scholarly journals Association between Inflammatory Cytokines and Liver Functions in Rheumatoid Arthritis Patients

2021 ◽  
Author(s):  
Mohamed Abdelrhman Eltahir ◽  
Kawthar Abdelgaleil Mohammedsalih ◽  
Elhaj Noureldien Mohamed ◽  
Faisal Makki Babekir ◽  
Amar Mohamed Ismail
Keyword(s):  
Rheumatoid Arthritis ◽  
Young Adults ◽  
Liver Function ◽  
Inflammatory Cytokines ◽  
Liver Function Tests ◽  
P Value ◽  
Interleukin 17 ◽  
Function Tests ◽  
Liver Functions ◽  
Anti Inflammatory

Background: Rheumatoid arthritis (RA) is associated with abnormal liver tests, and the medications used for RA are often hepatotoxic. Therefore, this study aimed to investigate an association between pro-inflammatory and anti-inflammatory cytokines and liver function tests in RA patients. Methods: In this descriptive cross-sectional study, 88 RA patients were included, 84 of them were women and 4 men, aged 21–81 years. Serum interleukin-10 (IL-10), interleukin-17 (IL-17), Osteopontin (OPN) were measured and liver function tests were conducted. Results: The frequency of RA was higher among adults aged >41 years (72 [81.8%]) than young adults aged ≤41 years (16 [18.2%]). RA was more common in women (84 [95.5%]) than in men (4 [4.5%]) – approximately 21:1-fold. Young adults had higher abnormal IL-10 than adult RA patients (OR = 3.72, p-value 0.044). Abnormal IL-17 (OR = 5.67, p-value 0.034) was found to be increased in young-adult RA patients. No association was observed between age and OPN and between the duration of disease and IL-10, IL-17, and OPN. Similarly, no association was noted between the types of treatment and IL-10, IL-17, and OPN, nor between IL-10, IL-17, OPN and liver parameters (AST, ALT, ALP, ALB, TP, and GGT). Conclusion: Pro-inflammatory and anti-inflammatory cytokines are not associated with abnormal liver functions, as has been demonstrated in RA patients.

scholarly journals P037 DMARDs & hepatitis E: the hidden culprit

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Geraint A Brown ◽  
Louise Kearney ◽  
Elizabeth Warner ◽  
Spencer Ellis
Keyword(s):  
Rheumatoid Arthritis ◽  
Liver Function ◽  
Liver Function Tests ◽  
Hepatitis E ◽  
British Society ◽  
Good Effect ◽  
Solid Organ ◽  
Seropositive Rheumatoid Arthritis ◽  
Function Tests ◽  
Contaminated Food

Abstract Background/Aims  Disease-modifying anti-rheumatic drugs (DMARDs) require blood monitoring as recommended by the British Society for Rheumatology guidelines. Deranged liver function tests are a common abnormality, and when a significant transaminitis occurs further investigations are required. We wish to present three cases where a transaminitis was caused by acute hepatitis E. Hepatitis E rarely causes illness in the general population. Transmission can occur via sewage-contaminated food and water, undercooked or raw pig and game meat, or processed pork and shellfish. Blood transfusion and solid organ transplantation is very rare. There is an estimated 60,000 cases of Hepatitis E per year in England. Those who are immunosuppressed are more likely to develop chronic liver disease. Methods  . Results  Case 1 is 55 year old male with a seronegative inflammatory arthritis treated with methotrexate and sulfasalazine whose ALT rose to 2043 U/l. After a negative liver screen including autoantibodies, Hepatitis E IgM was detected. Case 2 is a 71 year old male with seropositive rheumatoid arthritis prescribed Methotrexate and Sulfasalazine who developed a transaminitis following a holiday to Spain. Hepatitis E serology was positive. Case 3 is a 65 year old male with seropositive rheumatoid arthritis on Abatacept and Methotrexate who also developed deranged liver function tests following a trip to Spain. Alcohol excess was initially suspected due to the consumption of > 20 units per week. However, on cessation of all medications the ALT continued to rise to 1087 U/l. He was found to be Hepatitis E IgM positive with viral PCR also detected. In all three cases contaminated food was likely to be the source of infection and DMARDs were successfully restarted in all patients following normalisation of liver function tests. Conclusion  This case series highlights an important differential for transaminitis with very little published literature. Hepatitis E is under reported and not routinely requested in practice as part of a liver screen. Failure to check Hepatitis E serology may lead to DMARDs being discontinued inappropriately. All patients should be educated about the risks of Hepatitis E from food products.We recommend that DMARDs are suspended once Hepatitis E infection has been diagnosed in order to allow the immune system combat the infection. Treatment is usually self limiting, though in severe cases Ribavirin has been used with good effect. DMARDs should be restarted once liver markers normalise, and two serum Hepatitis E RNA results and two stool samples are negative. The presence of persistent Hepatitis E RNA (viral shedding) is highly suspicious for chronic infection, which would warrant hepatology input. Disclosure  G.A. Brown: None. L. Kearney: None. E. Warner: None. S. Ellis: None.

