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 a study of severe, decompensated liver failure, we tried to find a correlation between hemorrhage and parameters of hemostasis and fibrinolysis. Three groups of patients were studied: alcoholic cirrhosis; nonalcoholic cirrhosis, and acute liver failure without known prior liver disease. The two cirrhotic groups did not differ significantly from each other in coagulation or in fibrinolytic parameters, although liver function was more impaired in nonalcoholic cirrhosis. The levels of clotting factors, antithrombin III, prekallikrein, plasminogen and alpha 2-antiplasmin were significantly lower in the third group. Mean values of fibrinolytic activity (fibrin plate method) were slightly reduced as compared to normal in all three groups. Tissue plasminogen activator-related antigen tended to be elevated especially in alcoholic cirrhosis. The free fast-acting plasminogen activator inhibitor showed extremely high and extremely low levels in some patients among all three groups. Nonvariceal, capillary-type bleeding, including mucosal bleeding, hematomas and bleeding from puncture sites correlated with low thrombotest and normotest levels (p less than 0.01), low fibrinogen concentration (p less than 0.05) and with a high quotient of fibrinolytic activity (square root of lysis area) and normotest (p less than 0.001). The ratio between fibrin formation and dissolution appears to be an important parameter of hemorrhagic tendency in liver disease. Variceal bleeding appeared not to be related to impairment of hemostasis or fibrinolysis.
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PMID:Hemostasis and fibrinolysis in severe liver failure and their relation to hemorrhage. 394 92

To assess the value of the aminopyrine breath test (ABT) and antithrombin III (AT III) determinations in liver disease, both tests were performed on 77 consecutive patients who underwent liver biopsies for increased values of liver enzymes and in 20 patients with clinical cirrhosis. The mean values of AT III and ABT were significantly lower in cases of liver cirrhosis than in cases of steatosis and steatofibrosis. The AT III and ABT values were abnormal in, respectively, 83.9% (26/31) and 90.3% (28/31) of the patients with cirrhosis and 22.7% (15/66) and 28.8% (19/66) of the patients without cirrhosis. The association of the two tests increased the specificity without modifying the sensitivity. Both the AT III test and the ABT can be used as noninvasive diagnostic procedures for cirrhosis in patients for whom the liver biopsy is not available or contraindicated.
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PMID:Diagnostic value of antithrombin III and aminopyrine breath test in liver disease. 396 48

Hepatic blood flow (HBF) has been reported to reflect liver cell mass. HBF was studied in 21 patients with chronic active hepatitis (CAH) and in 20 patients with liver cirrhosis (LC). It was correlated with such indices of liver protein synthesis as serum albumin, Normotest, plasma activity of antithrombin III, prekallikrein, alpha 2-antiplasmin and plasminogen. No correlation between HBF and the examined parameters was seen in CAH. HBF correlated with all the indices of liver protein synthesis in LC, thus suggesting that serum albumin, antithrombin III, Normotest, prekallikrein, plasminogen, and alpha 2-antiplasmin could reflect the residual liver cell mass in LC.
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PMID:Correlation between hepatic blood flow and coagulation indices in chronic active hepatitis and liver cirrhosis patients. 402 56

Such parameters of blood coagulability as levels of antithrombin III, plasminogen, plasminogen activator and fibrinogen were compared in patients suffering cancer of different localization (51), cholelithiasis (52), mechanical jaundice of uncertain etiology (57), acute biliary pancreatitis (17), cirrhosis of the liver (39) and healthy subjects. More cases of cancer and mechanical jaundice caused by factors other than cancer showed elevated levels of antithrombin III and fewer cases--normal ones. This was matched by relatively frequent normal concentrations of plasminogen, plasminogen activator and fibrinogen and a less frequent increase in the said levels. Changes in the levels of the four parameters of hemostasis were relatively more frequent in cancer patients.
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PMID:[Hemostatic indices of oncological patients with different forms of jaundice]. 404 Feb 94

An unusual thrombin inhibitor is described in a patient suffering from liver cirrhosis, associated with a polyclonal gammopathy. In all screening tests that are based on thrombin action, the plasma clotting time was prolonged; in contrast, a test using the thrombin-like enzyme thrombin coagulase was not influenced. A specific thrombin inhibitor, present in the patient's plasma, was assumed. Fractionation experiments showed that the inhibitor was associated with the patient's IgG fraction. The IgG fraction dose-dependently inhibited the action of thrombin on fibrinogen and the inhibition of thrombin by antithrombin III, but the amidolytic activity of thrombin was only little affected.
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PMID:Acquired thrombin inhibitor in a patient with liver cirrhosis. 407 47

