scholarly journals PATHOHISTOLOGICAL PECULIARITIES OF THE FORMATION OF IRON OVERLOAD SYNDROME IN PATIENTS WITH STEATOHEPATITIS DEPENDING ON ITS ETIOLOGY

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
T.M. Antofiichuk ◽  
I.S. Davydenko ◽  
O.S. Khukhlina ◽  
N.P. Antofiichuk ◽  
V.S. Haidychuk
Keyword(s):  
Iron Overload ◽  
Optical Density ◽  
Liver Cells ◽  
Trivalent Iron ◽  
Histopathological Features ◽  
Alcoholic Steatohepatitis ◽  
Histochemical Methods ◽  
Sudan Iii ◽  
Hematoxylin And Eosin ◽  
Liver Biopsies

The aim – to study some histopathological features of the iron overload syndromeformation in patients suffering from steatohepatitis depending on its etiology.Material and methods. Liver biopsies were analyzed in 30 patients with nonalcoholicsteatohepatitis (NASH) and 20 patients with alcoholic steatohepatitis (ASH). Themorphological examination of the liver was carried out according to the standardmethods. The histopathological features of the liver were established on the basis ofthe method of staining with hematoxylin and eosin, with the confirmation, in case ofnecessity, by the histochemical methods - staining for fat (the method with Sudan-III) andcollagen fibers (the method with chromotropic-water blue according to N.Z Slinchenko).Microspectrophotometric studies were conducted using a cytological analyzer withsoftware "VideoTest - Size 5.0" (2000).Results. The same regularities for both trivalent iron and twovalent iron were revealed asa whole in the liver cells at histological investigations, that is in ASH the optical densityis at the average 1.3 (p<0.05) times higher than in NASH. The staining on trivalent ironis less intensive, than on the twovalent iron. There is probable iron overload syndrome inthe alcoholic steatohepatitis patients with increased uptake of it both 2+- and 3+- valentforms in the liver cells – reticuloendotheliocytes and hepatocytesConclusions. Iron overload syndrome with increased uptake of it for both 2+- and3+-valent takes place in the liver cells – endotheliocytes and hepatocytes – in patientswith alcoholic steatohepatitis. At alcoholic steatohepatitis the optical density withhistochemical staining on iron 2+ in reticuloendotheliocytes of the liver is 1.2 times andin hepatocytes – 1.3 times higher than at non-alcoholic steatohepatitis irrespective ofthe presence or absence of anemia. At alcoholic steatohepatitis the optical density ofhistochemical iron staining 3+ in reticuloendotheliocytes of the liver and hepatocytesis 1.3 times higher than in non-alcoholic steatohepatitis, and is irrespective of anemiapresence as well.

scholarly journals Histopathological features of liver tissue in non-alcoholic and alcoholic steatohepatitis depending on the presence of concomitant anemia

2021 ◽  
Vol 25 (1(97)) ◽  
pp. 3-10
Author(s):  
T. Antofiichuk ◽  
I. Davydenko ◽  
O. Khukhlina ◽  
M. Antofiichuk
Keyword(s):  
Connective Tissue ◽  
Pathological Process ◽  
Tissue Growth ◽  
Morphological Examination ◽  
Histopathological Features ◽  
Alcoholic Steatohepatitis ◽  
Sudan Iii ◽  
Hematoxylin And Eosin ◽  
Liver Biopsies ◽  
Hepatocyte Necrosis

The aim: to study some histopathological changes in the liver affected by steatohepatitis of various etiologies with the presence of anemia. Material and methods. Liver biopsies were analyzed in 30 patients with non-alcoholic steatohepatitis (NASH) and 20 patients with alcoholic steatohepatitis (ASH). The morphological examination of the liver was carried out according to the standard methods. The histopathological features of the liver were established on the basis of hematoxylin and eosin staining method, with confirmation, if necessary, by the histochemical methods - staining for fat (method with Sudan-III) and collagen fibers (method with chromotropic-water blue by NZ Slinchenko). Microspectrophotometric studies were performed using a cytological analyzer with software "VideoTest - Size 5.0" (2000). Results. A number of parameters revealed the statistical differences in the average trends with the use of the nonparametric Mann-Whitney method (p<0.05). The highest rate of hepatocyte necrosis was observed in the patients with ASH with anemia, in particular, more than a third of hepatocytes in these patients had signs of colic necrosis, which was more pronounced in ASH than in NASH. NASH with anemia was accompanied by more pronounced necrosis of hepatocytes than NASH without anemia. In ASH without anemia, the percentage of affected hepatocytes was on average approximately the same as in NASH without anemia. Fatty dystrophy of hepatocytes was observed in all the patients with NASH and ASH, but the severity of the general pathological process was not the same. Conclusions. Due to the comorbidity of fatty liver disease with anemia in both NASH and ASH, a much higher percentage of hepatocytes affected by reversible swelling are formed, which coincides with the tendency for hepatocyte oncosis. Anemia affects the nature of connective tissue growth in NASH and ASH (in ASH, the specific volume of connective tissue was higher than in NASH). At the same time, the intensity of regenerative processes in the liver (ductal reactions of the liver) is most pronounced in patients with anemia, and most - in ASH.

