Elevated serum enzymes in patients with wasp/bee sting and their clinical significance

Houndstongue ( Cynoglossum officinale), a noxious weed that contains pyrrolizidine alkaloids (PAs), infests pastures and fields in the western United States and Europe. The purpose of this study was to develop techniques to better diagnose PA poisoning and describe the progression of gross and microscopic lesions caused by houndstongue intoxication. Six horses were gavaged daily with a suspension of houndstongue containing 5 or 15 mg/kg total PA for 14 days. Two horses were treated similarly with ground alfalfa as controls. Liver biopsy samples and serum biochemical and hematologic values were evaluated biweekly. Within 7 days after dosing, horses treated with 15 mg/kg PA developed severe liver disease characterized by altered bile acid metabolism, elevated serum enzymes, and extensive hepatocellular necrosis with minimal periportal fibrosis and biliary hyperplasia. The condition of these animals continued to deteriorate, and they were euthanized. For several weeks after dosing, horses treated with 5 mg/kg PA were depressed, had transient elevations of serum enzymes and bile acids, and developed minimal periportal hepatocellular necrosis with fibrosis. The biochemical changes resolved by 6–8 weeks; however, the histologic disease persisted with extensive megalocytosis by week 14. Throughout the study, the rate of hepatocellular proliferation remained constant. Biliary cells had an increase in mitotic rate that correlated with the histologic changes. Hepatic tissue-bound pyrroles (PA metabolites) were identified in necropsy samples of treated animals using gas chromatography/mass spectrometry and photometrically with Ehrlich's reagent. These findings suggest that pyrrole extraction and identification are useful in documenting PA exposure and that houndstongue is extremely toxic to horses.

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Clinical Significance of Elevated Serum Triiodothyronine to Thyroxine Ratios in Patients with Graves' Disease Treated with Antithyroidal Drugs

Folia Endocrinologica Japonica ◽

10.1507/endocrine1927.59.3_295 ◽

1983 ◽

Vol 59 (3) ◽

pp. 295-303

Author(s):

Junta TAKAMATSU

Keyword(s):

Clinical Significance ◽

Elevated Serum ◽

Graves Disease

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Clinical significance of elevated serum interferon- inducible protein-10 levels in hepatitis C virus carriers with persistently normal serum transaminase levels

Journal of Viral Hepatitis ◽

10.1046/j.1365-2893.2001.00309.x ◽

2001 ◽

Vol 8 (5) ◽

pp. 341-348 ◽

Cited By ~ 36

Author(s):

Y. Itoh ◽

A. Morita ◽

K. Nishioji ◽

S. Narumi ◽

T. Toyama ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Clinical Significance ◽

Elevated Serum ◽

Normal Serum ◽

Serum Transaminase ◽

Inducible Protein ◽

Interferon Inducible Protein

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Risk factors for acute kidney injury among patients with rhabdomyolysis

10.21203/rs.3.rs-19317/v1 ◽

2020 ◽

Author(s):

