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

Three elderly females presenting with iron deficiency anaemia and faecal loss of blood were found to have a macronodular cirrhosis of the liver and an unusual red spotty appearence of the prepyloric antral mucosa. One patient underwent antral resection and the surgical specimen revealed abnormalities of the (sub)mucosal blood vessels. Anaemia and occult faecal blood loss disappeared after operation. It is suggested that this type of antral vascular abnormality is aetiologically related to hepatic cirrhosis and may represent a gastric equivalent of cutaneous spider angiomata.
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PMID:Abnormal blood vessels of the prepyloric antrum in cirrhosis of the liver as a cause of chronic gastrointestinal bleeding. 30 20

Because of uncertainty as to the molecular weight of transferrin, a previous comparison [Von der Heul et al., Clin. Chim. Acta 38, 347 (1972)] between transferrin content of serum and total iron-binding capacity cannot be definitive. We found a conversion factor for expressing the maximum amount of iron bound by 1 mg of transferrin. We compared the resulting calculated value with values obtained by three other methods for measuring total iron-binding capacity. We agree with the previous observation that the latter, as measured radioisotopically, give higher results than would be judged from the transferrin content but the same as those for two chemical methods. The diffusion rate of transferrin in agar was the same irrespective of the degree of iron saturation. Serum transferrin concentrations were low in patients with anemia resulting from malignancy, chronic disorders, and cirrhosis of the liver, and high or normal in patients with iron deficiency anemia and in pregnant women or women who were taking birth-control pills. Measurement of transferrin concentration can be used to distinguish iron deficiency anemia from anemia resulting from chronic disorders, but offers no advantages over existing methods for estimating total iron-binding capacity.
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PMID:Immunological measurement of transferrin compared with chemical measurement of total iron-binding capacity. 113 10

Antral vascular ectasia (watermelon stomach) is an uncommon localised vascular abnormality which may cause occult gastrointestinal blood loss and iron deficiency anaemia. The endoscopic appearances are characteristic with well demarcated, often raised or nodular bright red streaks radiating from the pylorus back along the antrum. Endoscopic biopsies can be taken without risk of haemorrhage and may help distinguish this condition from gastritis. The aetiology remains obscure, but there is an association with achlorhydria, hypergastrinaemia, and cirrhosis of the liver. Four patients are described; two had antrectomy with long term control of their anaemia, and two were treated conservatively. The lesion may be diagnosed more frequently with more widespread recognition of the condition.
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PMID:Antral vascular ectasia: the watermelon stomach. 150 52

Magnetic resonance demonstrated siderotic regenerating nodules in a patient with hepatocellular carcinoma with accompanying liver cirrhosis. The siderosis disappeared when iron deficiency anemia developed in association with biliary hemorrhage. Magnetic resonance was sensitive enough to follow changes in the siderosis. The mechanism of iron deposition in regenerating nodules that accompanied liver cirrhosis did not seem to be related to the severity of the liver damage.
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PMID:Siderotic nodules in hepatic cirrhosis disappearing after biliary hemorrhage: MR imaging. 165 91

Iron absorption is under delicate control and the level of absorption is adjusted to comply with the body's need for iron. To measure the intestinal setting for iron absorption, and thereby indirectly assess body iron requirements, cobaltous chloride labelled with (57)Co or (60)Co was given by mouth and the percentage of the test dose excreted in the urine in 24 hours was measured in a gamma counter. Seventeen control subjects with normal iron stores excreted 18% (9-23%) of the dose. Increased excretion, 31% (23-42%), was found in 10 patients with iron deficiency anemia and in 15 patients with depleted iron stores in the absence of anemia. In contrast, 12 patients with anemia due to causes other than iron deficiency excreted amounts of radiocobalt within the normal control range. In patients with iron deficiency, replenishment of iron stores by either oral or parenteral iron caused the previously high results to return to normal.Excretion of the test dose was normal in portal cirrhosis with normal iron stores but it was markedly increased in patients with cirrhosis complicated by either iron deficiency or endogenous iron overload. It was also raised in primary hemochromatosis. Excretion of the dose was reduced in gluten-sensitive enteropathy. Gastrointestinal surgery and inflammatory disease of the lower small intestine had no effect on the results except that some patients with steatorrhea had diminished excretion.The cobalt excretion test provides the clinician with a tool for the assessment of iron absorption, the detection of a reduction in body iron stores below the level that is normal for the subject in question, the differentiation of iron deficiency anemia from anemia due to other causes, and the investigation of patients with iron-loading disorders.
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PMID:Cobalt excretion test for the assessment of body iron stores. 557 25

The excessive storage of iron in idiopathic haemochromatosis leads to severe organic lesion up to life-threatening conditions (cardiac insufficiency, portal decompensation). The symptoms melanodermia , diabetes mellitus and other endocrine failures, liver cirrhosis, cardiac insufficiency and arthropathy appear together or in various combinations. The diagnosis is ascertained by the proof of iron storage, the multiple organic affection and by familial accumulation of the various laboratory diagnostic possibilities are particularly to be emphasized the serum iron value together with the percetal transferrin saturation (as search test), serum ferritin, the desferrioxamine test, simple ferrokinetic investigations and the quantitative determination of iron in the liver in the bioptate . For family examinations, apart from the search test, a HLA typisation is reasonable, in order to estimate the risk of the disease (particularly of brothers and sisters). The therapy of choice are blood- lettings (0.5 l once to twice a week) up to obtaining a permanent easy iron deficiency anaemia. The maintenance therapy should be performed with monthly to quarterly blood- lettings . Only in cases exception a desferal treatment is indicated. Endocrine failures and cardiac disturbances need a particular therapy.
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PMID:[Idiopathic hemochromatosis--diagnosis and therapy]. 673 May 91

