scholarly journals Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

2020 ◽  
Vol 15 (8) ◽  
pp. 1399-1407 ◽  
Author(s):  
Marco Vincenzo Lenti ◽  
◽  
Federica Borrelli de Andreis ◽  
Ivan Pellegrino ◽  
Catherine Klersy ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Intensive Care ◽  
Liver Function ◽  
Laboratory Data ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests ◽  
Altered Liver ◽  
The Impact ◽  
Internal Medicine Unit

Abstract Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

scholarly journals New insights into vitamin D regulation: is there a role for alkaline phosphatase?

2021 ◽  
Author(s):  
G. Bellastella ◽  
L. Scappaticcio ◽  
M. Longo ◽  
R. Carotenuto ◽  
C. Carbone ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Liver Function ◽  
Significant Negative Correlation ◽  
Liver Function Tests ◽  
Bone Alkaline Phosphatase ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests ◽  
Group 2 ◽  
Group 1

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r =  − 0.03; p = 0.8), ALT (r =  − 0.02; p = 0.91), GGT (r =  − 0.08; p = 0.68), direct bilirubin (r =  − 0.02; p = 0.89), indirect bilirubin (r =  − 0.24; p = 0.21), and total bilirubin (r =  − 0.24; p = 0.21) but one between 25OHD and ALP (r =  − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r =  − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

scholarly journals The Role of CEA and Liver Function Tests in the Detection of Hepatic Metastases From Colo-Rectal Cancer

HPB Surgery ◽  
1990 ◽  
Vol 3 (1) ◽  
pp. 29-37 ◽  
Author(s):  
G. Bonfanti ◽  
Luigia Bombelli ◽  
F. Bozzetti ◽  
R. Doci ◽  
L. Gennari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Liver Function ◽  
Liver Metastases ◽  
Predictive Value ◽  
Imaging Technique ◽  
Hepatic Metastases ◽  
Liver Function Tests ◽  
Good Prediction ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests

Carcinoembryonic antigen and some liver function tests (alkaline phosphatase, gamma-glutamyl-transpeptidase, lactic dehydrogenase and cholinesterase) were evaluated in patients with primary colorectal cancer in order to define their role in the pre-operative detection of liver metastases.The records of 278 consecutive patients admitted to the Istituto Nazionale Tumori of Milan between January 1982 and December 1983 who were suffering from primary invasive colo-rectal cancer and who underwent laparotomy were retrospectively analyzed.At laparotomy, liver metastases were found in 38 pts (13.7%). Considering single tests, CEA was the most sensitive (71%); no single test was found to be reliably predictive, when the result was abnormal. On the contrary, the normal value of each test was associated with a good prediction.When we considered all the five tests together in the single patient their predictive value, when abnormal, proved to be quite good only if four or five results were abnormal. On the other hand, liver metastases in the presence of all normal tests were found only in two patients, so giving a negative predictive value of about 97%.So we conclude that, in the lack of an infallable imaging technique for liver evaluation, in the presence of all normal tests any other investigation on the liver could be avoided. However, when liver tests are pathologic, some other imaging technique should be performed in order to supply the surgeon with information about the extent and the spread of the metastases.

scholarly journals Pancytopenia and Peripheral Neuropathy in a Woman with Altered Liver Function Tests

2019 ◽  
Vol 65 (8) ◽  
pp. 956-960 ◽  
Author(s):  
Eduardo Martínez-Morillo ◽  
María García-García ◽  
Clara Barneo-Caragol ◽  
Alejandra Fernández Fernández ◽  
Francisco V Álvarez
Keyword(s):  
Peripheral Neuropathy ◽  
Liver Function ◽  
Liver Function Tests ◽  
Function Tests ◽  
Altered Liver

Prognostic Value of Altered Liver Function Tests in Critically Ill Patients

2015 ◽  
Vol 5 ◽  
pp. S74
Author(s):  
Krishna Tejaswy ◽  
Harshavardhan Rao ◽  
Rajesh Gopalakrishna ◽  
Ismail Siyad ◽  
Shine Sadasivan ◽  
...  
Keyword(s):  
Liver Function ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prognostic Value ◽  
Liver Function Tests ◽  
Function Tests ◽  
Altered Liver

scholarly journals Diagnosis experiences from 50 hepatitis B patients in Chongqing, China: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangxi Zhou ◽  
Fan Zhang ◽  
Yongping Ao ◽  
Chunli Lu ◽  
Tingting Li ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Function ◽  
Healthy Lifestyle ◽  
Signs And Symptoms ◽  
Liver Function Tests ◽  
Irreversible Damage ◽  
Function Tests ◽  
Professional Mental Health ◽  
The Impact

Abstract Background The aim of this study was to provide recommendations for reducing the impact of hepatitis B infection on patients with chronic hepatitis B by describing their experiences during the diagnosis process. Methods We conducted face-to-face interviews with 50 hepatitis B patients recruited by convenient sampling from an infectious diseases department of a teaching hospital in Chongqing, China from July to August 2019. Thematic analysis framework included interviewees’ social demographic characteristics, diagnosis approach, signs and symptoms before diagnosis, feelings after diagnosis, and doctor’s instructions. Results Most patients first detected hepatitis B through various types of physical examinations when the patients were asymptomatic or had only mild symptoms. Most patients were shocked, scared, or overwhelmed when they were diagnosed with hepatitis B. They were able to remember the doctor’s instructions about maintaining a healthy lifestyle, but not impressed by the doctor’s advice about regular follow-up liver function tests. The lack of regular follow-up has caused irreversible damage to some patients. Conclusions Most patients are passively diagnosed with hepatitis B due to their lack of awareness on active hepatitis B prevention. Patients need professional mental health care to overcome the negative emotions that following the diagnosis. Physicians’ instruction should emphasize the importance of regular follow-up liver function tests in addition to a healthy lifestyle.

