The isoenzymes of lactic dehydrogenase. II. Pulmonary embolism, liver disease, the postoperative state, and other medical conditions

Background. There are multiple aetiologies for dyspnea in patients with liver disease, including pneumonia, pulmonary embolism, hepatic hydrothorax, portopulmonary syndrome, and hepatopulmonary syndrome. The aim of this paper is to emphasize the importance of early diagnosis and management of hepatopulmonary syndrome. Case Presentation. We report a case of a 65-year-old male who was known to have chronic hepatitis C presented with one-year history of shortness of breath and cyanosis. The initial impression of pulmonary embolism was excluded by comprehensive diagnostic investigations. The correlation between the clinical picture and investigations raised the possibility of hepatopulmonary syndrome which was confirmed by contrast-enhanced transthoracic echocardiography. Conclusions. High suspicion is required to diagnose hepatopulmonary syndrome in patients with liver disease and hypoxemia. Screening for this complication is appropriate in liver transplant candidates, and diagnosed patients should be evaluated extensively for liver transplant.

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Serum Lactic Dehydrogenase Activity and Radioactive Lung Scanning in the Diagnosis of Pulmonary Embolism

Annals of Internal Medicine ◽

10.7326/0003-4819-65-6-1247 ◽

1966 ◽

Vol 65 (6) ◽

pp. 1247 ◽

Cited By ~ 9

Author(s):

ELIAS AMADOR

Keyword(s):

Pulmonary Embolism ◽

Dehydrogenase Activity ◽

Lactic Dehydrogenase ◽

Serum Lactic Dehydrogenase ◽

Lung Scanning

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Medical conditions increasing the risk of chronic thromboembolic pulmonary hypertension

Thrombosis and Haemostasis ◽

10.1160/th04-10-0657 ◽

2005 ◽

Vol 93 (03) ◽

pp. 512-516 ◽

Cited By ~ 144

Author(s):

Diana Bonderman ◽

Johannes Jakowitsch ◽

Christopher Adlbrecht ◽

Michael Schemper ◽

Paul Kyrle ◽

...

Keyword(s):

Pulmonary Embolism ◽

Pulmonary Hypertension ◽

Odds Ratio ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Medical Conditions ◽

Symptomatic Pulmonary Embolism ◽

Increased Risk ◽

Lung Scan ◽

Thromboembolic Pulmonary Hypertension ◽

Inflammatory Bowel

SummaryChronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organized thromboemboli that obstruct the pulmonary vascular bed. Although CTEPH is a serious complication of acute symptomatic pulmonary embolism in 4% of cases, signs, symptoms and classical risk factors for venous thromboembolism are lacking. The aim of the present study was to identify medical conditions conferring an increased risk of CTEPH. We performed a case-control-study comparing 109 consecutive CTEPH patients to 187 patients with acute pulmonary embolism that was confirmed by a high probability lung scan. Splenectomy (odds ratio=13, 95% CI 2.7–127), ventriculoatrial (VA-) shunt for the treatment of hydrocephalus (odds ratio=13, 95% CI 2.5–129) and chronic inflammatory disorders, such as osteomyelitis and inflammatory bowel disease (IBD, odds ratio=67, 95% CI 7.9–8832) were associated with an increased risk of CTEPH.

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Massive Pulmonary Embolism In A Postpartum Case of Caesarean Section A Case Report

JMS SKIMS ◽

10.33883/jms.v19i2.296 ◽

2016 ◽

Vol 19 (2) ◽

pp. 90-94

Author(s):

Javid Ahmad Wani ◽

Irfan Ahmed ◽

Showkat Ali Mufti

Keyword(s):

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Caesarean Section ◽

Supportive Care ◽

Pulmonary Thromboembolism ◽

Post Partum ◽

Standard Of Care ◽

Massive Pulmonary Embolism ◽

Sudden Onset ◽

Postoperative State

Introduction : The overall incidence of acute pulmonary embolism is 0.004% per year1; among post-partum women, the incidence of venous thromboembolism is approximately 3 to 7 every 10,000 deliveries, which is 15 to 35 times that of females of the same age who are not pregnant2. Venous thromboembolism contributes to 20% of pregnancy-related mortalities. The highest risk is in the puerperium3. Thrombolysis is standard of care in pulmonary thromboembolism with shock and right ventricular hypokinesia4-7, however, immediate postoperative state compels conventional treatment. Patients do well with anticoagulation and proper supportive treatment as illustrated in this case.Case report : We report a case of a 34-year old female who developed sudden onset breathlessness while walking on the 2nd post-operative day of an uneventful caesarean section. She was dyspneic, cyanosed and in hypotension. CXR was normal, ECG showed S1Q3T3 pattern, and d-dimer was raised. CTPArevealed features of pulmonary embolism. Thrombolysis was contemplated but was abandoned in view of recent surgery. She received anticoagulation with Heparin (and later warfarin) and supportive care including intravenous fluids, oxygen and Dopamine and Doubutamine. She improved and was discharged after 10 days on warfarin anticoagulation.Conclusion: Breathlessness in a patient in the post-operative period or pregnancy should lead to the possibility of pulmonary thromboembolism. PTE with hypotension or RV hypokinesia has a high mortality, merits thrombolysis plus anticoagulation. But patients with contraindication to thrombolysis should receive anticoagulation and standard supportive care. JMS 2016; 19(2):90-94.

