Clinical Manifestations of the Haemostatic Failure in Acute and Chronic Liver Disease

Iron abnormalities in chronic liver disease may be the result of genetic diseases or secondary factors. The present study aimed to identify subjects with HFE-HH in order to describe the frequency of clinical manifestations, identify risk factors for iron elevation, and compare the iron profile of HFE-HH to other genotypes in liver disease patients. A total of 108 individuals with hepatic disease, transferrin saturation (TS) > 45%, and serum ferritin (SF) > 350 ng/mL were tested for HFE mutations. Two groups were characterized: C282Y/C282Y or C282Y/H63D genotypes (n=16) were the HFE hereditary hemochromatosis (HFE-HH) group; and C282Y and H63D single heterozygotes, the H63D/H63D genotype, and wild-type were considered group 2 (n=92). Nonalcoholic liver disease, alcoholism, and chronic hepatitis C were detected more frequently in group 2, whereas arthropathy, hepatocarcinoma, diabetes, and osteoporosis rates were significantly higher in the HFE-HH group. TS > 82%, SF > 2685 ng/mL, and serum iron > 178 μg/dL were the cutoffs for diagnosis of HFE-HH in patients with liver disease. Thus, in non-Caucasian populations with chronic liver disease, HFE-HH diagnosis is more predictable in those with iron levels higher than those proposed in current guidelines for the general population.

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Hepatic Encephalopathy

10.2310/gastro.5498 ◽

2017 ◽

Author(s):

Allison R Schulman ◽

Nikroo Hashemi

Keyword(s):

Differential Diagnosis ◽

Liver Disease ◽

Hepatic Encephalopathy ◽

Chronic Liver Disease ◽

Wide Spectrum ◽

Clinical Manifestations ◽

Minimal Hepatic Encephalopathy ◽

The Body ◽

Chronic Liver ◽

Intrahepatic Portosystemic Shunt

Hepatic encephalopathy (HE) is one of the most debilitating manifestations of acute or chronic liver disease and/or portosystemic shunting. The clinical manifestations of HE span a wide spectrum of neurologic or psychiatric abnormalities, ranging from subclinical neuropsychological disturbances to coma. HE severely affects the lives of patients and their caregivers and results in the use of more health care resources in adults than other manifestations of hepatic dysfunction. To date, there are insufficient clinical studies and standardized definitions, making the diagnosis, classification, and treatment of HE challenging. This review covers the epidemiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, and follow-up of HE. Figures show the numerous processes and mechanisms involved in the pathogenesis of HE and ammonia trafficking and metabolism within the body. Tables list the four factors that dictate categorization and grading of HE, differential diagnosis of HE, summary of testing used for minimal HE and covert HE with associated advantages and/or disadvantages, and precipitating causes of HE in patients with cirrhosis. This review contains 2 highly rendered figures, 4 tables, and 77 references. Key words: chronic liver disease; covert hepatic encephalopathy; hepatic encephalopathy; minimal hepatic encephalopathy; overt hepatic encephalopathy; transjugular intrahepatic portosystemic shunt

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Clinical manifestations of chronic liver disease, clinical teaching project. American gastroenterological association. Mini-Unit A. By C.A. Riely and R.S. Koff. Timonium, MD: Milner-Fenwick, Inc., 1993. $25

Hepatology ◽

10.1002/hep.1840200451 ◽

1994 ◽

Vol 20 (4) ◽

pp. 1102-1102

Author(s):

Albert D. Min

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Clinical Teaching ◽

Clinical Manifestations ◽

Chronic Liver ◽

American Gastroenterological Association

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Chronic Liver Disease in Children

Pediatrics in Review ◽

10.1542/pir.14.11.436 ◽

1993 ◽

Vol 14 (11) ◽

pp. 436-443

Author(s):

Catherine Mews ◽

Frank Sinatra

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Chronic Liver Disease ◽

Clinical Presentation ◽

Wide Spectrum ◽

Laboratory Data ◽

Clinical Manifestations ◽

Chronic Liver ◽

Drug Induced ◽

Laboratory Investigations

Chronic liver disease encompasses a wide spectrum of disorders, including infectious, metabolic, genetic, drug-induced, idiopathic, structural, and autoimmune diseases. The clinical presentation and initial laboratory data in many of these diseases are similar, and a definitive diagnosis often relies on specialized laboratory investigation and histologic examination of liver tissue. The aim of this article is to: 1) Define chronic hepatitis and cirrhosis; 2) Review briefly the clinical presentation, pathophysiology, diagnosis, and management of the more common pediatric causes of chronic liver disease; 3) Review the complications associated with chronic liver disease and discuss their appropriate management; and 4) Review the indications for hepatic transplantation. Chronic Hepatitis Chronic hepatitis is defined as ongoing inflammation within the liver that is capable of progression to cirrhosis, liver failure, and death. The presence of continued hepatic inflammation, as confirmed by clinical manifestations and laboratory studies, for a period of greater than 10 weeks usually excludes a self-limited hepatitis and implies chronicity. However, to fulfill the international criteria for chronic disease strictly, evidence of continued hepatic inflammatory activity needs to be present for a period of at least 6 months. Most pediatricians, however, allow 3 months for an acute liver insult to clear before undertaking specialized laboratory investigations and invasive studies.

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Clinical Manifestations of HBsAg and Anti-HCV Negative Chronic Liver Disease in Nagasaki Prefecture, Japan.

Internal Medicine ◽

10.2169/internalmedicine.35.600 ◽

1996 ◽

Vol 35 (8) ◽

pp. 600-604 ◽

Cited By ~ 1

Author(s):

Katsuhisa OMAGARI ◽

Kohei KOMATSU ◽

Yuji KATO ◽

Keisuke NAKATA ◽

Yukio KUSUMOTO ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Clinical Manifestations ◽

Chronic Liver ◽

Nagasaki Prefecture

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Prediction of hepatocellular carcinoma risk in patients with chronic liver disease from dynamic modular networks

Journal of Translational Medicine ◽

10.1186/s12967-021-02791-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Yinying Chen ◽

Wei Yang ◽

Qilong Chen ◽

Qiong Liu ◽

Jun Liu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Chronic Liver Disease ◽

Complex Disease ◽

Clinical Manifestations ◽

Chronic Liver ◽

Classification Error ◽

Structural Variations ◽

Classification Error Rate ◽

Risk Of Cancer

Abstract Background Discovering potential predictive risks in the super precarcinomatous phase of hepatocellular carcinoma (HCC) without any clinical manifestations is impossible under normal paradigm but critical to control this complex disease. Methods In this study, we utilized a proposed sequential allosteric modules (AMs)-based approach and quantitatively calculated the topological structural variations of these AMs. Results We found the total of 13 oncogenic allosteric modules (OAMs) among chronic hepatitis B (CHB), cirrhosis and HCC network used SimiNEF. We obtained the 11 highly correlated gene pairs involving 15 genes (r > 0.8, P < 0.001) from the 12 OAMs (the out-of-bag (OOB) classification error rate < 0.5) partial consistent with those in independent clinical microarray data, then a three-gene set (cyp1a2-cyp2c19-il6) was optimized to distinguish HCC from non-tumor liver tissues using random forests with an average area under the curve (AUC) of 0.973. Furthermore, we found significant inhibitory effect on the tumor growth of Bel-7402, Hep 3B and Huh7 cell lines in zebrafish treated with the compounds affected those three genes. Conclusions These findings indicated that the sequential AMs-based approach could detect HCC risk in the patients with chronic liver disease and might be applied to any time-dependent risk of cancer.

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