The natural history of histologically proved drug induced liver disease

BACKGROUNDThe long term outcome of drug related liver disease is unknown.AIMSTo study the natural history of histologically proved drug induced hepatotoxicity.METHODS110 patients with liver biopsies coded either as drug induced liver disease or hepatitis/cholestasis of unknown aetiology were identified from hospital records 1978–1996. Review of case notes and histology identified 44 patients with definite drug induced hepatotoxicity. Forty surviving patients were invited to attend a follow up clinic. History, examination, full liver screen, and isotope and ultrasound liver scans were repeated in all patients. Repeat liver biopsies were offered to patients with abnormal liver tests.RESULTSPresentation at index biopsy was jaundice in 24 patients, abnormal liver tests in 17, and hepatic failure in three. Antibiotics (n=13) and non-steroidal anti-inflammatory drugs (n=11) were the most common drugs implicated. Initial histology showed acute hepatitis in six, chronic hepatitis in 20, and cholestasis in 18. At 1–19 years (median 5 years) follow up, 13/33 (39%) patients had persistent significant abnormalities in their liver blood tests and/or scans. Three of the five repeat liver biopsies performed showed significant abnormalities. Factors predicting persistence or development of chronic liver disease were fibrosis and continued exposure to the drug.CONCLUSIONSDrugs should be considered in the differential diagnosis of abnormal liver function and/or histology, as failure to withdraw the offending drug is associated with a high risk of persistent liver damage.

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The natural history of glycogen storage disease types VI and IX: Long-term outcome from the largest metabolic center in Canada

Molecular Genetics and Metabolism ◽

10.1016/j.ymgme.2014.09.005 ◽

2014 ◽

Vol 113 (3) ◽

pp. 171-176 ◽

Cited By ~ 43

Author(s):

Anne Roscher ◽

Jaina Patel ◽

Stacy Hewson ◽

Laura Nagy ◽

Annette Feigenbaum ◽

...

Keyword(s):

Natural History ◽

Glycogen Storage Disease ◽

Storage Disease ◽

Glycogen Storage ◽

Term Outcome ◽

Long Term Outcome ◽

History Of

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Long-Term Outcomes After Reversible Cerebral Vasoconstriction Syndrome

Stroke ◽

10.1161/strokeaha.119.027703 ◽

2020 ◽

Vol 51 (2) ◽

pp. 670-673 ◽

Cited By ~ 4

Author(s):

Rosalie Boitet ◽

Solène de Gaalon ◽

Claire Duflos ◽

Grégory Marin ◽

Jérôme Mawet ◽

...

Keyword(s):

Thunderclap Headache ◽

Reversible Cerebral Vasoconstriction Syndrome ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome ◽

Follow Up Study ◽

Cerebral Vasoconstriction ◽

History Of

Background and Purpose— We aimed to further investigate the long-term outcomes after reversible cerebral vasoconstriction syndrome (RCVS). Methods— A longitudinal follow-up study was conducted in 173 RCVS patients. Results— Of the 172 patients who completed a mean follow-up of 9.2±3.3 years, 10 had a recurrent RCVS that was benign in all. Independent predictors of relapse were having a history of migraine and having exercise as a trigger for thunderclap headache during initial RCVS. After new delivery, the rate of postpartum RCVS was 9%. Conclusions— Overall, long-term outcome after RCVS is excellent.

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The Natural History Of The Overactive Bladder Ana Detrusor Overactivity. A Review Of The Evidence Regarding The Long-Term Outcome Of The Overactive Bladder

The Journal of Urology ◽

10.1097/01.ju.0000050305.05345.40 ◽

2003 ◽

Vol 169 (3) ◽

pp. 843-848 ◽

Cited By ~ 38

Author(s):

STEPHEN GARNETT ◽

PAUL ABRAMS

Keyword(s):

Natural History ◽

Overactive Bladder ◽

Detrusor Overactivity ◽

Term Outcome ◽

Long Term Outcome ◽

History Of

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Incidence of Post-Thrombotic Syndrome Following Asymptomatic Thrombosis in Survivors of Childhood Acute Lymphoblastic Leukemia.

