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)

Chronic liver disease is often accompanied by hypoxaemia. We investigated the clinical factors that were related to the arterial oxygen tension (PaO2) in 40 women, all non-smokers with chronic liver disease. They were positive for hepatitis C virus (HCV) antibody and had no evidence of cardiopulmonary disease. Arterial blood was collected from patients at rest (> 15 min) for analysis of blood gases. We determined the correlation between blood gas tension and the clinical variables, i.e. the presence or absence of skin manifestations such as cutaneous spider nevi and palmar erythema, the presence or absence of splenomegaly, vital capacity, forced expiratory volume in one second, V25/body height, serum alanine aminotransferase (AST), serum asparate aminotransferase (ALT), serum cholinesterase, serum gamma-globulin/total protein, excretion of indocyanine green at 15 min (15-min retention rate, ICG level), blood level of ammonia, blood level of endotoxin, plasma level of glucagon and the serum level of type IV collagen-7S. The mean level of PaO2 was 78 +/- 11 (range: 43-95) torr. The mean alveolar-arterial oxygen tension gradient (A-aDO2) was 19 +/- 13 (range: 2-60) torr. Multiple regression analysis used PaO2 and A-aDO2 as objective variables, and the clinical findings as explanatory variables. The explanatory variables that were significantly correlated with blood gas values were ICG level, blood level of endotoxin and presence of skin manifestations. The ICG level showed a high correlation with blood gas values; the ICG level increased, the PaO2 decreased (r = -0.69), while the A-aDO2 showed a high positive correlation (r = +0.78, P < 0.001). Findings suggest that a reduction in hepatic blood flow and hepatocellular function interfere with the inactivation of vasoactive substances such as endotoxin by the liver, leading to the development of skin manifestations, the dilatation of intrapulmonary capillaries and the induction of hypoxaemia.
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PMID:Clinical factors that affect blood gases in non-smoking women with chronic liver disease. 951 26

Two hundred and fifty two blood donors HBsAg positive (mean age = 32.6, 91, 7% male) were searched into a transversal study to determine their clinical, laboratorial and histological characteristics. It was also compared the positiviness and negativiness of the serologic markers HBeAg, anti-Hbe and IgM anti-HBc with the values of serum aminotransferases. Hepatomegaly and splenomegaly were detected in 9.9% (25/252) and in 2.4% (6/252) respectively. In 17.5% (44/251) and 28.3% (71/251) the AST and ALT were respectively, over 50 UI/I. The positive frequencies of the various serologic markers of hepatitis B virus in 120 patients were: anti-HBc total in 89.5% (102/114), HBeAg in 25.7% (28/109) anti-Hbe in 67.3% (66/98), IgM anti-HBc in 40.8% (49/120); anti-Delta in 0.0% (0.66). Thirty one patients were submitted to liver biopsy, due do clinical alteration and/or of the aminotransferases. The hystological findings were: normal liver in 16.1% (5/31), non specific hystological alterations in 22.6% (7/31), persistent chronic hepatitis in 22.6% (7/31), active chronic hepatitis in 6.5% (2/31), cirrhosis in 12.9% (4/31), alcoholic hepatitis in 3.2% (1/31), lobular chronic hepatitis in 3.2% (1/31) and alterations exclusively due to schistosomiasis in 12.9% (4/31). Schistosomiasis elements (granuloma and/or Symmers fibrosis) were also notived in 7 patients. The comparative analysis of positiveness and negativeness of the serologic markers with the aminotransferases ("t" test of Student) showed significative difference of the averages (p < 0.05) only in relation to the simultaneous positeveness and negativeness of the HBeAg and IgM anti-HBc (average of AST = 56.11 and ALT = 78.00 when HBeAg and IgM anti-HBc were positive; average of AST = 24.25 and ALT = 27.00 when HBeAg and IgM anti-HBc were negative). According to this study the conclusion are: 1) The presence of two markers (HBeAg and IgM anti-HBc) and not only one determinant of viral replication in asymptomatic HBsAg carriers can strongly indicate a significant biochemical activity suggestive of hepatocellular lesion. 2) The presence of HBeAg in 25.7% (28/109) clearly shows the high rate of carriers with a potential of infectivity. 3) The results of hepatic histology shows that the majority of our patients had either normal liver or mild histological alterations. It is important to notice that only the cases with elevated aminotransferases were submitted to liver biopsies. The alterations caused by schistosomiasis shows, as is well known, the high prevalence of the parasitism in our surroundings. 4) The clinical aspects of the patients studied did not show significant alterations. Risk factors to get the infection were low. The hematologic and biochemical parameters (except aminotransferases) were either normal or just slightly abnormal. It was not detected a statistically significant difference. 5) The co-infections by delta virus was null.
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PMID:[Clinical, laboratory and liver histology of HBsAg-positive volunteer blood donors in Belo Horizonte, State of Minas Gerais, Brazil]. 1041 47

