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)

A reaction of the RES with its organs (lymph nodes, spleen, bone marrow and Kupffer's cells) is not uncommon in rheumatoid arthritis. Although these manifestations are pronounced in Felty's syndrome, reviewing articles about Felty's do not mention liver manifestations. This paper summarises the publications about liver findings in Felty's syndrome. Hepatomegaly, abnormal bromsulfalein tests, raised alkaline phosphatase and transaminases have been stated in many case reports. Among 34 patients, the frequency of hepatomegaly was 68%, of abnormal bromsulfalein tests 27%, of alkaline phosphatase 23% and of transaminases 18%, respectively (52). Alkaline phosphatase and transaminases were raised in almost all of 12 patients (3). The histological correspondence is an infiltration with lymphocytes of sinusoids and portal fields, a portal fibrosis and occasionally a cirrhosis. These histological abnormalities, as well as enlarged lymph nodes and splenomegaly, have to be considered as organic manifestations of rheumatoid arthritis. If the nodular regenerative hyperplasia of the liver, which has been reported also after use of contraceptives, is a manifestation of Felty's syndrome, remains unresolved.
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PMID:[Liver findings in Felty's syndrome. A review]. 69 99

Alkaline phosphatase isoenzymes have been studied by acrylamide gel disc electrophoresis in 76 patients with liver disorders comprising 15 with an extrahepatic lesion, 53 with an intrahepatic lesion, and eight patients who had features of both intra- and extrahepatic disease. No intestinal band was found in the 15 cases of extrahepatic liver disease, in marked contrast to the patients with intrahepatic lesions in whom an intestinal band was found in 45% of cases. The intrahepatic group was heterogeneous, a high incidence of intestinal bands being found in patients with cirrhosis of the liver. It is concluded that where a raised serum alkaline phosphatase is found in a patient with jaundice, and a gut band is present on electrophoresis, the lesion is likely to be intrahepatic.
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PMID:Intestinal alkaline phosphatase in the diagnosis of liver disease. 86 86

Granulomatous inflammation is a specific type of chronic inflammation in which macrophages and T-cell-mediated immunity to the inciting agent play a pivotal role. In the present study, granulomatous hepatitis was induced in rats by the administration of a single intravenous dose of porcine intestinal alkaline phosphatase. The cellular composition of the hepatic granulomas was analyzed in-situ with a number of recently developed mouse anti-rat monoclonal antibodies to cells of the monocyte-macrophage lineage and lymphocyte subsets. Well-developed granulomas consisted of aggregates of macrophages with central modification into epithelioid cells, a peripheral rim of T- and B-lymphoid cells, including considerable numbers of immunoblasts and plasma cells. In addition, the periphery of the granulomas contained many fat storing cells, a sinusoidal cell type thought to play a central role in hepatic fibrosis. Moreover, intense immunostaining for the extracellular matrix proteins fibronectin and collagen type III was observed at the periphery of the lesions. The granulomas persisted for long periods without eliciting liver cirrhosis. Alkaline phosphatase induced hepatic granulomas in the rat may help to elucidate the contribution of cells of the B-lineage to chronic granulomatous inflammation.
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PMID:Immunopathology of alkaline phosphatase-induced granulomatous hepatitis in rats. 135 74

Chronic hepatitis is infrequently reported in the course of RA (1.9%). We report 6 cases with such an association. The six patients were all female (mean age: 59.5 years) with typical RA (ACR criteria), and sicca syndrome in 5 cases. Chronic hepatitis always developed after the onset of RA (delay: 1 to 47 years). Laboratory findings revealed a mild increase of transaminases. Alkaline phosphatase were increased in 3 cases. Liver insufficiency was present in 4 cases and polyclonal hypergammaglobulinemia in 6 cases. Rheumatoid factors were detected in 5 cases; antinuclear antibodies and anti-smooth muscle antibodies were also detected in 5 cases. Histological examination of liver biopsy disclosed active chronic hepatitis in 5 cases (with cirrhosis in 3 cases) and persistent chronic hepatitis in 1 case. Steroid therapy was administered in 4 cases of active chronic hepatitis with clinical and biological improvement (18 months to 6 years follow-up). One patient died of gastric bleeding.
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PMID:Chronic hepatitis during rheumatoid arthritis. 195 1

We analyzed 31 patients with a diagnosis of primary biliary cirrhosis, 29 of them males, aged 23 to 72 years. Liver biopsy was diagnostic in all showing initial findings of the disease in 5. Echotomography and cholangiography demonstrated a patent biliary, tract. Anti-mitochondrial antibodies were present in 94% of patients. Alkaline phosphatase and biliary acid levels were useful for diagnosis. Pruritus was present with varying intensity in all patients, with premenstrual exacerbations in 5 females who had cholestasis of pregnancy or hepatitis caused by progestin drugs before developing cirrhosis. Recurrent urinary tract infection was present in 8 patients, osteoporosis in 24, Sjogren's syndrome in 24 and Crest syndrome in 4. Survival ranged from 1 to 12 years, death being caused by ruptured esophageal varices in 12 patients and by liver failure in 7. Persistence of pruritus and altered liver function tests after cholestasis of pregnancy or hepatitis caused by progestins should lead to investigation of biliary cirrhosis.
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PMID:[Primary biliary cirrhosis. The clinical experience in 31 patients]. 215 67