scholarly journals Aminotransferase Levels in Relation to Short-Term use of Acetaminophen Four Grams Daily in Postoperative Cardiothoracic Patients in the Intensive Care Unit

2011 ◽  
Vol 39 (6) ◽  
pp. 1056-1063 ◽  
Author(s):  
S. J. G. M. Ahlers ◽  
L. van Gulik ◽  
E. P. A. van Dongen ◽  
P. Bruins ◽  
D. Tibboel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Liver Function ◽  
Alanine Aminotransferase ◽  
Liver Function Tests ◽  
Analgesic Agent ◽  
Short Term ◽  
Function Tests ◽  
Volunteer Study

A volunteer study suggested that taking paracetamol 4 g daily could result in elevated alanine aminotransferase plasma levels in a substantial proportion of healthy volunteers. The safety of this dose of paracetamol for acute postoperative pain remains controversial. This study aimed to examine the incidence of alanine aminotransferase elevations after short-term use of paracetamol 4 g daily, as part of the standard pain management protocol, for 93 consecutive patients after cardiothoracic surgery. Alanine aminotransferase levels and other liver function tests were measured preoperatively as baseline and once daily after surgery during the intensive care unit stay. Preoperative alanine aminotransferase levels of more than one time the upper limit of normal (ULN, >40 U/l) was observed in 11% (n=10) of the patients but none of these baseline alanine aminotransferase levels exceeded three times the ULN (>3×ULN). The average daily dose of paracetamol administered was 50 mg/kg (SD=16) after surgery. Postoperative alanine aminotransferase levels of >1×ULN was observed in 17% (n=16), and 4% (n=4) exceeded >3×ULN. The other liver function tests of the latter four patients, including aspartate aminotransferase (range 173 to 5590 U/l), γ-glutamyltransferase (range 56 to 103 U/l), lactate dehydrogenase (range 376 to 3518 U/l) and the International Normalised Ratio (range 2.0 to 6.6), were all abnormal. These four patients all had right ventricular failure or cardiogenic shock during the postoperative period which could explain the significant rises in alanine aminotransferase after surgery. In conclusion, the incidence of significant alanine aminotransferase elevations after using daily paracetamol as an analgesic agent for cardiac surgery, at a dose of 4 g per day, was low and mostly due to complications after surgery. Our results, albeit still very limited, provided some reassurance about the safety of paracetamol 4 g daily, as a supplementary analgesic agent for adult patients undergoing cardiac surgery.

Adverse reactions to perhexiline (pexid)

1977 ◽  
Vol 15 (17) ◽  
pp. 68-68
Keyword(s):  
Peripheral Neuropathy ◽  
Liver Function ◽  
Adverse Reactions ◽  
Liver Function Tests ◽  
Function Tests ◽  
Β Blockers ◽  
Altered Liver

Last December we concluded that ‘perhexiline (Pexid - Merrell) is probably worth trying in patients with severe angina when nitrates and β-blockers control symptoms poorly. Minor unwanted effects and altered liver function tests are very common. Overt hepatotoxicity and peripheral neuropathy seem infrequent but the risks must be borne in mind’.1

scholarly journals Liver Function Test Abnormalities in Patients with Inflammatory Bowel Diseases: A Hospital-based Survey

2014 ◽  
Vol 7 ◽  
pp. CGast.S13125 ◽  
Author(s):  
Maria Cappello ◽  
Claudia Randazzo ◽  
Ivana Bravatà ◽  
Anna Licata ◽  
Sergio Peralta ◽  
...  
Keyword(s):  
Liver Function ◽  
Fatty Liver ◽  
Inflammatory Bowel Diseases ◽  
Normal Values ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transpeptidase ◽  
Drug Induced ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Altered Liver

Background and Aims Inflammatory bowel diseases (IBD) are frequently associated with altered liver function tests (LFTs). The causal relationship between abnormal LFTs and IBD is unclear. The aim of our study was to evaluate the prevalence and etiology of LFTs abnormalities and their association with clinical variables in a cohort of IBD patients followed up in a single center. Materials and Methods A retrospective review was undertaken of all consecutive IBD in- and outpatients routinely followed up at a single referral center. Clinical and demographic parameters were recorded. Subjects were excluded if they had a previous diagnosis of chronic liver disease. LFT abnormality was defined as an increase in aspartate aminotransferase, (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), or total bilirubin. Results A cohort of 335 patients (179 males, mean age 46.0 ± 15.6 years) was analyzed. Abnormal LFTs were detected in 70 patients (20.9%). In most cases, the alterations were mild and spontaneously returned to normal values in about 60% of patients. Patients with abnormal LFTs were less frequently on treatment with aminosalicylates (22.8 vs. 36.6%, P = 0.04). The most frequent cause for transient abnormal LFTs was drug-induced cholestasis (34.1%), whereas fatty liver was the most frequent cause of persistent liver damage (65.4%). A cholestatic pattern was found in 60.0% of patients and was mainly related to older age, longer duration of disease, and hypertension. Conclusions The prevalence of LFT abnormalities is relatively high in IBD patients, but the development of severe liver injury is exceptional. Moreover, most alterations of LFTs are mild and spontaneously return to normal values. Drug-induced hepatotoxicity and fatty liver are the most relevant causes of abnormal LFTs in patients with IBD.

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