An 11-year-old boy was diagnosed as having acute lymphoblastic leukemia (ALL, L1) in 1987 and underwent treatment with an ALL high-risk protocol (prednisolone, vincristine (VCR), daunorubicin, 1-asparaginase), which resulted in complete remission. In 1990 he developed chronic hepatitis C and received interferon therapy. In December 1994, ALL recurred, and the patient was treated with VCR. He subsequently developed severe hemolysis (Hb 12.5 g/dl-->6.8 g/dl) with increases of indirect bilirubin, AST, and LDH. Furthermore, symptoms resembling a syndrome of inappropriate secretion of ADH (SIADH) and DIC developed. Upon incubation of the patient's red blood cells with VCR in vitro, extreme deformity of the cells was observed. These findings suggested that splenomegaly, due to liver cirrhosis which had developed rapidly from chronic hepatitis C while the patient was in an immunosuppressed state induced by anticancer drugs, had trapped the deformed red blood cells and resulted in severe hemolysis. The patient died on the 165th day after admission due to liver failure.
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PMID:[Severe hemolysis and SIADH-like symptoms induced by vincristine in an ALL patient with liver cirrhosis]. 1119 45

Two groups of patients were studied. First one included 50 schistosomiasis mansoni patients, 30 with simple infection, 10 with splenomegaly and with ascites. Second group included 111 patients of whom 20 with pure S. mansoni, 27 with pure HCV infection, 54 with mixed infection of schistosomiasis and HCV and 10 with schistosomiasis, HCV and typhoid fever. Serum transaminases and anti-HCV antibodies performed, showed anti-HCV raised levels in 10% of simple schistosomiasis, 60% in splenomegalic patients, 80% in ascites patients, and 7.1% in controls. Liver function tests in first group were within normal range except in those with ascites. In second group, liver function tests was norma in pure schistosomiasis patients, in pure HCV patients serum bilirubin was normal in 22.2%, AST, ALT and alkaline phosphatase were higher. In mixed infection, serum bilirubin was normal in 18.5%, serum transaminases were higher and alkaline phosphatase was normal among 77.7%. Patients with typhoid fever, HCV and schistosomiasis (12.6%) showed significant increase of liver function as compared with each of pure HCV or HCV and schistosomasis. Results were discussed.
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PMID:Studies on patients with Schistosomiasis mansoni, HCV and/or typhoid fever. 1147 57

Autoimmune hepatitis is one of the causes of chronic progressive liver disease in childhood. Here we report 14 cases with clinical findings, therapeutic management and prognosis, in order to define the course of the disease. Diagnosis of autoimmune hepatitis was done with the presence of at least one of these autoantibodies; antinuclear antibody, smooth muscle antibody, liver-kidney microsomal type 1 antibody, and perinuclear antineutrophilic cytoplasmic antibody. Patients were seen every 3 to 6 months. After doing a complete physical examination, biochemical parameters and autoantibodies determined at each visit. Mean age at diagnosis was 10.9 +/- 2.6 years (range, 7-15.5 years) and female to male ratio was 1:3. Thirteen patients had jaundice and all had high levels of ALT, AST and gammaglobulin. Hepatomegaly was found in 71.4% and splenomegaly in 64.3% of the patients. All patients were classified as type 1 autoimmune hepatitis. Liver biopsies revealed severe active hepatitis with mononuclear cell infiltration in portal areas, piecemeal necrosis. Drug therapy consisted of prednisone (2 mg/kg/day) per oral at the beginning, and addition of azathioprine (1.5 mg/kg/day) per oral at the 3rd-6th month with slow tapering of prednisone in 12 children. Both drugs were started together to two patients. Follow-up period was 30.7 +/- 15.6 months (range, 12-72 months). Sustained normalization of ALT could not be obtained with tapering doses of prednisone alone. Decrease in ALT levels did not correlate with disappearance of serum autoantibodies. None of the patients showed decompensation of liver disease. Azathioprine administration is necessary to decrease prednisone dose and to maintain a sustained normal transaminase values.
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PMID:Autoimmune hepatitis. 1156 49

