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)

Clinical features of hepatocellular carcinoma in 22 patients without serum HBsAg, HBV DNA, anti-HCV antibody and HCV RNA were characterized and possible pathogenic factors for this cryptogenic hepatocellular carcinoma were prospectively assessed. Twenty-two patients were selected from 434 patients with hepatocellular carcinoma (HCC) who were treated at the Second Department of Internal Medicine, Kurume University Hospital between January 1994 and December 1996. Serum samples collected from these patients were all negative for HBsAg, HBV DNA, anti-HCV antibody, and HCV RNA. Patients were evaluated based on past history, present illness, history of habitual alcohol consumption, results of the serological and biochemical laboratory tests at diagnosis of HCC, Anti-HBc antibody, autoantibodies, GBV-C/HGV RNA, and histopathologic findings of non-cancerous portion of the liver were also evaluated. Among 22 patients with non-B non-C HCC, 16 patients (72.7%) had a history of alcoholic liver disease, 6 patients had an infection of schistosomiasis Japonica, and 1 patient had Budd-Chiari syndrome. Nine patients (40.9%) were positive for anti-HBc antibody, but their titers were low in all cases. Among 22 patients, positive for auto antibody, 7 patients (31.8%) were positive for anti-nuclear antibody, and 17 patients (77.3%) were positive for anti-smooth muscle antibody. Only 1 patient was positive for GBV-C/HGV RNA. Histopathologic examination was performed in 3 cases for non-cancerous portions of the liver. Liver cirrhosis and liver with passive congestive fibrosis were diagnosed in 2 cases each. The remaining one case showed normal feature of the liver. In conclusion, the majority of the 22 patients with non-B non-C HCC had a history of alcoholic liver disease. Many were also positive for auto antibodies. These results suggest that patients with alcoholic liver disease or hepatic disease with autoantibodies may be defined as the high-risk group of developing non-B non-C HCC and should be periodically underwent a complete medical examination.
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PMID:Clinical aspects of cryptogenic hepatocellular carcinoma. 965 59

Brazil has a young population and areas of endemic mansoni schistosomiasis where Wilson's disease might be easily misdiagnosed in patients erroneously classified as having either the hepatosplenic or the hepatointestinal form of the helminthiasis. Twenty five patients with the "hepatic form" of Wilson's disease (14 males and 11 females) were investigated in Belo Horizonte, MG; the mean age was 13.7 years (3 to 22). Nineteen had hepatomegaly (76%) and nine splenomegaly (36%). Twenty two (88%) had cirrhosis. The Kaiser-Fleisher ring was detected in fifteen (60%). Four (16%) had clear neurological abnormalities. Eleven (44%) had ascitis and/or jaundice. Ninety one point three per cent and 92% had low ceruloplasmin and copper serum levels respectively. Eighty four point two per cent showed an increased 24 hours urinary copper excretion; seven patients in whom hepatic copper was determined had increased values. Six out of nine had at least a ten fold increase in 24 hours urinary copper excretion following penicillamine use ("penicillamine test"). Three out of 19 patients (15.8%) had mansoni schistosoma ova in stools examination, a common prevalence in our population. Their biopsies showed inactive cirrhosis without schistosomiasis-associated alterations. At least fourteen patients (56%) could be misdiagnosed as having hepatointestinal or hepatosplenic schistosomisis when in fact they suffered from Wilson's disease with or without asymptomatic intestinal schistosomiasis, losing the chance of an early treatment. The follow-up time of 22 patients was 52 months (1 to 96); eight (36.3%) died, four from bleeding esphageal varices, three from terminal hepatic failure and one from fulminant liver failure. The majority of the patients, including those who died, had abandomned the use of penicillamine or had taken it irregularly, due mainly to its highly expensive cost. A 17 year old patient underwent a successful liver transplant in 1989.
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PMID:[Wilson's disease ("hepatic form") in a region endemic for schistosomiasis mansoni: clinical presentation of 25 patients]. 971 8