1. The metabolism of human antithrombin III (ATIII) was studied by using 125I-labelled tracer. 2. The plasma half-life (t0.5) was 2.71 +/- 0.26 days in normal subjects and was similar in patients with cirrhosis or primary carcinoma of liver. 3. Patients with cirrhosis had low ATIII levels, decreased intravascular mass, total body mass and decreased absolute catabolic rate, suggesting decreased synthesis. The positive correlation of ATIII level with fractional catabolic rate (K10) indicated that the decreased catabolic might exert a positive inhibition on ATIII production. 4. These abnormalities were more exaggerated in patients with macronodular cirrhosis associated with hepatitis surface antigen or in those with ascites. 5. In cirrhotic patients with ascites an additional extravascular pool of ATIII was present which did not turn over at the same rate as the intravascular pool. 6. Patients with primary carcinoma of liver had moderately low ATIII, but normal intravascular mass and total body mass because of the increased plasma volume and normal absolute catabolic rate. 7. The negative correlation of ATIII levels with K10 suggested that the low levels could be due to increased catabolism or consumption. 8. One patient with disseminated malignancy and active superficial thrombophlebitis had normal ATIII metabolism.
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PMID:Metabolism of antithrombin III in cirrhosis and carcinoma of the liver. 626 40

In order to assess the true incidence of haemostatic disorders in cirrhotic gastro-intestinal haemorrhage, a comparative prospective study of primary haemostasis, coagulation and fibrinolysis was carried out in 37 patients distributed into two groups: cirrhotics with gastro-oesophageal varices that had never bled (Group A = 22), and cirrhotics who had had an intestinal bleed from "ruptured" gastro-oesophageal varices (Group B = 15). Combination of thrombocytopenia (less than 100 10(9)/l) and a bleeding time greater than 8 mn was more frequent in Group B (80%) than in Group A (45%) (p = less than 0.05). On the other hand, no significant difference between the two groups was found in the activated cephalin time, thrombin time, prothrombin complex factors (II, V, VII-X), fibrinogen, antithrombin III, Factor VIII complex factors, FDP levels or plasminogen. In conclusion, these results suggest that disorders of primary haemostasis may be involved in bleeding from gastro-intestinal varices in cirrhosis. However, coagulation disorders and anomalies of fibrinolysis would not seem to play a determining role.
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PMID:[Importance of disorders of primary hemostasis in the occurrence of upper digestive hemorrhage in cirrhosis]. 633 45

In order to establish whether injection sclerotherapy of oesophageal varices could bring about a worsening of the coagulation abnormalities of patients with cirrhosis, the platelet count and the coagulation profile were monitored prior to, then 30 min and 18 h after, the injection in 8 patients undergoing 18 sclerotherapy sessions. Under basal conditions the platelet count, prothrombin activity, normotest and antithrombin III were all reduced; fibrinogen was in the low, and partial thromboplastin time in the high, normal range. A significant shortening of PTT and a further reduction in the platelet count, in the normotest and in fibrinogen occurred after 30 min. On one occasion laboratory evidence of disseminated intravascular coagulation was observed. After 18 h most parameters approached basal values, but the normotest remained persistently reduced. Even though a transient activation of the coagulation process, with consumption of platelets and the liver-dependent clotting factors took place after sclerotherapy in most cases, leading in one to self-limiting disseminated intravascular coagulation, haemorrhagic complications did not occur in our patients. These results suggest that injection sclerotherapy did not lead to clinically significant deterioration of coagulation even in patients with abnormal coagulative function. The observed changes appeared to be self-limiting and confined to the laboratory level in all cases.
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PMID:Study on coagulation profile of patients with cirrhosis of the liver undergoing elective fibreoptic injection sclerotherapy of oesophageal varices. 646 1

AT III substitution is indicated in patients with inherited antithrombin III deficiency if these patients suffer acute thrombosis, if they have to be treated surgically and in the case of pregnancy in women with AT III deficiency who have an abortion or thrombosis, as well as during and after delivery. In acquired antithrombin III deficiency such as in patients with liver cirrhosis or the nephrotic syndrome, AT III substitution may be necessary if thrombotic complications occur. AT III substitution has been propagated especially in patients with polytrauma, septicaemia, DIC, acute liver failure and in toxaemia. In AT III substitution initial doses of 1 U/kg body weight are used to reach a 1,5% rise in plasma AT III level. If AT III turnover is normal a rise above 80% of normal should be achieved. If AT III turnover is increased, much higher initial and maintenance doses may be needed to normalize plasma AT III levels and to block DIC.
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PMID:Substitution of antithrombin III. 652 16

Prekallikrein (Prekk), antithrombin III (ATIII), plasminogen and alpha 2-antiplasmin were evaluated in chronic active hepatitis and in liver cirrhotic patients and correlated with Normotest. Prekk, ATII and plasminogen were significantly decreased in chronic active hepatitis as well as in liver cirrhosis. Alpha 2-antiplasmin levels in chronic active hepatitis patients did not differ from controls; liver cirrhotic patients, on the contrary, showed significantly low values of alpha 2-antiplasmin, Prekk, ATIII and plasminogen were significantly correlated with Normotest in both groups, but when cirrhotic patients were divided into the compensated and decompensated state only Prekk was correlated with Normotest in the decompensated state. The investigation seems to suggest that Prekk could be a reliable index for protein liver failure.
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PMID:Prekallikrein behaviour in chronic active hepatitis and in cirrhotic patients. 656 63


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