyloroplasty. In the absence of other local lesions and mainly in high-risk patients with cirrhosis, diabetes, chronic renal disease, tuberculosis, etc. excision of the perforated duodenal ulcer, pyloroplasty according to Finney and vagotomy were performed (48 operations), while in purulent peritonitis (8 patients) suturing only was applied. Bearing in mind the above aspects, the authors lost none of their patients. Final and similar results can be achieved with performed (in 48 cases), while in the case of purulent peritonitis only suturing was applied in 8 patients. None of the patients was lost. Similar results can be achieved with emergency antrectomy and vagotomy as under elective conditions. In the majority of cases the perforated duodenum can be operated upon in such a way which will abolish the perforation and ensure a final healing of the ulcer.
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PMID:Treatment of perforated duodenal ulcer by vagotomy-associated antrectomy. 729 9

High-risk patients who should receive the pneumococcal vaccine include asplenic patients, those with sickle cell anemia, nephrotic syndrome, congestive heart failure, pulmonary or renal disease, insulin-dependent diabetics, alcoholics with cirrhosis and immunocompromised patients. The vaccine should not be used in children under two years of age. It is safe, relatively inexpensive and effective when antibody response can be generated.
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PMID:Use of the pneumococcal vaccine. 729 14

After rapid intravenous injection of furosemide 40 mg (Fu), plasma levels were determined in 7 healthy volunteers, 8 patients with liver cirrhosis with ascites and 7 patients with end-stage renal disease (ESRD). The diuretic response was evaluated by measuring the urinary excretion of sodium and potassium and the urine volume. The mean elimination half life (t 1/2 beta) of Fu averaged 51 +/- 7.7 (+/- SD) min in healthy subjects, 52 +/- 7.7 min in cirrhosis and 200 +/- 57 min in ESRD. The non-renal clearance (Clnr) in healthy subjects (56 +/- 28 ml/min) corresponds to the total plasma clearance in functionally anephric patients (54 +/- 18 ml/min). In cirrhosis there was no significant change in the disposition parameters of Fu in comparison to the healthy volunteers, but there was a significant reduction in urine sodium and volume, whereas potassium excretion remained unchanged. Fu "excretion rate--response" curves showed diminished tubular sensitivity to Fu in cirrhosis.
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PMID:Influence of hepatic cirrhosis and end-stage renal disease on pharmacokinetics and pharmacodynamics of furosemide. 730 69

Reference intervals for prothrombin time (PT) and activated partial thromboplastin time (APPT) of undiluted and serial dilutions of citrated platelet-poor plasma were determined for 30 healthy dogs. The PT and APTT were similarly determined for 32 dogs with naturally occurring hepatic disease. Hepatic disease was confirmed by histopathologic examination of hepatic biopsy materials and comprised degeneration (13 dogs), inflammation (11 dogs), cirrhosis (4 dogs), and neoplasia (4 dogs). Coagulation test values were compared with serum alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase activities and Bromsulphalein retention for sensitivity in detecting hepatic disease in the dog. Coagulation test results were at variance with reference values in 66% of the 32 dogs with hepatic disease; serum alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase were increased in 59%, 72%, and 75%, respectively and Bromsulphalein retention was increased in 22% of the 32 dogs. Thus, the PT and APTT were sensitive indicators of hepatic disease. However, the PT and APTT lacked specificity for any given hepatic disease. The sensitivity of the coagulation tests for detecting hepatic disease was enhanced by using dilutions of citrated platelet-poor plasma. Only 15% of dogs with hepatic disease showed variances from reference values in the coagulation tests done with undiluted plasma, but 66% showed variances in the tests with dilutions of plasma. Coagulation tests were also done in 13 dogs with normal hepatic function amd morphology, but with various extrahepatic diseases: chronic renal disease (5 dogs), dirofilariasis (4 dogs), encephalitis (1 dog), cutaneous disease (2 dogs), and femoral fracture (1 dog). Twelve of the 13 dogs had coagulation test values within the reference intervals.
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PMID:Alterations of prothrombin time and activated partial thromboplastin time in dogs with hepatic disease. 734 May 74

