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)

Corticosteroids, azathioprine and antiviral agents have a questionable effect on CAH B. Chloroquine, a lysosomotropic agent, was used to treat 7 patients with histologically confirmed CAH B. All were HBeAb positive. A working hypothesis considering cellular death in CAH B as the result of lysosomal enzyme liberation by activated Kupffer cells was the basis for treatment. In this model T lymphocytes have only an immunoregulatory role. Clinical and laboratory follow-up was done for 6-16 months (median 12 months). Serum chloroquine levels were recorded by a fluorimetric method. 150-450 mg of chloroquine base were administered according to bio-chemical disease activity. In all patients AST and ALT values returned to normal and there was a fall in serum delta GT and improvement of prothrombin time. an increase of globulins was noted. Inadvertent drug withdrawal resulted in aminotransferase increase in 3 patients with prompt restoration of normal values on readministration. One patient refused to continue the drug and died after two months. Variceal bleeding was the cause of death of a second patient. No side effects were noted. A repeat liver biopsy, a year later (4 patients) revealed inactive cirrhosis in all. Chloroquine administration is a safe treatment for patients with CAH B. Further studies are justified.
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PMID:Treatment of chronic active hepatitis B (CAH B) with chloroquine: a preliminary report. 375 92

We measured serum guanase (EC 3.5.4.3) activity in patients with various diseases and in healthy controls, and evaluated the clinical usefulness of this enzyme in liver diseases. The reference range, which showed no significant difference between sexes and ages over the range studied, was 0 to 1.8 U/L. The mean guanase activities for patients with various liver diseases, including acute hepatitis, chronic hepatitis, liver cirrhosis, hepatoma and metastatic carcinoma, were above the upper limit of the reference range. In acute hepatitis and metastatic carcinoma of the liver, the activities were especially high. Validity (sensitivity + specificity) of guanase, which in all tests was above 1.66, was compared to that of AST and ALT in liver diseases. With guanase, the highest validity (1.98) was found in acute hepatitis and metastatic carcinoma. Specificity of guanase was 0.98, whereas sensitivity of AST was 1.00 in all diseases. Sensitivity and specificity of ALT were 0.85 to 0.97 in all diseases. As guanase was specific, including this enzyme with other liver function tests, such as AST and ALT, may decrease false-positive results and may be effective for prediction of liver disease.
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PMID:Clinical evaluation of serum guanase activity in liver diseases. 649 63

We retrospectively reviewed the clinical and laboratory data of 1154 patients with biopsy-proven CAH observed in 12 Italian referral liver units. The data obtained at the time of hospitalization were recorded and computerized. The data were analyzed for the presence or absence of HBsAg, sex, classes of age and three different degrees of the histological severity of CAH (mild, severe, with cirrhosis). HBsAg was present in 700 patients (61%). As compared with HBsAg negative patients HBsAg positive patients were younger, showed higher values of aminotransferases, were more frequent males and less frequently showed histological evidence of cirrhosis and associated diseases (diabetes, peptic ulcer and biliary stones). Patients younger than 15 years showed higher AST and lower gammaglobulins levels than patients in other age classes. Moreover, both in HBsAg positive and HBsAg negative CAH, patients with cirrhosis were older than patients without histological evidence of cirrhosis.
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PMID:Chronic active hepatitis in Italy: a multicentric study on clinical and laboratory data of 1154 cases. A report from the study group for CAH of the Italian Association for the Study of the Liver. 662 2

Twelve serologically proven cases of non-A, non-B (NANB) hepatitis have been described. The clinical course was mild in 11 patients. One patient, however, presented in portal systemic encephalopathy and required steroid treatment. Nine of the 12 patients continued to exhibit raised transaminase (AST) activities six or more months after the onset of the acute hepatitis. In these immunoglobulin concentrations were normal and autoantibodies were not present in significant titre. Four patients had evidence of previous hepatitis B infection, suggesting that the route of transmission of NANB might be similar to that of hepatitis B virus. A further four patients gave a history which suggests a possible parenteral mode of transmission. Liver biopsies were carried out both in the acute (8 cases) and chronic (6 cases) phases of the disease. Histological findings in liver biopsies covered the whole spectrum of acute and chronic hepatitis and 1 patient had cirrhosis. One notable feature in these biopsies was the presence of fatty changes.
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PMID:Clinical and histological features of a group of patients with sporadic non-A, non-B hepatitis. 679 15