Alkaline phosphatase (ALP) was studied by enzyme histochemical methods and by biochemical quantitations in rat livers with chronic bile duct obstruction and experimental cirrhosis. The most evident ALP increase was histochemically found in portal tracts of rats with bile duct obstruction and localized to the walls of proliferating blood vessels. Furthermore, a slight canalicular membrane enzyme increase was histochemically found in both groups, most evident in cirrhosis, whereas the biochemical assay of ALP in serum and liver from both pathological groups showed 3 times higher values compared to controls. The portal tracts did not seem to contribute to the serum increase, since the rise of serum ALP was similar in chronic bile duct obstruction and in experimental cirrhosis without changes of the portal tracts. It is concluded that the increase ALP activity in serum from rats with bile duct obstruction and cirrhosis mainly has a hepatocytic origin.
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PMID:Alkaline phosphatase in cholestatic and cirrhotic rats. A biochemical and histochemical study. 261 54

Biochemical indexes of bone metabolism, bone mineral density, and histomorphometry were evaluated in 14 male patients with noncholestatic cirrhosis due to primary hemochromatosis (six cases) or to chronic alcohol abuse (eight cases), and in 30 male controls of similar age. Alkaline phosphatase in alcoholic patients was significantly higher than in controls (mean +/- SD 50.4 +/- 33.7 vs 33.0 +/- 7.1 U/L, p less than 0.01), as was urinary hydroxyproline in both hemochromatotics and alcoholics (mean +/- SD, 44.3 +/- 8.4 and 40.4 +/- 16.8, respectively, vs 30.1 +/- 4.5 mg/g, p less than 0.001 and p less than 0.005). Bone mineral density was significantly lower in hemochromatotics than in alcoholics and controls (mean +/- SD, 591 +/- 90 vs 765 +/- 87 and 759 +/- 34 mg/cm2, respectively, p less than 0.005 and p less than 0.001). At bone biopsy, trabecular osteoporosis was observed in two hemochromatotics and four alcoholics, and osteomalacia was seen in another alcoholic. Overall densitometric and histomorphometric findings indicate a derangement of trabecular bone in both alcoholic and hemochromatotic cirrhosis, whereas cortical osteoporosis seems limited to hemochromatotic patients.
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PMID:Bone involvement in primary hemochromatosis and alcoholic cirrhosis. 280 72

Eleven acute rejections were found in 9 patients with liver transplantation due to end-stage liver cirrhosis. The rejections were diagnosed with fine-needle aspiration biopsy (FNAB) giving the cellular picture of immunoactivation in the liver graft when compared to a simultaneous sample of peripheral blood. s-Alkaline phosphatase and s-bilirubin increased within 1 week after onset of rejection in 7 and 10 cases, respectively. s-Alanine amino-transferase and b-ammonium were of no value in the diagnosis of acute rejection. A core biopsy was obtained only in a case of severe liver damage, mainly to estimate the need for retransplantation. One year after grafting, 6 out of 7 cirrhotic patients are well, all with normal liver function. Two have died of sepsis. One patient died from pulmonary metastases of occult liver carcinoma 6 months after the transplantation. FNAB seems helpful in detecting early acute rejection and also excluding such an event in the liver graft.
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PMID:Diagnosis of acute rejection in liver transplantation. 304 94

The authors have previously described the presence of gammaglutamyl transferase and alkaline phosphatase in the saliva of healthy individuals and of patients with hepatobiliary and pancreatic diseases. The authors show in this work the values of said enzymes in the blood serum and saliva of 23 cases of liver cirrhosis and 17 patients with liver tumors. Both enzymes increase significantly in the serum of liver tumor patients with respect to the amounts found in liver cirrhosis patients (p less than 0.005). Alkaline phosphatase increased significantly in the saliva of patients with liver cirrhosis (p less than 0.005), where as no differences were found between the two groups of patients with liver cirrhosis (p less than 0.005), where as no differences were found between the two groups of patients for the salivary gamma-glutamyl transferase. The determination of seric alkaline phosphatase and gamma-glutamyl transferase, and of salivary alkaline phosphatase may be useful for the differential diagnosis between liver cirrhosis and liver tumor.
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PMID:[Gamma-glutamyltransferase and alkaline phosphatase in the serum and saliva of patients with hepatic tumors and hepatic cirrhosis]. 615 69

Common bile duct (CBD) strictures associated with chronic pancreatitis may cause significant hepatobiliary disease. Nine patients with chronic alcohol-related pancreatitis and CBD obstruction requiring operative biliary or pancreatobiliary decompression are reported. Alkaline phosphatase was the most specific biochemical indicator of cholestasis. Abnormal CBD anatomy was delinated accurately in 89 per cent of cases with percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP). All strictures were localized to the intrapancreatic portion of the distal CBD. Pancreatic pseudocysts (PPC) were identified in six (67%) cases. All nine patients underwent biliary decompression. Simultaneous PPC drainage or pancreatic duct decompression (Peustow procedure) was performed in eight cases (89%). No perioperative mortality occurred, and all patients reported subjective improvement in symptoms. Biliary tract strictures sufficient to cause clinical or biochemical cholestasis are a poorly recognized complication of chronic pancreatitis. Cholangiography (PTC or ERCP) should be obtained in order to delineate radiographic features, and extent and severity of the biliary stricture because there is no predictable correlation between levels of serum alkaline phosphatase and liver histopathology. A percutaneous biopsy is requisite to document changes in hepatic morphology. In order to prevent potential hepatobiliary complications such as cholangitis and secondary biliary cirrhosis, biliary strictures should be managed surgically even in anicteric and otherwise asymptomatic patients. Simultaneous treatment of associated pancreatic pathology can be performed if necessary with little added morbidity.
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PMID:Common bile duct strictures associated with chronic pancreatitis. 661 52


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