Human fascioliasis is increasing in the Nile Delta particularly in Dakahlia Governorate, where it reached 7.47%. In this study, the tetrad of fascioliasis was established as high eosinophilia (100%), fever (85.6%), painful hepatomegaly (81.93%) and anaemia (100%). The laboratory results showed ESR accelerated in 87%, ALT elevated in 21.5%, AST elevated in 21.9%, S. bilirubin elevated in 16.5%, gamma GT elevated in 80.6%, and SAP elevated in 76.4%. Abdominal ultrasonography showed variable findings, as hepatomegaly, splenomegaly, periportal fibrosis, thickened wall of gall bladder, dilated common bile duct, dilated biliary radicals (partial), dilated common bile duct and biliary radicals (total), Fasciola worms in gall bladder, Fasciola worms in common bile duct, stones in gall bladder, stones in bile duct, cystic lesions in the liver, local lesions in the liver and ascitis. The highest was hepatomegaly in 81.93% of fascioliasis patients and the lowest was biliary dilated radicles (partial) in 0.26%.
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PMID:Clinico-epidemiological study of human fascioliasis in an endemic focus in Dakahlia Governorate, Egypt. 1177 99

A parasitological survey of stool and urine of 2577 from 3281 individuals living in Abis villages, Alexandria was undertaken in 1998 in order to investigate the prevalence of schistosomiasis in this area and risk factors for hepatic morbidity. A random sample of 1082 individuals was interviewed using a questionnaire regarding risk factors for liver morbidity. All interviewed adults (total: 728) were clinically examined for evidence of organomegally (hepatomegally and/or splenomegally). Individuals with clinically detected organomegally were referred for detailed investigations (total: 65). The criteria for severe hepatic morbidity were AST/ALT ratio higher than 1, prothrombin activity < 70%, and evidence of portal hypertension. The results revealed that prevalence of S. mansoni accounted for 20.5%, with low intensity of infection and increased with age to reach a maximum of 40-46.3% at 15-30 years of age. Intensity of infection followed the same pattern. All tested urine samples were negative for S. haemato-bium. The prevalence of clinically detected organomegally was 10.3% among adults (75/728). Significant risk factors for developing organomegally were age > or = 35 years (2.2 folds), farming occupation (1.7 fold), history of parenteral anti-schisto-somal treatment (PAT) with or without tablets (2.03 folds), and heavy water canal exposure (2.85 folds). Detailed morbidity study on 65 individuals with clinically detected organomegally showed that 52.3% reported heavy score for water canal exposure, 33.8% were positive for HCV antibodies, and 7.7% for HBV antibodies. Procollagen level was higher than 5.5 microg/l in 26.2% of this group. The results of Doppler ultrasonography showed that 33.3% recorded a portal vein diameter > or = 13 mm, 26.2% periportal fibrosis more than grade 2 (> 5 mm), 19% hepatofugal direction of portal blood flow, 30.2% collaterals, 28.6% splenomegaly, and 17.5% hepatofugal direction of splenic blood flow. The burden of severe hepatic morbidity was alarming among this group: 33.8% with portal hypertension, 24.6% with prothrombin activity < 70, and 13.8% with AST/ALT ratio > 1. There was a 4.44 and 3.7 fold increased risk for portal hypertension with elevated levels of PIIIP and positive serologic tests for HCV and/or HBV infections, respectively. Similarly, a 4.58 and 18.35 fold increased risk for AST/ALT more than one was attributed to these two factors, respectively. Elevated procollagen level was significantly associated with viral infection (HCV and/or HbsAG). Seropositivity for HCV antibodies was found strikingly high in adults above 35 years (positive HCV antibodies in 45.9% of individuals). This indicates a high level of endemicity in the study area which is also endemic for S. mansoni. So, a heavy burden of severe liver disease exist in rural Alexandria is attributed to combined infection of S. mansoni and hepatitis viruses. This emphasizes the need for intervenetion strategies targeting these two main liver offenders.
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PMID:Morbidity of schistosomiasis mansoni in rural Alexandria, Egypt. 1470 47

