Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Portal hypertension and variceal hemorrhage may be found in the renal transplant patient with chronic liver disease. The development of portal hypertension was found to occur after long-term graft survival without significant rejection. The development of positive cytomegalic virus and negative hepatitis-associated antigen appeared to be common. Splenomegaly and prominent venous collateral were the most frequent physical findings, while ascites and hepatomegaly were less frequent. Portasystemic decompression can be performed successfully, however, the mortality and morbidity appear to be higher for this group than for other cirrhotic patients with comparable hepatic reserve.
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PMID:Portal hypertension following renal transplantation. 35 15

The study aimed at the confrontation of the results from the investigation of the immunoglobulines G, M, and A (IgG, IgM and IgA), the test for spontaneous rosette formation and the determination of Australian antigen (HBsAg) in 110 patients with chronic liver disease (liver steatosis, chronic persisting hepatitis, chronic aggressive hepatitis and liver cirrhosis). The diagnosis was morphologically confirmed and some of the patients were repeatedly examined. No significant interrelations among the three main classes of immunoglobulines were established in the majority of the groups of chronic liver diseases, speaking for the individual information, carried by the separate immunoglobuline classes. Correlation was established between IgG and IgM in chronic active hepatitis. The mean values of IgG and IgM are considerably higher in cases with splenomegaly. IgG is more often increased when the patients are carriers of HBsAg, being in agreement with the contemporary concepts about the differences in immune pathological mechanism in chronic liver diseases, with and without HB5-antigenemia.
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PMID:[Immunological indices in chronic liver diseases]. 89 22

Splenomegaly is an unusual finding in Crohn's disease and can be persistent or transient. In three febrile patients it was so prominent that the diagnosis of lymphoma was considered. In two additional patients the splenomegaly was an incidental finding. It is probably a nonspecific response to the basic disease in most cases, or occasionally a response to the chronic liver disease that can occur in inflammatory bowel disease.
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PMID:Variability of splenomegaly in Crohn's disease. 90 Jan 15

The prevalence of hepatitis C infection and possible predisposing factors was assessed in a renal unit. Of 343 patients at our renal dialysis centre, 37 (10.8%) were anti-HCV positive by a 1st-generation assay (ELISA, Ortho/Chiron) and confirmed positive in 35 (10.2%) with a 2nd-generation test (UBI, New York). Anti-HCV positivity was significantly associated with: duration of renal replacement therapy (P < 0.0001); quantity of blood transfused (P < 0.002); duration of hospital haemodialysis (P = 0.0001); duration with a functional renal transplant (P = 0.039); and aspartate aminotransferase (P < 0.0001). Logistic regression determined the following variables to be independent risk factors: duration of renal replacement therapy with a relative risk of 34.3 for 5-9 years and 87.4 when the duration was in excess of 10 years; renal transplant for less than 1 year (relative risk of 5.0); transfusion in excess of 50 units of blood (relative risk of 11.6). Clinical assessment of anti-HCV-positive patients revealed peripheral signs of chronic liver disease in 40%, hepatomegaly in 34%, and splenomegaly in 9%. This prevalence of hepatitis C infection is similar to other European and North American centres, but contrasts with low prevalence rates reported from dialysis populations in the UK. It adds further support for routine screening of blood and possibly organ donors and implementation of further infection control measures in dialysis centres.
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PMID:Prevalence of antibodies to hepatitis C in dialysis patients and transplant recipients with possible routes of transmission. 827 37

Between July 1986 and April 1989, 334 hospitalized adult Ethiopian patients with chronic liver disease were studied according to a protocol to define their clinical features and to identify risk factors with the aim of preventive intervention. Of these, 14 had chronic hepatitis, 208 cirrhosis and 112 hepatocellular carcinoma (HCC). Both clinical and histological diagnostic criteria were employed. A detailed questionnaire was used to document demographic and clinical data. A common clinical presentation among patients with chronic hepatitis was darkening of the face and hands with or without hypertrichosis of the face and blisters over the dorsi of the hands. This overt or latent form of porphyrea cutanea tarda (PCT) responds to chloroquine. Patients with cirrhosis of the liver commonly present for the first time with ascites, splenomegaly, haematemesis and/or melena from oesophageal varices, and mental changes due to hepatic encephalopathy. Overt or latent forms of PCT are also common features. Peculiar to these cirrhotics is the rarity of spider naevi, gynaecomastia, testicular atrophy, Dupuytren's contracture, parotid gland enlargement and clubbing of the fingers. Exhaustion, loss of appetite, rapid loss of weight, right upper quadrant and/or epigastric pain (all often of less than 6 months' duration, a big, hard, tender and grossly nodular liver with bruit, signs of portal hypertension, and/or hepatic encephalopathy, in a young male with a rapid down hill course characterize the Ethiopian patient with HCC. Serum anti-nuclear factor, anti-mitochondrial anti-bodies and anti-smooth muscle anti-bodies were absent in those with chronic hepatitis and were uncommon in the cirrhotics and HCC cases. One or more hepatitis B virus markers were found in 86% of chronic hepatitis, 88% cirrhosis and 78% HCC and the HBsAg carrier state was found in 36%, 29% and 23%, respectively. Among the HBsAg carriers, HBeAg positivity was less common than anti-HBe but anti-HDV was significantly higher than in the healthy general population. Alphafetoprotein (AFP) levels greater than 500 mg/ml were present in 16 (8%) cirrhotics and 58 (52%) patients with HCC. Histologically, 3 of the chronic hepatitis patients had progressed to cirrhosis, 8 of the cirrhotic patients had chronic active hepatitis and 85% of HCC cases occurred in a background of macronodular cirrhosis. Three cirrhotics developed HCC during follow-up.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Chronic liver disease in Ethiopia: a clinical study with emphasis on identifying common causes. 131