scholarly journals Additional effect of etanercept or infliximab on the liver function tests of patients with rheumatoid arthritis: a cohort study

2018 ◽  
Vol Volume 14 ◽  
pp. 1943-1950
Author(s):  
Saeed Akhlaghi ◽  
Maryam Sahebari ◽  
Mahmoud Mahmoodi ◽  
Mehdi Yaseri ◽  
Mohammad Ali Mansournia ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Liver Function ◽  
Liver Function Tests ◽  
Function Tests

scholarly journals A High Percentage of Patients Recovered From COVID-19 but Discharged With Abnormal Liver Function Tests

2021 ◽  
Vol 12 ◽  
Author(s):  
Qinyi Gan ◽  
Beilei Gong ◽  
Manli Sun ◽  
Zhujun Cao ◽  
Yuyan Zheng ◽  
...  
Keyword(s):  
Liver Function ◽  
Oxygenation Index ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transferase ◽  
Function Tests ◽  
Liver Functions ◽  
Global Health Issue ◽  
Treatment Data ◽  
Independent Risk Factors ◽  
Glutamyl Transferase

BackgroundCoronavirus disease 2019 (COVID-19) pandemic has become the most severe global health issue. Abnormal liver functions are frequently reported in these patients. However, liver function abnormality was often overlooked during COVID-19 treatment, and data regarding liver functions after cure of COVID-19 is limited. This study aimed to reveal the changes of liver function tests (LFTs) during hospitalization, and its clinical significance in patients with COVID-19.MethodsIn this retrospective, bi-center study, a total of 158 hospitalized patients diagnosed with COVID-19 in China were included from January 22nd, 2020 to February 20th, 2020. Clinical features, laboratory parameters including LFTs, and treatment data were collected and analyzed. LFTs included alanine transaminase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin. Patients were considered with abnormal LFTs when any value of these tests was higher than upper limit of normal.ResultsOf 158 patients with COVID-19, 67 (42.41%) patients had abnormal LFTs on admission and another 50 (31.65%) patients developed abnormal LFTs during hospitalization. The incidence of LFTs abnormality in severe COVID-19 cases was significantly higher than non-severe cases. All LFTs in COVID-19 patients were correlated with oxygenation index. There was no statistical difference in treatment between the patients with or without liver test abnormalities. By the time of discharge, there were still 64 (40.50%) patients with abnormal LFTs. Logistic regression analysis identified younger age, hypertension and low lymphocyte counts as independent risk factors for persistent abnormal LFTs during hospitalization.ConclusionLiver function tests abnormality was common in COVID-19 patients and was more prevalent in severe cases than in non-severe cases. A substantial percentage of patients still had abnormal LFTs by the time of discharge.

Liver Function Tests in Rheumatoid Arthritis

1972 ◽  
Vol 1 (1) ◽  
pp. 184-195 ◽  
Author(s):  
Veikko Laine ◽  
Toivo Holopainen ◽  
Helka-Marjatta Koskinen
Keyword(s):  
Rheumatoid Arthritis ◽  
Liver Function ◽  
Liver Function Tests ◽  
Function Tests

Liver Function Tests in Rheumatoid Arthritis

1955 ◽  
Vol 1 (1-4) ◽  
pp. 184-195 ◽  
Author(s):  
Veikko Laine ◽  
Toivo Holopainen ◽  
Helka-Marjatta Koskinen
Keyword(s):  
Rheumatoid Arthritis ◽  
Liver Function ◽  
Liver Function Tests ◽  
Function Tests

scholarly journals Adverse Events Profile of Low-dose Methotrexate in Nepalese Patients with Rheumatoid Arthritis: an Observational Study

