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

We are reporting on a 62 year old female patient with portal hypertension (splenomegaly, esophageal varicosis) without signs of liver cirrhosis, who was hospitalized for sclerotherapy of her esophageal varices. Physical examination showed up palmar- and plantar hyperkeratosis and Morbus Bowen or basalioma-like skin lesions++. Anamnestic evaluation revealed, that the patient's psoriasis had been treated with arsenic for many years. This kind of treatment may have induced intraluminal proliferation and obliteration of the portal vein's endothelium, thus being the etiologic factor responsible for noncirrhotic portal hypertension in this patient.
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PMID:[Portal hypertension and chronic arsenic exposure. A differential diagnostic challenge]. 262 81

Between 1972 and 1981 a total of 121 male and female wine-dressers with late after-effects from arsenic were medically examined and treated. Skin and liver were examined regularly every 3 months. With advancing years an increase in typically arsenic melanosis, precancerous, carcinomas and hyperkeratosis in palmae and plantae was observed. A significant increase in Dupuytren's contracture was found in the age groups between 50 and 80 with a growing progression of typically arsenic horned pearls on the palms of the hands and soles of the feet. The typically arsenic horned pearls and arsenical keratosis occurred most frequently in the Dupuytrenical changes of the skin. The liver parameters showed no pathological results such as cirrhosis of the liver as compared with the other patients.
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PMID:[Dupuytren contracture in Mosel wine dressers with arsenic-induced aftereffect damage]. 621 79

From post-mortem examinations performed at the Pathology Institute at Koblenz, 163 cases of wine growers affected by chronic arsenic poisoning were analyzed. While a reduction could be seen in the number of cases of liver cirrhosis, the carcinoma rate was still high and even increased when compared to earlier reports. Lung cancers were identified in 66% of all wine growers affected and are thus the leading form of the skin were observed. A particular characteristic of amount of carcinomas or precarcinogenic alterations of arsenic carcinoma. However, nearly the same amount of carcinomas or precarcinogenic alterations of the skin were observed. A particular characteristic of cases. Among the multiple tumors, up to six different carcinomas were found. As arsenic is no longer detectable by toxicologic-chemical means the deposits of arsenic have been depleted and excreted long ago and so the diagnosis of chronic poisoning today depends on morphological changes of the skin (arsenic hyperkeratosis, melanosis and M. Bowen) which have been shown to be reliable. A comparison of our analysis with much more extensive material collected by the trade association supports our experience and the determined case rates. Furthermore modern theories on the carcinogenic action of arsenic, the question of the tumor latency and the relation of specific cancers to the poison are presented. In addition medical opinions on chronic arsenic poisoning are discussed.
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PMID:The consequences of chronic arsenic poisoning among Moselle wine growers. Pathoanatomical investigations of post-mortem examinations performed between 1960 and 1977. 682 38

Two dogs with metabolic epidermal necrosis had hyperkeratosis of the footpads accompanied by erythematous, erosive and crusting lesions affecting the muzzle, external genitalia, perineum and periocular regions. Histopathological examination of skin biopsies revealed a superficial hydropic dermatitis with marked parakeratosis. Both dogs had high plasma activities of alkaline phosphatase and alanine aminotransferase and high concentrations of glucose, and also a marked hypoaminoacidaemia. Despite these similarities, the cutaneous eruptions were associated with different underlying diseases. One dog had a pancreatic carcinoma which had metastasised widely; the primary tumour and the metastases showed glucagon immunoreactivity on immunocytochemical staining, and the dog's plasma glucagon concentration was markedly greater than that of control dogs. The other dog had diffuse hepatic disease; its plasma glucagon concentration was similar to that of control samples and cirrhosis was identified post mortem. Metabolic epidermal necrosis in dogs is a distinct cutaneous reaction pattern which may be associated with different underlying systemic diseases; however, the pathogenesis of the skin lesions remains unclear.
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PMID:Metabolic epidermal necrosis in two dogs with different underlying diseases. 763 36