In Yamanashi Prefecture, one of the former areas in Japan endemic for Schistosoma japonicum, there have been no cases of schistosomiasis since 1978. We attempted to find out in this study whether there was still a chronic effect of schistosomiasis, e.g., liver cancer or liver cirrhosis present in this region. The subjects studied were the population in Yamanashi Prefecture from 1973 through 1992. We divided the population into residents in an area endemic for schistosomiasis and those in a nonendemic area. We calculated the standardized mortality ratios (SMRs) for liver cancer and liver cirrhosis in both areas. The schistosome egg-positive rate of liver cancer and liver cirrhosis specimens from the patients in these two endemic areas was also calculated. Male SMRs for liver cancer in the endemic area were 188.5% in 1985 and 188.0% in 1990. Even today, many years after the last case of schistosomiasis, schistosome eggs can be found in the livers of deceased liver cancer and cirrhosis patients. The chronic effect of S. japonicum could contribute to the current high mortality rate for liver cancer in the endemic area, although we need to consider the other etiologic factors of liver cancer, e.g., hepatitis B virus, hepatitis C virus, and alcohol intake.
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PMID:Epidemiologic study of the relationship between schistosomiasis due to Schistosoma japonicum and liver cancer/cirrhosis. 979 Apr 29

A clinical study on the evolution of patients with schistosomiasis mansoni has been conducted since 1983 at the outpatient clinic of the Infectious and Parasitic Disease Service in the Clementino Fraga Filho University Hospital in Rio de Janeiro, Brazil, comparing prevalence of positive tests for HBsAg, anti-HBsAg, and anti-HBc among patients infected with Schistosoma mansoni coming from various regions of Brazil and with different clinical forms of the disease. A non-significant predominance of HBsAg, anti-HBsAg, and anti-HBc was detected among patients with the hepatosplenic form of schistosomiasis, who presented a more severe clinical evolution with a higher frequency of hematemesis and/or melena, in addition to the development of macronodular cirrhosis and a worse prognosis as compared to patients with the toxemic form, schistosomiasis-infection and the hepatointestinal form.
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PMID:Prognosis of schistosomiasis mansoni patients infected with hepatitis B virus. 992 63

Ultrasonography is now widely used in the diagnosis and management of patients with chronic Schistosoma mansoni infections. The present study was undertaken to evaluate the use of ultrasonography in patients with hepatosplenic schistosomiasis (HSS) with and without cirrhosis. Ninety-seven patients (52 males; median age 38 years, range 19-68 years) with HSS, 65 with well compensated (HSSC) and 32 with decompensated (HSSD) disease and cirrhosis, were systematically examined by ultrasound. Hepatic fibrosis was graded according to WHO recommendations. Typical atrophy of the right hepatic lobe accompanied by hypertrophy of the left lobe, with a rounded inferior marginal edge, was seen in 86 (88.7%) patients. Periportal fibrosis was observed in 83 (85.6%) cases and confirmed histologically in all. In 66 patients (68.0%) thickening of the gallbladder wall, associated with periportal fibrosis and extending from the branches of the porta hepatis, was noted. No evidence of biliary disease was found in these patients and gallstones were present in only 3 cases. Fourteen (43.8%) of the HSSD patients could not be classified for grade of fibrosis because of the advanced stage of cirrhosis related to hepatitis B or C viral infection. Of the remaining 18 HSSD patients, none had only grade I fibrosis (vs. 10.8% of HSSC, P = 0.054) and only 6 had grade II (vs. 67.7% of HSSC, P < 0.0005), while the frequency of grade III was significantly higher in the HSSD patients than in those with HSSC (37.5% vs. 21.5%, P = 0.049). These findings indicate that although ultrasonography is a very valid technique for assessing patients with pure HSS, and should be considered the 'gold standard', it is not reliable for assessing periportal fibrosis in patients with concomitant cirrhosis due to other causes.
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PMID:Ultrasonography of the liver and spleen in Brazilian patients with hepatosplenic schistosomiasis and cirrhosis. 1032 9