Blood ◽

10.1182/blood.v110.11.1631.1631 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1631-1631

Author(s):

Stefan Kuhle ◽

Maria Spavour ◽

Jacqueline Halton ◽

Patricia Massicotte ◽

Irene Cherrick ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Term Outcome ◽

Long Term Outcome ◽

Group I ◽

Arm Circumference ◽

History Of ◽

Group Ii

Abstract BACKGROUND: Asymptomatic deep venous thrombosis (DVT) are well-known complications of treatment of acute lymphoblastic leukemia (ALL) in children. However, the clinical significance of radiographically detected, asymptomatic DVT is unclear and controversial, as there are no studies on long-term outcome of asymptomatic DVT in children available. There are two likely reasons for the studies not being done in this area. First, there is a lack of defined cohorts of pediatric patients screened for DVT and secondly, there is a great deal of difficulty in following patients over many years. The study, Prophylaxis with Antithrombin Replacement in Kids with ALL treated with L-Asparaginase (PARKAA) was a multicentre randomized controlled trial in which children with ALL were screened for DVT. As survivors of childhood cancer, the PARKAA cohort continues to be followed in their respective centers. Therefore, establishment of the PARKAA cohort (1997–99) and the ability to locate these patients provided a unique opportunity to study the long-term outcome of asymptomatic DVT. OBJECTIVE: To assess the incidence of PTS in children with ALL who previously had an asymptomatic DVT. The objective were approached in two ways. Firstly, to assess the outcome of asymptomatic DVT by determining the prevalence of PTS in children with a history of ALL with radiographically diagnosed DVT (PARKAA cohort); secondly, to corroborate the findings by determining the prevalence of PTS in an unselected group of survivors of childhood ALL. METHODS: Cross-sectional study in two separate populations: Group I comprised of children enrolled in the PARKAA multicentre study who had been screened for, and diagnosed with, DVT in the upper venous system. Group II consisted of non-selected patients < 21 years with a history of ALL followed at Stollery Children’s Hospital, Edmonton. Patients were invited for a follow-up at their treatment centre (Group I) or were assessed for PTS childhood cancer survivor clinic (Group II). PTS was assessed by two of the investigators (Group I) or by the attending oncologist (Group II), respectively, using a standardized scoring sheet. RESULTS: Group I: 13 PARKAA patients with a history of ALL and objectively diagnosed DVT were assessed for PTS (4 males; median age 11.9 years; median age at diagnosis of ALL 4.4 years). 7/13 patients had PTS (54%, 95%CI 25;81). All patients with PTS had collaterals on examination, 3 also had increased arm circumference. Group II: 41 patients with a history of ALL were enrolled (61% males; median age at diagnosis 3.0 years; 28% high-risk, 67% standard risk). Mean length of follow-up since diagnosis was 9.5 years. PTS was diagnosed in 10/41 (24%; 95%CI 11–38) patients. All patients with PTS had collaterals on examination, 5 (50%) also had increased arm circumference. CONCLUSIONS: There is a clinically significant prevalence of PTS in children with a history of ALL and radiographically diagnosed DVT. A significant proportion of survivors of ALL develop PTS, indicating previously undiagnosed DVT in this population.

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Natural history of nonalcoholic fatty liver disease: A prospective follow‐up study with serial biopsies

Hepatology Communications ◽

10.1002/hep4.1134 ◽

2017 ◽

Vol 2 (2) ◽

pp. 199-210 ◽

Cited By ~ 34

Author(s):

Patrik Nasr ◽

Simone Ignatova ◽

Stergios Kechagias ◽

Mattias Ekstedt

Keyword(s):

Liver Disease ◽

Natural History ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Follow Up Study ◽

History Of

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Long-term outcome of profound hyponatremia: a prospective 12 months follow-up study

Acta Endocrinologica ◽

10.1530/eje-16-0500 ◽

2016 ◽

Vol 175 (6) ◽

pp. 499-507 ◽

Cited By ~ 16

Author(s):

Bettina Winzeler ◽

Nica Jeanloz ◽

Nicole Nigro ◽

Isabelle Suter-Widmer ◽

Philipp Schuetz ◽

...

Keyword(s):