To determine whether the aminopyrine breath test reflects the presence of increased pericentral fibrosis, steatonecrosis, and cirrhosis following jejunoileal bypass, 21 patients were evaluated with liver biopsies, liver chemistry tests, 45-min bromosulfothalein retention tests, and aminopyrine breath tests prior to bypass and at 3, 6, and 12 months thereafter. Following bypass, 15 biopsies demonstrated increased pericentral fibrosis, steatonecrosis, or cirrhosis, and 35 biopsies revealed increased fatty infiltration alone. Although the aminopyrine breath test results were significantly lower in patients with increased pericentral fibrosis, steatonecrosis, and cirrhosis at 6 and 12 months following bypass (P less than 0.05), this test had a positive predictability of only 0.67. An abnormal AST had a positive predictability of 0.87. Other liver function tests were less reliable in identifying patients with potentially progressive lesions following bypass. Thus, the AST is more useful than the aminopyrine breath test in reflecting increased pericentral fibrosis, steatonecrosis, and cirrhosis following jejunoileal bypass. The nonspecific effects of obesity and increased fatty infiltration of the liver following jejunoileal bypass may account for the low predictability of the aminopyrine breath test.
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PMID:Aminopyrine breath test. Prospective comparison with liver histology and liver chemistry tests following jejunoileal bypass performed for refractory obesity. 683 4

A group of 48 patients (42 suffering from hepato-biliary diseases and 6 without hepatic diseases) was followed by the authors for a period lasting from 5 to 8 years, 13 out of them for longer. The hepatic disease was assessed on the basis of physical examination, current liver chemistry and proper and specific instrumental procedures. Initial and final diagnosis and the aminotransferases (AST, ALT) trend in years were carefully considered. First of all it was concluded that no advantage is obtained in monitoring the two aminotransferases instead of one alone. Moreover it is stressed the opportunity of referring aminotransferases activities in a simple way such as per cent of variation as referred to considered upper normal value differing from one to the other laboratory. The aminotransferase increase maintains an important and diagnostic significance in acute liver damage such as in acute hepatitis. An inappreciable prognostic value may be drawn from the follow up of these enzymatic parameters: for example the development of posthepatic fibrosis, or cirrhosis or hepatoma cannot be foreseen on the basis of the aminotransferases trend. A greater variability and sharp increases in AST-ALT values are recorded in patients with biliary gallstones.
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PMID:[Diagnostic-prognostic significance of long-term (5-11 years) variations in serum GOT-GPT levels in the blood]. 717 59

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the liver that is characterized by progressive cholestasis and the development of secondary biliary cirrhosis. There is no widely recognized therapy for this disease, although anti-inflammatory agents (steroids), immunosuppressive agents (methotrexate), anti-fibrotics (colchicine), and choleretic agents (ursodeoxycholic acid) have been used in various small series. In the present study, Tacrolimus (FK 506), a new and powerful immunosuppressive macrolide antibiotic, has been used to treat 10 patients with PSC. Each subject had a liver biopsy, ERCP with visualization of the intra- and extrahepatic biliary tree, and a panel of hematological, serological, and biochemical laboratory tests before the initiation of the FK 506 therapy. The FK 506 was administered orally at 12-h intervals and was monitored by serial plasma FK 506 trough levels. After 360 days of treatment, the median serum bilirubin level was reduced by 75%, and the serum alkaline phosphatase was reduced by 70%. Moreover, the serum ALT and AST levels were reduced by 80 and 86%, respectively. No change in the serum level of BUN and creatinine levels occurred as a consequence of the FK 506 treatment. These data demonstrate that: 1) FK 506 can be used to treat PSC; 2) the response to FK 506 by patients with PSC is rapid; and, 3) no adverse effect on the serum BUN and creatinine levels was observed. It is anticipated that FK 506 will become an important agent for the treatment of patients with PSC because of its powerful immunosuppressive activity.
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PMID:Tacrolimus (FK 506), a treatment for primary sclerosing cholangitis: results of an open-label preliminary trial. 753 12