Case report of diet-related improvements of non-alcoholic steatohepatitis evaluated by four consecutive liver biopsies

2016 ◽  
Vol 47 (5) ◽  
pp. 480-484
Author(s):  
Miwa Kawanaka ◽  
Kazuhiro Nouso ◽  
Syoichiro Yano ◽  
Jun Nakamura ◽  
Ken Nishino ◽  
...  
Keyword(s):  
Case Report ◽  
Alcoholic Steatohepatitis ◽  
Liver Biopsies

Lack of reliability of liver biopsies in non-alcoholic steatohepatitis (NASH) clinical trials - potential implications for developing new therapies for NASH

2020 ◽  
Vol 73 ◽  
pp. S123-S124
Author(s):  
Beth Davison ◽  
Stephen A. Harrison ◽  
Gad Cotter ◽  
Naim Alkhouri ◽  
Arun Sanyal ◽  
...  
Keyword(s):  
Clinical Trials ◽  
New Therapies ◽  
Alcoholic Steatohepatitis ◽  
Liver Biopsies

Evaluation of Chronic Transfusion (Tx) Practices in Children with Sickle Cell Disease (SCD): A Survey of STOP II Investigators.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3732-3732 ◽  
Author(s):  
Ofelia Alvarez ◽  
Scott Miller ◽  
Brian Berman ◽  
Clark Brown ◽  
James Casella ◽  
...  
Keyword(s):  
Iron Overload ◽  
Stroke Prevention ◽  
Packed Red Blood Cells ◽  
Increased Risk ◽  
Hb S ◽  
Liver Biopsies ◽  
Machine Programming ◽  
Key Barrier ◽  
Total Exchange

The follow-up Stroke Prevention Trial (STOP II) attempts to optimize tx therapy for primary stroke prevention in children with SCD who are at increased risk due to an abnormal Doppler ultrasound. A survey of participating investigators (PIs) was performed in order to assess tx practices; 12 PIs out of 26 responded. To begin chronic tx, 42 % of the PIs preferred erythrocytapheresis (ECP), partial or total exchange to bring hemoglobin (Hb) S <30%, 33% used frequent txs over a month, and the rest used either method. For continuation of chronic tx, 5 PIs used only simple tx for their pts, 2 used partial exchange (phlebotomy and simple tx), and 5 used either simple tx or exchange to transfuse their patients (pts). The most common reason to choose a method was intravenous (IV) accessibility. 4 PIs mentioned that they start with simple tx but later might use exchange if unable to keep Hb S <30% or to avoid iron overload. For simple tx, most PIs ordered 10–15 ml/kg leucoreduced, Rh and Kell compatible, S negative packed red blood cells (PRBC). Pts returned for the next tx, depending on prior pre-tx Hb S (goal < 30%), or every 4 weeks unless Hb S was >30%. Most PIs had a post-tx target hematocrit (Hct) 35–36%, but a third of them did not have one. Pre-tx Hct and/or Hb S (but not post-tx values) were used to predict the timing of the next tx by 83% of the group. When performing ECP, the PIs participated in the decision of how much to exchange pts only 33% of the time; generally ECP was planned by a blood bank physician and/or by machine programming. Chelation began either after 12–30 months of tx (median 18 months), or after serum ferritin 1000–2500 ng/ml (median 2000). 67% of the PIs obtained liver biopsies in all or some of the STOP II pts. Indications for liver biopsies were cited as routine for transfused pts (5 PIs) or depending on ferritin values (6 PIs). Deferoxamine 25–50 mg/kg was infused subcutaneously over 8–10 hours 5–7 nights a week in all pts. Eight PIs reported the use of central venous lines (ports) in some pts to facilitate IV access. Barriers cited to effective chronic tx were: pt compliance with chelation (7 reported it as most important), IV access, pt compliance with tx schedule, hypersplenism, and alloimmunization. We conclude that hematologists :(1) Administer leucoreduced Rh and Kell compatible, S negative PRBC to keep pre-tx Hb S levels <30%, (2) use pre-tx Hb S and Hct to predict next tx, usually every 3–4 weeks, (3) monitor and treat iron overload, and (4) report that poor compliance with chelation is a key barrier to an effective tx program. Although liver biopsy to monitor iron stores and partial/total exchange to limit iron overload are accepted interventions, medical practice still varies.