Millions now suffer the effects of chronic arseniasis related to environmental arsenic exposure. The biological mechanisms responsible for arsenic-induced toxicity and especially chronic effects, including cancer, are not well known. The U.S. Armed Forces Institute of Pathology (AFIP) is participating in an international research effort to improve this understanding by the development of the International Tissue and Tumor Repository for Chronic Arsenosis (ITTRCA). The ITTRCA obtains, archives, and makes available for research purposes, tissues from subjects exposed to arsenic. We provide here a short overview of arsenic-induced pathology, briefly describe arsenic-induced lesions in the skin and liver, and present five case reports from the ITTRCA. Arsenic-induced skin pathology includes hyperkeratosis, pigmentation changes, Bowen disease, squamous cell carcinoma, and basal cell carcinomas. A unique spectrum of skin lesions, known as arsenical keratosis, is rather characteristic of chronic arseniasis. Bowen disease, or squamous cell carcinoma in situ of the skin, has been well documented as a consequence of arsenical exposure. A spectrum of liver lesions has also been attributed to chronic arseniasis. Of these, hepatocellular carcinoma, angiosarcoma, cirrhosis, and hepatoportal sclerosis have been associated with arsenic exposure. We present case reports that relate to these health conditions, namely, squamous cell carcinoma, basal cell carcinoma, and Bowen disease of the skin and hepatocellular carcinoma and angiosarcoma of the liver. Four patients had been treated with arsenical medications for such conditions as asthma, psoriasis, and syphilis, and one case occurred in a boy chronically exposed to arsenic in drinking water.
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PMID:Pathology related to chronic arsenic exposure. 1242 52

Systemic sclerosis (SSc) is a chronic systemic disease that affects the skin, lungs, heart, gastrointestinal tract, kidneys, and musculoskeletal system. Although up to 90% of patients with scleroderma have been estimated to have gastrointestinal involvement, liver disease has been reported only rarely. A 51-year-old woman was hospitalized due to esophageal variceal bleeding. Her serum was positive for anti-nuclear antibody and anti-centromere antibody. Sclerodactyly was noted on both hands, and she had recently developed Raynaud's syndrome. Punch biopsy of the hand showed hyperkeratosis, regular acanthosis, and increased basal pigmentation in the epidermis, and thick pale collagenous bundles in the dermis. Liver biopsy showed chronic active hepatitis with bridging fibrosis. Consequently, she was diagnosed with liver cirrhosis due to autoimmune hepatitis (AIH) combined with SSc. AIH had subsided after administration of prednisolone at 40 mg per day. She received 5-10 mg/day of prednisolone as an outpatient, and her condition has remained stable. Patients with either AIH or SSc should be monitored for further development of concurrent autoimmune diseases. The early diagnosis of AIH combined with SSc will be helpful in achieving optimal management.
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PMID:Liver cirrhosis due to autoimmune hepatitis combined with systemic sclerosis. 2228 55

Although first described almost half a century ago, parastomal varices are not easily recognised as a cause of stomal bleeding even though they occur in up to 5% of all people who have a stoma. The main challenges associated with this condition are diagnosis and management. For that reason, the aim of the present study was to perform a systematic review of all the available literature pertaining to this topic. The primary end point was recurrent variceal haemorrhage after a particular mode of management. Several secondary endpoints focused on means of diagnosis and pathological conditions of abdominal organs that could contribute to both the formation of these varices and the rate of re-bleeding. Sixty-six articles comprising 210 patients were analysed. Parastomal varices tend to be more frequent in men manifesting with bleeding in the fifth decade of life. The majority (72.0%) of patients who bleed from parastomal varices do so from an ileostomy. The most common pathology leading to stoma formation is ulcerative colitis (57.8%). Liver cirrhosis is the most common cause of portal hypertension leading to the development of parastomal varices and primary sclerosing cholangitis is in second place. A third of patients with parastomal varices also have co-existent oesophageal varices. There are no pathognomonic symptoms or signs of parastomal varices and only the minority of patients have a raspberry appearance of the stoma, visibly dilated submucosal veins and bluish discoloration and hyperkeratosis of the skin around it. Venous phase contrast angiography or portal venography is the most successful radiological investigation to confirm the diagnosis. The transjugular intrahepatic portosystemic shunt (TIPS) procedure has the highest success rate in preventing recurrent haemorrhage and local measures, either non-operative or surgical, are the least effective. Comparison of TIPS with non-operative and local surgical treatment groups produced a risk reduction in 4.60 and 3.85, respectively. Treatment of 1.37 people with a TIPS procedure prevents one person suffering from recurrent variceal bleeding and using TIPS can reduce the likelihood of re-bleeding by 78.5%. Surgical portosystemic shunting or embolisation alone leaves patients with approximately 50% chance of re-bleeding. Although TIPS has gained popularity over the last two decades almost three quarters of patients with parastomal varices are still treated with local measures as first-line management. Liver transplantation as a treatment of the primary cause of parastomal varices remains very rare.
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PMID:Management of parastomal varices: who re-bleeds and who does not? A systematic review of the literature. 2315 77