The aim of the study was to identify moderate liver impairment in a group of hyperbilirubinaemic adolescents. Using gas chromatography we assessed both total bile acid and primary bile acid levels in 50 adolescents with juvenile hyperbilirubinaemia. At the same time we performed hepatologic examinations and subsequent follow-up assessment of these patients for a period of at least 2 years. As a control group we examined 30 adolescents without any impairment of both the liver and gastrointestinal tract, and 18 patients with low grade (moderately) active chronic hepatitis. In both groups we assessed total and primary bile acids levels as well as conventional liver tests (bilirubin, ALT, AST). On the basis of the clinical course and laboratory findings we divided our patients with juvenile hyperbilirubinaemia into two groups: a group of individuals with Gilbert's syndrome (30 patients) and a group of individuals with probable moderate liver impairment (20 patients). The latter group consisted of the adolescents who exhibited bilirubinaemia over 90 micromol/l and/or exhibited hepatomegaly or splenomegaly proved by the ultrasound examination and/or exhibited intermittent elevation of the liver aminotransferases serum levels. In the group of individuals with moderate liver impairment serum total bile acid levels were significantly elevated in 26% of patients, and the serum cholic acid level was significantly elevated in 25% of patients. These two parameters mutually correlated at a high level of significance. Juvenile hyperbilirubinaemia is one of the common conditions of adolescent age. Its etiology is diverse; it includes both benign conditions like Gilbert's syndrome and post-hepatitic and toxic conditions that require a long-term regimen and follow-up examinations. The number of people suffering from juvenile hyperbilirubinaemia has been growing in the population. Currently 4-6% of the adolescent population suffers from this disease. This growing number is probably caused by external factors of our environment (infection, toxic effects). The determination of mild liver disease in hyperbilirubinaemic patients and the provision of an adequate regimen of exercise and adequate nutritional measures is of great importance for the health of the adolescent population.
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PMID:Importance of serum bile acids determination in adolescents with juvenile hyperbilirubinaemia. 1524 29

A 54-year-old man with chronic idiopathic myelofibrosis (CIMF) underwent RIST. His clinical course had been uneventful until day 60, when splenomegaly reappeared. Hepatic dysfunction developed on day 75. Recipient-type hematopoiesis increased to 51% on day 90. After rapid tapering of cyclosporin, serum levels of AST and ALP normalized in parallel with recovery of complete chimerism on day 134. Yet, jaundice progressed. He died of liver failure on day 176. Postmortem examination revealed neither GVHD nor VOD. Graft rejection following RIST for CIMF may lead to fatal hepatic damage through extramedullary hematopoiesis in the liver or cytokine-mediated immune dysregulations.
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PMID:Fatal hepatic failure associated with graft rejection following reduced-intensity stem-cell transplantation for chronic idiopathic myelofibrosis (CIMF). 1562 70

A 16-year-old Caucasian girl of Albanian origin was admitted to the hospital complaining of intermittent fever (38 degrees C) for a week, nausea, vomiting, and abnormal laboratory findings (elevated serum aminotransferases levels AST/ALT 77/40 U/l and erythrocyte sedimentation rate 80 mm/first hour, as well as leukopenia 2.5 x 10(3)/mm3), which were found in a blood examination. Physical examination revealed slight hepatomegaly and splenomegaly, as well as cervical and axillary lymphadenopathy. A diagnostic open lymph node biopsy was performed and Kikuchi-Fujimoto disease (KFD) was established based on the characteristic histological pattern. Other abnormal laboratory findings were C-reactive protein 6.8 mg/dl and serum lactate dehydrogenase 900 U/l. Her history included a diarrhoea syndrome 2 months before the present admission, during the summer holidays, for which she was treated with metronidazole. At that time, characteristic cysts of giardia lamblia intestinalis were observed in the stools. Herein, we present this case hypothesising that the protozoal infection caused by the giardia lamblia intestinalis was probably triggering an immune response leading to KFD. The patient's age in combination with this firstly reported protozoal pathogen, as a triggering agent leading to KFD, consist a very interesting originality. Additionally, some review data is also given.
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PMID:Giardia lamblia intestinalis: a new pathogen with possible link to Kikuchi-Fujimoto disease. An additional element in the disease jigsaw. 1564 21


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