The red-cell 2,3-diphosphoglycerate (DPG) concentration is determined in 60 patients with hepatic cirrhosis, in 33 with iron deficiency anaemia and in 86 healthy subjects. In all cases, the erythrocyte volume fraction and the haemoglobin concentration are simultaneously measured, while the cirrhotic patients undergo, at the same time, analyses of the arterial pH, pO2 and pCO2 and of the levels of inorganic phosphate, bicarbonate and lactate in their venous blood. In the 60 cirrhotic patients the red-cell DPG concentration (7.40 +/- 1.23 mmol/l) is significantly higher (P less than 0.001) than in the 86 control subjects (4.58 +/- 0.59 mmol/l) and the 33 patients with iron deficiency anaemia (5.86 +/- 1.06 mmol/l), although the level of anaemia in the latter is greater (P less than 0.001) than in the patients with liver cirrhosis. The DPG concentration found in the cirrhotic patients was far higher (P less than 0.001) than the theoretical value attributable to them by virtue of their grade of anaemia (5.21 +/- 0.95 mmol/l), which value is deduced mathematically from the equation of the regression line between haemoglobin and DPG normal in patients with iron deficiency anaemia. Anaemia, hypoxaemia and acid-base disturbances are disorders frequently associated with cirrhosis of the liver. In the present study we deduce that alkalosis, and therefore the plasma pH level, is the most important factor causing the increased DPG concentration in patients with liver cirrhosis for any level of haemoglobin, with respect to other subjects with anaemia.
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PMID:Relationship of red-cell 2,3-diphosphoglycerate with anaemia, hypoxaemia and acid-base status in patients with cirrhosis of the liver. 716 27

Erythrocytosis is occasionally observed in patients with hepatocellular carcinoma (HCC). The pathogenesis of the phenomenon remains uncertain. It has been speculated that tumors produce erythropoietin (Epo), and several studies on the Epo in tumor tissues have been reported. Using a sensitive enzyme linked immunosorbent assay, we measured the serum Epo concentration in 92 HCC patients and 30 liver cirrhosis (LC) patients. The levels of Epo in normal subjects, HCC patients and LC patients were 10.5 +/- 4.1 (mean +/- SD, mU/ml), 55.6 +/- 218.0 and 18.4 +/- 19.4, respectively. Some patients with high Epo values had low levels of hemoglobin (Hb), and a scatter-gram of the two parameters was similar to that in iron deficiency anemia. In patients whose Hb levels were more than 12 g/dl, we found Epo levels of 15.0 +/- 8.8 (mean +/- SD mU/ml) and 10.3 +/- 7.7 in HCC and LC, respectively. Epo values in HCC were significantly higher than those of normal subjects (P < 0.001) and LC patients (P < 0.05), and 18.2% (10/55) had concentrations above the upper limit of the normal range. The increase was not, however, a marked one. In conclusion, as the incidence of erythrocytosis was low (2.2%) in HCC patients, the high Epo values in some patients could be related to the abnormal production of Epo by HCC.
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PMID:Serum erythropoietin measurements by a one-step sandwich enzyme linked immunosorbent assay in patients with hepatocellular carcinoma and liver cirrhosis. 769 89

Watermelon stomach is a rare disorder causing gastric blood loss and iron deficiency anemia. We report a case that occurred during the course of post-hepatitis C cirrhosis, which condition was dramatically improved by alpha-interferon treatment.
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PMID:Dramatic improvement of watermelon stomach with alpha-interferon. 777 96

Watermelon stomach is an unusual cause of gastrointestinal bleeding and iron deficiency anemia. Its etiology is unknown, but it has been reported to be associated with a variety of diseases, including autoimmune disorders and cirrhosis. We report on the long-term outcome of 15 patients (13 women, 2 men) treated with neodymium-yttrium-aluminum-garnet (Nd:YAG) laser therapy. The mean age of patients at presentation was 71.6 years (range, 59 to 85 years). Fourteen patients were transfusion-dependent, requiring an average of 9.6 units of blood in the 12 months preceding diagnosis and treatment. Associated diseases included scleroderma (3 patients), mixed connective tissue disease (1 patient), history of cancer (3 patients), cryptogenic cirrhosis (3 patients), and chronic renal failure (3 patients). In 7 of 9 patients who had an antinuclear antibody test, an elevated titer greater than 1:160 in a speckled pattern was noted. Nd:YAG laser coagulation therapy was administered to all patients without complications and was successful in reducing bleeding in every case. Five patients died during the course of follow-up without signs of recurrent gastrointestinal bleeding. The remaining 10 patients have had both endoscopic and hematologic improvement during a mean follow-up period of 4.4 years from the time of initial diagnosis (range, 2 to 8 years). The 10 survivors are no longer transfusion-dependent and have stable hematocrits.
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PMID:The watermelon stomach: long-term outcome in patients treated with Nd:YAG laser therapy. 749 2


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