Sodium Level ◽

Medical Condition ◽

Tertiary Care ◽

Drug Induced ◽

Term Outcome ◽

Long Term Outcome ◽

Mortality And Morbidity ◽

Follow Up Study

Background Hyponatremia is the most common electrolyte abnormality in hospitalized patients and given its impact on mortality and morbidity, a relevant medical condition. Nevertheless, little is known about factors influencing long-term outcome. Methods This is a prospective observational 12-month follow-up study of patients with profound hyponatremia (≤125 mmol/L) admitted to the emergency department of two tertiary care centers between 2011 and 2013. We analyzed the predictive value of clinical and laboratory parameters regarding the following outcomes: 1-year mortality, rehospitalization and recurrent profound hyponatremia. Results Median (IQR) initial serum sodium (s-sodium) level of 281 included patients was 120 mmol/L (116–123). During the follow-up period, 58 (20.6%) patients died. The majority (56.2%) were rehospitalized at least once. Recurrent hyponatremia was observed in 42.7%, being profound in 16%. Underlying comorbidities, assessed by the Charlson Comorbidity Index, predicted 1-year mortality (odds ratio (OR) 1.43, 95% confidence interval (CI) 1.25–1.64, P < 0.001). Furthermore, ‘s-sodium level at admission’ (OR 1.14, 95% CI 1.01–1.29, P = 0.036) and ‘correction of hyponatremia’ defined as s-sodium ≥135 mmol/L at discharge were associated with mortality (OR 0.47, 95% CI 0.23–0.94, P = 0.034). Mortality rate fell with decreasing baseline s-sodium levels and was lower in the hyponatremia category ≤120 mmol/L vs >120 mmol/L (14.8% and 27.8%, P < 0.01). Patients with s-sodium level ≤120 mmol/L were more likely to have drug-induced hyponatremia, whereas hypervolemic hyponatremia was more common in patients with s-sodium >120 mmol/L. Conclusion Hyponatremia is associated with a substantial 1-year mortality, recurrence and rehospitalization rate. The positive correlation of s-sodium and mortality emphasizes the importance of the underlying disease, which determines the outcome besides hyponatremia itself.

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Natural History of Non-Alcoholic Fatty Liver Disease: A Study With Paired Liver Biopsies

Journal of Clinical and Experimental Hepatology ◽

10.1016/j.jceh.2019.07.002 ◽

2020 ◽

Vol 10 (3) ◽

pp. 245-254 ◽

Cited By ~ 1

Author(s):

Yala K. Reddy ◽

Hemnishil K. Marella ◽

Yu Jiang ◽

Surosree Ganguli ◽

Peter Snell ◽

...

Keyword(s):

Liver Disease ◽

Natural History ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

History Of ◽

Liver Biopsies ◽

Alcoholic Fatty Liver Disease

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Abstract 2554: Natural History of Apical Hypertrophic Cardiomyopathy: Outcome Not as Benign as Previously Suspected

Circulation ◽

10.1161/circ.116.suppl_16.ii_564-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Christine H Attenhofer Jost ◽

Josepha Binder ◽

Kyle W Klarich ◽

Steve R Ommen ◽

Heidi M Connolly ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Natural History ◽

Clinic Visit ◽

Icd Implantation ◽

Exertional Dyspnea ◽

Long Term Outcome ◽

Apical Hypertrophic Cardiomyopathy ◽

American Patient ◽

History Of

Background. Apical hypertrophic cardiomyopathy (AHCM) has been considered a ``benign” form of HCM in Asian and non-Asian patients (pt). However, data on long-term outcome of pt with AHCM are limited. The purpose of this study was to determine the natural history of pt with AHCM followed at a tertiary referral center in North America. Methods. Between July 1976 and September 2006, 193 pt with the diagnosis of AHCM were seen at the Hypertrophic Cardiomyopathy Clinic. The last echocardiographic exam was reviewed in all pt. Follow-up data were obtained where possible (clinic visit). Results. Mean age at diagnosis 56±17 years, mean age at first presentation at our center was 58±17 years. Symptoms included chest pain in 69 pt (36 %), and exertional dyspnea ≥NYHA II in 97 pt (50 %). A family history of either HCM and/or sudden cardiac death was reported by 36 pt (19 %). Coronary artery disease was proven in 40 pt (21 %). Median follow up was 50 months (1–318) and obtained in 124 pt (64 %). The following events were reported at the last clinic visit: heart failure in =5 pt, syncope in =0 pt, ventricular tachycardia in =7 pt, ICD implantation in 22 pt, and stroke in 22 pt. Death from all causes occurred in 51 of 193 pt (26 %) at a mean age of 72 years (14–78). Kaplan-Meier survival analysis was used to examine survival from all causes of death since first presentation. Observed survival in patients with AHCM was significantly less than expected in an age- and gender matched Minnesota white population (p=0.009). The observed survival at 5, 10 and 15 years was 87 %, 82 %, and 57 % respectively, while the expected survival for these time points was 91 %, 81 %, and 72 %. Conclusions. AHCM in this predominantly North American patient population is associated with an increased mortality. Patients with AHCM have a high incidence of significant cardiovascular symptoms and ventricular arrhythmias. As the disease is less benign than previously suspected, careful longitudinal care by a cardiologist is warranted.

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