Alpha 1 Anti Trypsin Levels in Asymptomatic Patients with Abnormal Liver Function Tests

Cirrhosis of liver is a chronic process characterized by structurally abnormalnodules in the liver, with diffuse generalized increased fibrous tissue in the liver. Spontaneousbacterial peritonitis(SBP) is a serious complication occurring in 10 to 30% of patients hospitalizedwith cirrhotic ascites. Objective: Assess the frequency of SBP in asymptomatic patients of livercirrhosis. Study design: Cross sectional study. Setting: Hepatitis clinic medical unit- 1 Serviceshospital, Lahore. Duration of study: One year. Sample size: Total 100 patients of cirrhoticascites. Results: Ten patients were found to have SBP (10%, 95% CI, 4.1 to15.9) and 90 patientswere found to have no SBP (90%, 95%CI, 84.1 to 95.9). Seven SBP patients (70%) had pyurea(Fisher’s exact test p- value< 0.01), and abnormal liver function tests (Chi square-value<0.01).Conclusions: We concluded that 10% of asymptomatic patients with cirrhotic ascites had SBP.SBP patients had significantly abnormal liver function tests and pyuria.

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Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

Journal of Clinical Medicine ◽

10.3390/jcm10081730 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1730

Author(s):

Hiroshi Miyama ◽

Yasuyuki Shiraishi ◽

Shun Kohsaka ◽

Ayumi Goda ◽

Yosuke Nishihata ◽

...

Keyword(s):

Heart Failure ◽

Liver Function ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Adverse Outcomes ◽

Long Term Outcomes ◽

Function Tests ◽

Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

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