Secondary hyperaldosteronism and liver fibrosis in patients with compensated chronic liver disease or portal hypertension

Author(s):  
Giovanni Vitale ◽  
Kimberly Coscia ◽  
Guido Zavatta ◽  
Maria Cristina Morelli ◽  
Valentina Vicennati
2020 ◽  
Vol 40 (7) ◽  
pp. 1713-1724 ◽  
Author(s):  
Benedikt Simbrunner ◽  
Rodrig Marculescu ◽  
Bernhard Scheiner ◽  
Philipp Schwabl ◽  
Theresa Bucsics ◽  
...  

2020 ◽  
Vol 08 (11) ◽  
pp. E1623-E1632
Author(s):  
Carlos Robles-Medranda ◽  
Roberto Oleas ◽  
Miguel Puga-Tejada ◽  
Manuel Valero ◽  
Raquel Del Valle ◽  
...  

Abstract Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.


2021 ◽  
Author(s):  
Ola G Behairy ◽  
Soha A El‐Gendy ◽  
Dalia Y Ibrahim ◽  
Amira I Mansour ◽  
Ola S El‐Shimi

2021 ◽  
Vol 14 ◽  
pp. 175628482110234
Author(s):  
Mario Romero-Cristóbal ◽  
Ana Clemente-Sánchez ◽  
Patricia Piñeiro ◽  
Jamil Cedeño ◽  
Laura Rayón ◽  
...  

Background: Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indices with the prognosis of critically ill COVID-19 patients. Methods: The work presented was an observational study in 214 patients with COVID-19 consecutively admitted to the intensive care unit (ICU). Pre-admission liver fibrosis indices were calculated. In-hospital mortality and predictive factors were explored with Kaplan–Meier and Cox regression analysis. Results: The mean age was 59.58 (13.79) years; 16 patients (7.48%) had previously recognised chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indices were higher in non-survivors [Forns: 6.04 (1.42) versus 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) versus 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis ( p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11–1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99–1.72); p = 0.051] were independently related to survival after adjusting for the Charlson comorbidity index, APACHE II, and ferritin. Conclusion: Unrecognised liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.


2011 ◽  
Vol 54 ◽  
pp. S48-S49
Author(s):  
F. Grünhage ◽  
K. Hochrath ◽  
M. Krawczyk ◽  
B. Obermayer-Pietsch ◽  
M. Trauner ◽  
...  

Gut ◽  
2010 ◽  
Vol 59 (9) ◽  
pp. 1245-1251 ◽  
Author(s):  
J. Parkes ◽  
P. Roderick ◽  
S. Harris ◽  
C. Day ◽  
D. Mutimer ◽  
...  

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