Jia Yang ◽

Jiaojiao Zhou ◽

Xin Wang ◽

Siwen Wang ◽

Yi Tang ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

High Risk ◽

Hospital Mortality ◽

Laboratory Data ◽

Elevated Serum ◽

Kidney Injury ◽

Chronic Alcoholism ◽

Multiple Organ ◽

Bee Sting

Abstract Background Acute kidney injury (AKI) is a life-threatening complication of rhabdomyolysis (RM). The aim of the present study was to assess patients at high risk for the occurrence of AKI defined by the Kidney Disease Improving Global Outcomes criteria and in-hospital mortality. Methods We performed a retrospective study of patients with creatine kinase levels >1000 U/L, who were admitted to the West China Hospital of Sichuan University between January 2011 and March 2019. The sociodemographic, clinical and laboratory data of these patients were obtained from an electronic medical records database, and univariate and multivariate regression analyses were subsequently conducted. Results For the 329 patients included in our study, the incidence of AKI was 61.4%, and the overall mortality rate was 19.8%; furthermore, patients with AKI tended to have higher mortality rates than those without AKI (24.8% vs. 11.8%; P<0.01). The clinical conditions most frequently associated with RM were trauma (28.3%), sepsis (14.6%), bee sting (12.8%), thoracic and abdominal surgery (11.2%) and exercise (7.0%). Furthermore, patients with RM resulting from sepsis, bee sting and acute alcoholism were more susceptible to AKI. The risk factors for the occurrence of AKI among RM patients included age ≥60 years (OR=3.070), chronic alcoholism (OR=3.256), hypertension (OR=4.252), multiple organ dysfunction syndrome (MODS; OR=7.244), high levels of white blood cell count (OR=1.047) and elevated serum phosphorus (OR=5.526). Age ≥60 years (OR=3.188), MODS (OR=2.262), diabetes (OR=2.746) and elevated prothrombin time (OR=1.079) were independent risk factors for in-hospital mortality in RM patients with AKI. Conclusions AKI is independently associated with mortality in patients with RM, and several risk factors were found to be associated with the occurrence of AKI and in-hospital mortality. These findings suggest that, to improve the quality of medical care, the early prevention of AKI should focus on high-risk patients and more effective management.

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CLINICAL SIGNIFICANSE OF PROSTATE-SPECIFIC ANTIGEN IN BREAST CANCER PATIENTS

Siberian Journal of Oncology ◽

10.21294/1814-4861-2020-19-6-28-37 ◽

2020 ◽

Vol 19 (6) ◽

pp. 28-37

Author(s):

N. S. Sergeeva ◽

T. A. Karmakova ◽

I. I. Alentov ◽

A. D. Zikiryahodzhaev ◽

D. R. Ortabaeva ◽

...

Keyword(s):

Breast Cancer ◽

Prostate Specific Antigen ◽

Clinical Significance ◽

Molecular Subtype ◽

Specific Antigen ◽

Elevated Serum ◽

Breast Diseases ◽

Breast Cancer Patients ◽

Early Stages

Background. Prostate-specific antigen (PSA ) is predominantly produced by prostate epithelium, however, other tissues can serve as its minor sources in both men and women, including breast tissue. In women, elevated serum PSA levels have been described in different physiological and pathological conditions, including benign breast diseases and breast cancer (BC). PSA is considered as a potential serum tumor marker for BC, but evidences of its possible clinical significance are insufficiently convincing.Aim of the study: investigation of PSA levels in female BC patients and assessment of perspectives of its study as a diagnostic tool for early detection of BC.Material and methods. Serum PSA levels were measured by chemiluminescence immunoassay (ARCHITECT , Abbott) in 99 female patients with histologically confirmed BC (carcinoma in situ – 11, stage I – 56, stage IIA – 32) and 25 conditionally healthy female donors.Results. In the donor group, serum PSA was revealed in 22/25 (88,0 %) cases, and its mean level was 4.0 ± 0.9 ng/l. In the group of BC patients, detectable PSA level was revealed in 68/99 (68.7 %) cases, and its mean level was 2.8 ± 0.9 ng/l. Differences between groups of BC patients and donors in mean marker values were not statistically significant (p>0,05). Serum PSA levels were higher in young women: in the group of BC patients under 40 years old, percentage of PSA -positive cases was 89 %, in the group of patients over 50 years old – 60 %; in groups of donors under 40 and over 50 years old – 100 % and 80 %, respectively. In cases of in situ carcinoma, the mean serum PSA was higher than in cases with stages I and II (3.0 ± 1.2 ng/l vs 1.9 ± 0.3 ng/l and 1.6 ± 0.3 ng/l, respectively; p>0,05). In the group of BC patients, no PSA levels were found to be dependent on the histological type, grade and molecular subtype of the tumor.Conclusion. The PSA level has no clinical significance in early stages of BC, since the proportion of cases with elevated PSA levels and it’s mean value in patients with early stages of BC don’t differ from those in the group of healthy women.

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