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Evaluating the Cause of Death in Obese Individuals: A Ten-Year Medical Autopsy Study

Journal of Obesity ◽

10.1155/2015/695374 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Jad Saab ◽

Steven P. Salvatore

Keyword(s):

Pulmonary Embolism ◽

Heart Disease ◽

Liver Disease ◽

Cause Of Death ◽

Public Health Problem ◽

Autopsy Study ◽

Organ Systems ◽

Obese Population ◽

Disease Entities ◽

Nonobese Patients

Background. Obesity is a growing public health problem associated with increased morbidity and rate of death. Postmortem examination is imperative to determine the cause of death, to detect clinically unsuspected disease entities, and consequently to determine the actual impact of obesity on patient mortality.Methods. A total of 849 adult autopsies were retrospectively reviewed. Obese (BMI ≥ 30 kg/m2) and nonobese patients were separately studied. The primary cause of death in each group was categorized into malignancy, infection, stroke, ischemic and nonischemic heart disease, pulmonary embolism, hemorrhage, and primary nonneoplastic diseases of different organ systems.Results. Of 849 autopsies, 32.3% were obese. The leading causes of death in the obese population were malignancy (31.4%), infection (25.9%), ischemic heart disease (12.8%), and pulmonary embolism (6.2%). Obese individuals were statistically more likely to die from pulmonary embolism and liver disease and less likely to die from neurologic diseases and nonischemic heart disease.Conclusion. Autopsies on obese individuals constitute a third of all adult medical autopsies in our center. Increased death rates in the obese due to pulmonary embolism and liver disease should receive special clinical attention. Autopsy findings in the obese population should contribute to overall premortem disease detection, prevention, and management.

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Anticoagulant in Patients with Pulmonary Embolism and Fatty Liver: A Case Report

10.21203/rs.3.rs-80036/v1 ◽

2020 ◽

Author(s):

Sha-Sha Li ◽

Wei-Xian Lin ◽

Kun-Yu Huang ◽

Sheng-Yang Chen ◽

Juan Chen ◽

...

Keyword(s):

Pulmonary Embolism ◽

Liver Disease ◽

Fatty Liver ◽

Sequential Therapy ◽

Low Molecular Weight ◽

Test Results ◽

Efficacy And Safety ◽

Routine Test ◽

Bleeding Events ◽

Blood Routine Test

Abstract AIMS: Patients with liver disease are more prone to thrombosis and bleeding events than healthy people. The decision to use anticoagulation in patients with pulmonary embolism and liver disease requires a cautious evaluation of the risks of bleeding and the beneﬁts of anticoagulation. In order to make a recommendation for patient with fatty liver that developed pulmonary embolism, we reported this case. METHODS: In this paper, we reported a case of a patient with fatty liver that developed pulmonary embolism. The low molecular weight heparin sodium injection and different anticoagulants were evaluated for this patient.RESULTS: After evaluating the efficacy and safety of different anticoagulants in patients with pulmonary embolism and liver dysfunction, rivaroxaban is more suitable for this patient to be treated by sequential therapy. After three weeks of treatment with rivaroxaban, the patient’s blood routine test results were normal, and no side effect was found. CONCLUSIONS: For patients with pulmonary embolism and fatty liver, maybe NOAC is more suitable.

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Pre-existing medical conditions associated with Vibrio vulnificus septicaemia

Epidemiology and Infection ◽

10.1017/s0950268813001593 ◽

2013 ◽

Vol 142 (4) ◽

pp. 878-881 ◽

Cited By ~ 23

Author(s):

M. P. MENON ◽

P. A. YU ◽

M. IWAMOTO ◽

J. PAINTER

Keyword(s):

Liver Disease ◽

Vibrio Vulnificus ◽

Severe Disease ◽

Relative Importance ◽

Medical Conditions ◽

Life Threatening Illness ◽

Serious Infection ◽

Contaminated Food ◽

Life Threatening

SUMMARYVibrio vulnificus (Vv) can result in severe disease. Although pre-existing liver disease is a recognized risk factor for serious infection, the relative importance of other comorbidities has not been fully assessed. We analysed reports of Vv infections submitted to CDC from January 1988 to September 2006 in order to assess the role of pre-existing conditions contributing to severe outcomes. A total of 1212 patients with Vv infection were reported. Only patients with liver disease [adjusted odds ratio (aOR) 5·1)] were more likely to become septic when exposure was due to contaminated food. Patients with liver disease (aOR 4·1), a haematological disease (aOR 3·2), or malignancy (aOR 3·2) were more likely to become septic when infection was acquired via a non-foodborne exposure. As such, patients with these pre-existing medical conditions should be advised of the risk of life-threatening illness after eating undercooked contaminated seafood or exposing broken skin to warm seawater.

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Unique Case of Alpha 1-Antitrypsin Deficiency Causing Decreased Protein-C and S Activity Leading to DVT and Pulmonary Embolism

Edelweiss Applied Science and Technology ◽

10.33805/2576-8484.144 ◽

2018 ◽

pp. 232-233

Author(s):

Manoj Singla

Keyword(s):

United States ◽

Pulmonary Embolism ◽

Liver Disease ◽

Protein C ◽

The United States ◽

Unique Case ◽

Severe Deficiency ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin

Although Alpha-1 Antitrypsin Deficiency (AATD) is generally considered to be rare, estimates that 80,000 to 100,000 individuals in the United States have severe deficiency of AAT suggest that the disease is under-recognized. The prevalence of AAT varies considerably from one country to another; however, it is estimated that more than 3 million people worldwide have allele combinations associated with severe deficiency of AAT The pathogenesis of the liver disease is quite different and is called a "toxic gain of function." The liver disease results from the accumulation within the hepatocyte of unsecreted variant AAT protein. Only those genotypes associated with pathologic polymerization of AAT within the endoplasmic reticulum of hepatocytes (eg, PI*ZZ type AATD) produce disease. Most patients with liver disease due to AATD are homozygous for the Z allele (ie, PI*ZZ); liver disease does not occur in null homozygotes who have severe deficiency of AAT, but no intra-hepatocytic accumulation.

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