Infection with hepatitis C virus (HCV) has become the most important public health problem in Egypt. In Egypt, viral hepatitis along with infection with Schistosoma mansoni is the major cause of chronic liver disease and liver cirrhosis. Although HCV infection is highly prevalent in Egypt, very little information is available on the distribution of the different genotypes of HCV. Our aims in this study were first to determine the prevalence of viral and parasite infections in patients with chronic liver disease and then to assess the distribution of HCV genotypes in these patients. In the present study, 151 individuals (50 with chronic liver disease, 51 with chronic diseases of organs other than the liver, and 50 apparently healthy persons) were investigated. The last 2 groups served as control groups. These individuals were subjected to routine liver function tests and detection of serum antibodies to bilharziasis, hepatitis B surface antigen (HBsAg), and HCV. Furthermore, the presence of hepatitis G virus (HGV) and HCV in the serum samples were tested for by a reverse transcription polymerase chain reaction (RT-PCR). Prevalence of different genotypes of HCV in patients positive for HCV were determined by RT-PCR using type-specific primers. Results of the study revealed that 84, 74, 12, and 20% of patients with chronic liver disease were positive for Schistosoma mansoni, HCV, HBsAg, and HGV, respectively, as compared to 51, 43.1, 2, and 4% of patients with other chronic diseases and 22, 6, 0, and 0% of apparently healthy individuals. One hundred percent of patients with chronic liver disease, 72.5% of those with other diseases, and 26% of normal controls were shown to have at least one of the studied infectious agents. Two or more of the agents were highly coincident in patients with chronic liver disease. In Egypt, HCV genotype 4a is highly prevalent, where it contributed 85% of the tested samples in comparison to 10, 2.5, and 2.5% for subtypes 1b, 2a, and 3a, respectively. In conclusion, these results suggest that in Egypt, HCV along with schistosomal parasite infection is the major risk factor for chronic liver disease. In most Egyptian patients, HCV genotype 4 is highly prevalent.
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PMID:Effect of schistosomiasis and hepatitis on liver disease. 1040 20

Two hundred and fifty two blood donors HBsAg positive (mean age = 32.6, 91, 7% male) were searched into a transversal study to determine their clinical, laboratorial and histological characteristics. It was also compared the positiviness and negativiness of the serologic markers HBeAg, anti-Hbe and IgM anti-HBc with the values of serum aminotransferases. Hepatomegaly and splenomegaly were detected in 9.9% (25/252) and in 2.4% (6/252) respectively. In 17.5% (44/251) and 28.3% (71/251) the AST and ALT were respectively, over 50 UI/I. The positive frequencies of the various serologic markers of hepatitis B virus in 120 patients were: anti-HBc total in 89.5% (102/114), HBeAg in 25.7% (28/109) anti-Hbe in 67.3% (66/98), IgM anti-HBc in 40.8% (49/120); anti-Delta in 0.0% (0.66). Thirty one patients were submitted to liver biopsy, due do clinical alteration and/or of the aminotransferases. The hystological findings were: normal liver in 16.1% (5/31), non specific hystological alterations in 22.6% (7/31), persistent chronic hepatitis in 22.6% (7/31), active chronic hepatitis in 6.5% (2/31), cirrhosis in 12.9% (4/31), alcoholic hepatitis in 3.2% (1/31), lobular chronic hepatitis in 3.2% (1/31) and alterations exclusively due to schistosomiasis in 12.9% (4/31). Schistosomiasis elements (granuloma and/or Symmers fibrosis) were also notived in 7 patients. The comparative analysis of positiveness and negativeness of the serologic markers with the aminotransferases ("t" test of Student) showed significative difference of the averages (p < 0.05) only in relation to the simultaneous positeveness and negativeness of the HBeAg and IgM anti-HBc (average of AST = 56.11 and ALT = 78.00 when HBeAg and IgM anti-HBc were positive; average of AST = 24.25 and ALT = 27.00 when HBeAg and IgM anti-HBc were negative). According to this study the conclusion are: 1) The presence of two markers (HBeAg and IgM anti-HBc) and not only one determinant of viral replication in asymptomatic HBsAg carriers can strongly indicate a significant biochemical activity suggestive of hepatocellular lesion. 2) The presence of HBeAg in 25.7% (28/109) clearly shows the high rate of carriers with a potential of infectivity. 3) The results of hepatic histology shows that the majority of our patients had either normal liver or mild histological alterations. It is important to notice that only the cases with elevated aminotransferases were submitted to liver biopsies. The alterations caused by schistosomiasis shows, as is well known, the high prevalence of the parasitism in our surroundings. 4) The clinical aspects of the patients studied did not show significant alterations. Risk factors to get the infection were low. The hematologic and biochemical parameters (except aminotransferases) were either normal or just slightly abnormal. It was not detected a statistically significant difference. 5) The co-infections by delta virus was null.
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PMID:[Clinical, laboratory and liver histology of HBsAg-positive volunteer blood donors in Belo Horizonte, State of Minas Gerais, Brazil]. 1041 47