Cryptococcal peritonitis is usually associated with end-stage renal disease and peritoneal dialysis. Significant liver disease has not been well recognized as a risk factor for its development. We report two patients with cirrhosis who developed peritoneal infections with Cryptococcus neoformans. We also retrospectively review all cases of cryptococcal illness at the Ohio State University Medical Center from October 1990 to January 1994 and present a review of the literature regarding cryptococcal peritonitis associated with hepatic dysfunction. Cirrhotic patients with this entity present with subtle, nonspecific complaints resulting in delayed diagnoses, dissemination, and death. We suggest that clinicians maintain an increased awareness of this unusual but lethal entity in patients with liver impairment. Early and frequent abdominal paracenteses with bedside inoculations of fungal culture medium, India ink preparations, and serum cryptococcal antigen testing may hasten the diagnosis and institution of appropriate therapy.
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PMID:Cirrhosis: a risk factor for cryptococcal peritonitis. 748 20

We report a case of nephrotic syndrome which mimicked membranoproliferative glomerulonephritis (MPGN) and was associated with hemophagocytic syndrome after renal death. A 41-year-old Japanese man was referred to our hospital because of nephrotic syndrome in February 1979. He had no signs, symptoms nor laboratory data suggestive of liver damage. He was diagnosed as idiopathic MPGN and administered prednisolone and cyclophosphamide (total dose of about 50,000mg). He developed end-stage renal disease, and dialysis therapy was initiated in February 1992. Simultaneously, he was diagnosed as hepatitis C virus (HCV)-positive liver cirrhosis. In August 1994, he died because of reactive homophagocytic syndrome, which occurred in the setting of immunosuppression due to chronic renal failure, liver cirrhosis, and sesecondary diabetes. In this case, we can not deny the possibility that radical therapeutic intervention against "idiopathic MPGN" had a negative effect on the clinical course of chronic HCV infection.
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PMID:[A case of nephrotic syndrome mimicking membranoproliferative glomerulonephritis (MPGN) and associated with reactive hemophagocytic syndrome after renal death]. 760 13

There is a high incidence of chronic liver disease in end-stage renal failure patients on dialysis. Hepatitis C virus appears responsible for 80% of posttransfusion hepatitis, and up to 80% of sporadic hepatitis and cryptogenic cirrhosis. Anti-HCV antibodies correlate highly with the presence of active infection. The clinical implications of HCV infection in patients undergoing renal transplantation is unknown. Part I: We undertook a descriptive cross-sectional study of all renal failure patients admitted for kidney transplant between 1/84 and 12/88. Pretransplant sera were assayed for anti-HCV using an ELISA. Patients were divided into anti-HCV-positive (study group) and anti-HCV-negative (controls). Part II: A cohort study was performed with both groups followed from the time of transplantation to the present. Comparisons were made by t tests, chi-square analysis with Yates correction, Mann Whitney test for nonparametric results and multiple regression analysis. Part I: Anti-HCV was present in 76 of 716 sera assayed. There were no differences in sex, age, number of previous transplants, and underlying renal disease. Four variables predicted the presence of anti-HCV: number of blood transfusions; duration on dialysis; i.v. drug abuse, and nonwhite race. Part II: A group of 596 patients was further analyzed. The mean duration of follow-up was not different between the two groups. There were no differences in graft survival, overall mortality, or mortality secondary to liver disease or sepsis. Based on these results, the presence of anti-HCV should not be a contraindication for kidney transplantation.
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PMID:Hepatitis C--its prevalence in end-stage renal failure patients and clinical course after kidney transplantation. 767 27

The association between deficiency of alpha-1-antitrypsin (A1AT) and glomerulonephritis has been only sporadically reported on, as opposed to the linkage between A1AT-deficiency and lung emphysema or hepatic cirrhosis. We describe the case of a 30-year-old man with A1AT deficiency who developed hepatic cirrhosis in early childhood, and IgA glomerulonephritis and hypertension in adult life. The IgA nephritis followed an unusual course. After three years of slight elevation of serum creatinine levels, the patient rapidly developed renal failure necessitating acute hemodialysis. The deterioration of the renal function was preceded by eruption of skin lesions, believed to represent a vasculitis. After six months of hemodialysis, the patient successfully received a transplanted kidney from his mother. The literature is reviewed with respect to the association between A1AT-deficiency and renal disease. We discuss possible underlying causes for the rapid deterioration of renal function in this patient.
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PMID:[Alpha 1-antitrypsin deficiency--not only pulmonary and hepatic involvement]. 770 89


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