2020 ◽  
Vol 18 (3) ◽  
pp. 360-365
Author(s):  
Shweta Nakarmi ◽  
Kalpana Pudasaini ◽  
Bhojraj Adhikari ◽  
Binit Vaidya
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effect ◽  
Side Effects ◽  
Liver Function ◽  
Adverse Effects ◽  
Adverse Events ◽  
Observational Study ◽  
P Value ◽  
Function Tests ◽  
Patient Reported

Background: Methotrexate is considered as the anchor drug for the treatment of rheumatoid arthritis. However, various adverse effects limit its use leading to frequent discontinuation of treatment. This study aimed to evaluate the common adverse effects of methotrexate in patients with rheumatoid arthritis. Methods: A prospective observational study was conducted at National Center for Rheumatic Diseases from June 2018 to May 2019 among patients with rheumatoid arthritis using methotrexate monotherapy. Laboratory tests like liver function tests, renal function tests, complete blood count, C-reactive protein, erythrocyte sedimentation rate were done at baseline and every 3 months. Data on patients’ comorbidities, disease activity and side effects of drug were collected on every follow- up. Statistical analysis was carried out with the help of SPSS 23.0. Results: Out of 232 patients experiencing at least one adverse effect while on methotrexate monotherapy, 87.5% were female and mean age was 46.9±10.8 years. The mean dose of methotrexate was 16.6 ± 3.9 mg/week with the most frequently used dose of 20mg/week. Among the variety of adverse reaction observed, the most common was transaminitis (75.0%) with approximately 50.0% as isolated liver function abnormality, followed by nausea (19.4%), anorexia (12.9%), leukopenia (12.5%), oral ulcer (8.2%) and psychological intolerance (4.7%). Multiple regression analysis showed significant predictive value of body mass index for transaminitis (p-value 0.007). Conclusions: Asymptomatic liver function test derangement was the most frequent adverse-effect of methotrexate observed, whereas nausea and anorexia were the most common patient reported events. The frequent dose associated with side-effects in Nepalese patients was around 20mg/week. Keywords: Adverse events; methotrexate; Nepal; rheumatoid arthritis

scholarly journals SPONTANEOUS BACTERIAL PERITONITIS

2018 ◽  
Vol 21 (04) ◽  
pp. 606-612
Author(s):  
Ahsan Ayub ◽  
Muhammad Ishfaq
Keyword(s):  
Liver Function ◽  
Fibrous Tissue ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Abnormal Liver Function ◽  
P Value ◽  
Cross Sectional ◽  
Exact Test ◽  
Function Tests ◽  
Asymptomatic Patients

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.

scholarly journals Alterations of liver function tests in diabetic obese and nonobese individuals

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 781-786
Author(s):  
Avinash S. ◽  
Santhi Silambanan
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cost Effective ◽  
Liver Function Tests ◽  
P Value ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Introduction and Aim: India has emerged as the diabetes capital in Southeast Asia having around 74 million with diabetes, with a prevalence of 9.8% in 18–99 years of age. In type 2 diabetes mellitus, triglycerides get deposited in liver thus altering its structure and function, which is the feature of nonalcoholic fatty liver disease. This study was undertaken to study the alterations in liver function tests in obese and nonobese diabetic individuals.   Materials and Methods: The Department of Biochemistry at Sri Ramachandra Institute of Higher Education and Research was chosen to conduct the retrospective study on 200 diabetic individuals from September 2019 to February 2020. The data obtained were serum liver function tests, HbA1c, plasma glucose and lipid profile. Before the study ethics approval was obtained from the Institutional Ethics Committee for studies involving human participants. The obtained data were subjected to statistical analysis using SPSS version 16 and a P value less than 0.05 was considered statistically significant.   Results: Transaminases and ALP were significantly altered in obese diabetics; were positively correlated with bilirubin. TGL was negatively correlated with AST/ALT ratio.   Conclusion: Liver enzymes and bilirubin were altered in obese diabetics. Measurement of liver function biomarkers are cost effective diagnostic markers of non-alcoholic fatty liver disease.

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