In a preliminary study carried out in the study area we found that 19.1% (173/907) of patients with chronic liver disease and 51% (35/68) of hepatocellular carcinoma cases were infected with Japanese schistosomiasis. Analysis of data from 571 autopsies revealed a similarly high incidence of schistosomiasis among cases of hepatoma and other liver diseases. A prospective case-control study conducted over 10 years showed that hepatoma developed in 5.4% (26/484) of chronic schistosomiasis cases and in 7.5% (23/307) of patients with chronic liver disease (hepatitis, cirrhosis, etc). The difference was not statistically significant (P = 0.228). A high incidence of hepatitis C virus (HCV) antibody (HCVAb) was found in the schistosomiasis group (36.5%; 95% CI = 44.9-28.1%) and in the chronic liver disease group (56.0%), 39% of whom had chronic hepatitis (P = 0.028). Various factors that might have contributed to the development of hepatoma and schistosomiasis were investigated, but no evidence of a significant correlation between schistosomiasis and hepatoma was found. The high incidence of HCVAb was considered to have been responsible for the development of hepatocellular carcinoma in chronic schistosomiasis patients. The role of HBV infection in the development of hepatoma in schistosomiasis patients was not confirmed after an assay for HCVAb was included in the study.
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PMID:Chronic Japanese schistosomiasis and hepatocellular carcinoma: ten years of follow-up in Yamanashi Prefecture, Japan. 1044 81

Drinking mutagenic downstream water from the Huangpu River was hypothesized to have increased the risk for male esophageal cancer in Shanghai, China. The authors conducted a population-based case-control study of a total of 71 esophageal cancer deaths and 1,122 controls collected during a 5-year follow-up period, 1984-1988, from four male cohorts born before January 1, 1944, living in four communities consuming water with different mutagenicities in the Shanghai area. The controls represented a 1% random sample of the defined living cohorts selected at the end of each of the 5 years of follow-up. Logistic regression showed an odds ratio of 2.77 (95% confidence interval: 1.52, 5.03) for drinking mutagenic downstream water from the river versus drinking nonmutagenic upstream water after controlling for possible confounders including age, disease history (hepatitis, cirrhosis, schistosomiasis, digestive tract ulcer), hazardous occupational history, pesticide exposure, lifestyle factors (cigarette smoking, tea intake, and alcohol intake), dietary habits (intake of pickled vegetables, maize, peanuts, and cured meat), education, poverty, urban environment, and water chlorination.
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PMID:Mutagenic drinking water and risk of male esophageal cancer: a population-based case-control study. 1047 43

Schistosomiasis has been suggested to decrease the reproductive potential or castrate both invertebrate and vertebrate hosts. Furthermore, schistosomiasis may cause anatomic anomalies of the reproductive organs responsible for permanent or reversible infertility. To specify the effect of schistosomiasis on gonadal functions, production of testosterone (TS), leutinizing hormone (LH) and estradiol (E2) in Egyptian men infected with schistosomiasis were studied. All participants were tested for the following parameters: Clinical examination and diagnostic, semen, haematological and liver function tests and blood level of IL-2. The mean TS levels were at the lowest limit of normal range for liver cirrhotic patients. Mean E2 levels were increased in all patients, but patients with liver cirrhosis-related schistosomiasis had higher E2 levels. Linear regression analysis showed that the sex hormone levels correlated best with the patient's liver function parameters. The present data suggest that a sex hormone imbalance plays a role in patients with liver cirrhosis due to the inhibitory effects of schistosomiasis on gonadal functions.
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PMID:Possible role of Schistosoma mansoni infection in male hypogonadism. 1060 85


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