To determine if alcoholic liver fibrogenesis is exacerbated by dietary iron supplementation, carbonyl iron (0.25% wt/vol) was intragastrically infused with or without ethanol to rats for 16 wk. Carbonyl iron had no effect on blood alcohol concentration, hepatic biochemical measurements, or liver histology in control animals. In both ethanol-fed and control rats, the supplementation produced a two- to threefold increase in the mean hepatic non-heme iron concentration but it remained within or near the range found in normal human subjects. As previously shown, the concentrations of liver malondialdehyde (MDA), liver 4-hydroxynonenal (4HNE), and serum aminotransferases (ALT, AST) were significantly elevated by ethanol infusion alone. The addition of iron supplementation to ethanol resulted in a further twofold increment in mean MDA, 4HNE, ALT, and AST. On histological examination, focal fibrosis was found < 30% of the rats fed ethanol alone. In animals given both ethanol and iron, fibrosis was present in all, with a diffuse central-central bridging pattern in 60%, and two animals (17%) developed micronodular cirrhosis. The iron-potentiated alcoholic liver fibrogenesis was closely associated with intense and diffuse immunostaining for MDA and 4HNE adduct epitopes in the livers. Furthermore, in these animals, accentuated increases in procollagen alpha 1(I) and TGF beta 1 mRNA levels were found in both liver tissues and freshly isolated hepatic stellate cells, perisinusoidal cells believed to be a major source of extracellular matrices in liver fibrosis. The dietary iron supplementation to intragastric ethanol infusion exacerbates hepatocyte damage, promotes liver fibrogenesis, and produces evident cirrhosis in some animals. These results provide evidence for a critical role of iron and iron-catalyzed oxidant stress in progression of alcoholic liver disease.
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PMID:Experimental liver cirrhosis induced by alcohol and iron. 761 36

A prospective study of 21 patients with the diagnosis of non-alcoholic steatohepatitis (NASH) was carried out. All patients had hepatomegaly and in 10 (48%) image studies were consistent with steatosis and/or fibrosis. Biochemically, there was increase of AST, ALT and cholesterol in 48%, of GGT in 52% and of alkaline phosphatase in 38%. 18 patients were obese, 2 of them diabetic, 2 others had a history of exposure to drugs (amiodarone and isopropilic alcohol) and the last one presented hypothyroidism. Liver biopsies were studied using a semiquantitative scale to evaluate the degree of steatosis, inflammation and fibrosis in a scale from 1 to 3. Results showed a medium score of 2.6 for steatosis, 1.5 for inflammation and 1.8 for fibrosis. Four patients had cirrhosis and Mallory bodies were found in 11 cases (52%). NASH is an oligosymptomatic disease that can be found in different clinical conditions, mainly obesity, and is more frequent in women. It is histologically indistinguishable from alcoholic steatohepatitis. It is frequently underdiagnosed clinically and must be taken into account as a possible cause of cryptogenetic cirrhosis.
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PMID:[Non alcoholic steatohepatitis]. 765 98

Liver cirrhosis (LC) in habitual drinkers is divided into three categories: (1) alcoholic LC, (2) LC due to hepatitis C virus and alcohol, and (3) LC due to hepatitis C virus. In Japan, the frequency of LC related to hepatitis B virus in habitual drinkers is comparatively low. Although making a distinct differentiation is very difficult, it is possible to point out some characteristics which ars due to either alcohol or hepatitis C virus: (1) multiple spider angioma, acne rosacea, and palmar erythema are more frequently found in categories 1 and 2 than in 3, (2) levels of AST/ALT, gamma-GTP, TG, ALP, lactate, and UA are higher in category 1 than in 3, (3) enlargement of both lobes is observed in category 1, and (4) abnormality due to alcohol improves relatively soon after abstinence of alcohol.
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PMID:[Differentiation alcoholic liver cirrhosis from viral liver cirrhosis]. 790 45


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