Fifty-five patients with cytomegalovirus (CMV)-associated neonatal hepatitis (NH) were followed for 12 to 90 months. Six patients (10.9%) died from either a fulminant course or a chronic liver disease. Among the remaining 49 patients, whose liver function was completely recovered, there were eight with retardation of developmental or growth status, and two with hearing impairment. Overall, 20.4% of the survivors suffered from a long-term impact. The unfavorable outcome was related to several clinical and pathological parameters. These included persistence of clay-colored stool, presence of splenomegaly, ascites or anemia, high peak total and direct bilirubin, low nadir albumin levels, diffuse giant cell transformation and cirrhosis of the liver. The seropositivity of CMV infection did not significantly correlate with the outcome.
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PMID:Cytomegalovirus-associated neonatal hepatitis. 133 53

We report the case of a patient with renal insufficiency who was admitted for the evaluation of splenomegaly. He had received a kidney allograft 6 1/2 years ago. Treatment with azathioprine and prednisolone for immunosuppression had been discontinued 1 year before admission. The underlying cause of the splenomegaly appeared to be an idiopathic portal hypertension. Until now, this disease has been described in only 13 kidney transplant patients receiving long-term immunosuppressive therapy with azathioprine. For the first time we demonstrate that azathioprine can cause this chronic liver disease even if the drug has been withdrawn some time before. Therefore, the indication for azathioprine must be considered very carefully.
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PMID:Idiopathic portal hypertension in a renal transplant patient after long-term azathioprine therapy. 160 Mar 41

In this study, performed to assess the effect of auxiliary heterotopic liver transplantation on portal hypertension and hypersplenism, eight patients with chronic liver disease who underwent the procedure and had functioning grafts for at least 6 months were analyzed. The transplantation resulted in (a) normalization of platelet and leukocyte counts, (b) reduction of splenomegaly by 20% +/- 3% (P less than 0.02), (c) disappearance of ascites, and (d) diminution of esophageal varices in all patients. Intraoperatively, the mean portacaval pressure gradient decreased with 54% +/- 7% after recirculation of the graft (P less than 0.05). In conclusion, a functioning auxiliary heterotopic liver graft decompresses portal hypertension and reverses hypersplenism.
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PMID:Does auxiliary heterotopic liver transplantation reverse hypersplenism and portal hypertension? 835 66

An attempt was made to estimate noninvasively portal pressure (PP) in patients with chronic liver disease, using the theory of quantification, a kind of multivariate analysis. Forty-one patients with liver cirrhosis and 22 patients with chronic hepatitis in whom hepatic venous catheterization had been performed were studied. Seventeen parameters (age, sex, mean blood pressure, red blood cell count, platelet count, prothrombin time, lactate dehydrogenase, alkaline phosphatase, total bilirubin, albumin, gamma-globulin, indocyanine green retention at 15 min, blood urea nitrogen, hepatomegaly, splenomegaly, ascites and edema) were selected for the estimation of PP. The estimated PP correlated significantly with the data obtained by hepatic venous catheterization with a high correlation coefficient of 0.835 (p less than 0.01). An investigation using the theory of quantification was also undertaken to determine which of the 17 parameters selected above was most useful in estimating PP. Among the 17 parameters indocyanine green retention at 15 min, red blood cell count, prothrombin time, hepatomegaly and splenomegaly seemed to contribute significantly to the estimation of PP. When the formula was applied to 31 successive patients with chronic liver disease (external samples), the correlation between the estimated and measured PP was 0.455 (p less than 0.01). These results indicate that the formula is clinically useful in estimating PP in patients with chronic liver disease.
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PMID:[Estimation of portal pressure using the theory of quantification]. 201 41

We examined retrospectively 1,003 patients with chronic liver disease who underwent laparoscopy and liver biopsy. The diagnosis of cirrhosis was made in 411 patients and excluded in 570; in the remaining 22 patients, the laparoscopic/histologic diagnosis was inconclusive. When the two techniques were considered separately, a final diagnosis of cirrhosis was possible in 78.4% by laparoscopy and in 78.8% by biopsy of the total of 411 cases, whereas, doing both procedures improved the diagnostic yield to 97.7% by decreasing the percentage of false negatives for each technique. Laparoscopy can also provide important additional information by detecting intrabdominal signs of portal hypertension and so improve the macroscopic diagnosis of cirrhosis. In particular, splenomegaly seen at laparoscopy seems to be an important feature for the diagnosis and evaluation of chronic liver disease.
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PMID:Laparoscopy and liver biopsy: further evidence that the two procedures improve the diagnosis of liver cirrhosis. A retrospective study of 1,003 consecutive examinations. 213 81


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