Asymptomatic hemochromatosis subjects: genotypic and phenotypic profiles

Blood ◽  
2000 ◽  
Vol 96 (12) ◽  
pp. 3707-3711 ◽  
Author(s):  
Ronald L. Sham ◽  
Richard F. Raubertas ◽  
Caroline Braggins ◽  
Joseph Cappuccio ◽  
Margaret Gallagher ◽  
...  
Keyword(s):  
Iron Overload ◽  
Hereditary Hemochromatosis ◽  
Transferrin Saturation ◽  
Entire Group ◽  
Iron Loading ◽  
Asymptomatic Patients ◽  
Liver Biopsies ◽  
The Relationship ◽  
Genotypic Profile ◽  
Compound Heterozygotes

Screening for hereditary hemochromatosis (HHC) by means of transferrin saturation (TS) levels has been advocated and will identify many patients who are asymptomatic. The purposes of this study were (1) to determine HFE genotypes among asymptomatic HHC patients and correlate this profile with the degree of iron overload and (2) to evaluate the relationship between mobilized iron (mob Fe), age, serum ferritin (SF), and quantitative hepatic iron (QHI) in this population. One hundred twenty-three asymptomatic HHC patients were evaluated; all had quantitative phlebotomy to determine mob Fe and genotyping for C282Y and H63D mutations. Liver biopsies with QHI determinations were performed on 72 of the 123 patients. Of the entire group, 60% were homozygous for C282Y, and 13% were compound heterozygotes (C282Y/H63D). Among asymptomatic patients, the prevalence of homozygous C282Y is lower compared with previous studies that include clinically affected patients. Of those patients with more than 4 g mob Fe, 77% were homozygous C282Y. Asymptomatic patients with lower iron burdens frequently had genotypes other than homozygous C282Y. There was no correlation between age and mob Fe in these patients; however, there was a correlation between mob Fe and both SF (r = 0.68) and QHI (r = 0.75). In conclusion, asymptomatic patients with moderate iron overload had a different genotypic profile than was seen in advanced iron overload. The significance of identifying patients with modest degrees of iron loading, who may not be homozygous for C282Y, must be addressed if routine TS screening is to be implemented.

Acid Hydrolase Activities and Lysosomal Integrity in Liver Biopsies from Patients with Iron Overload

1976 ◽  
Vol 50 (1) ◽  
pp. 75-78 ◽  
Author(s):  
T. J. Peters ◽  
Carol A. Seymour
Keyword(s):  
Iron Overload ◽  
Liver Diseases ◽  
Cell Damage ◽  
Acid Hydrolase ◽  
Chronic Liver Diseases ◽  
Acid Hydrolases ◽  
Control Subjects ◽  
Essentially Normal ◽  
Patient Groups ◽  
Liver Biopsies

1. Iron, acid phosphatase and N-acetyl-β-glucosaminidase were assayed in liver biopsies from control subjects and patients with primary and secondary haemochromatosis. 2. The activities of the lysosomal enzymes were significantly higher in liver biopsies from patients with iron overload than in those from other patient groups. 3. Lysosomes from the livers of patients with iron overload were strikingly more fragile than those of control subjects as demonstrated by assays of latent and sedimentable N-acetyl-β-glucosaminidase. 4. Lysosomal integrity was essentially normal in biopsies from patients with a wide variety of chronic liver diseases. 5. It is suggested that iron accumulation damages the lysosomal membrane, releasing acid hydrolases into the cytoplasm and thus initiating cell damage.

scholarly journals PATHOMORPHOLOGY OF FIBROSING PROCESSES IN THE LIVER AND LUNGS IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS AND OBESITY AT COMORBIDITY WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
O.Ye. Hryniuk ◽  
I.S. Davydenko ◽  
O.S. Khukhlina ◽  
A.A. Antoniv ◽  
V.S. Haidychuk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Connective Tissue ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Specific Volume ◽  
Liver Parenchyma ◽  
Collagen Fibers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Steatohepatitis

Objective - to study the histochemical and histological features of the liver and lungtissues in patients with non-alcoholic steatohepatitis (NASH) and obesity under conditionof a comorbid course with chronic obstructive pulmonary disease (COPD).Material and methods. The autopsy material of 27 cases with NASH, including 13 casesof NASH and obesity of I degree (group 1), 14 cases of NASH, obesity of I degree withcomorbid COPD of II-III stage (group 2) was used. The groups of comparison includedautopsy material of 12 patients with isolated COPD of II-III stage (Group 3), as wellas 11 practically healthy persons (PHP), their main causes of death were polytraumaor traumatic brain injury or sudden coronary death. The groups were randomizedaccording to age, sex, degree of obesity. The average age of patients was (59,3 ± 3,21)years.Results. The volume of the connective tissue (CT) in the liver parenchyma in the 2nd groupwas in 1,9 times higher than in the 1st group (p<0,05), the specific volume of collagenfibers in 1,4 times, the optical density of collagen fibers by 1,2 times (p<0,05). In the 2ndgroup, the maximum damage to the respiratory parts of the lungs (RPL) was establishedin terms of percentage of filling of the RPL spaces with desquamated cells (in 9.4 times incomparison with PHP, by 1,3 times compared to the indicator in the 3rd group); specificvolume growth of the blood vessels in the peribronchial CT by 1,4 times (p<0,05). Thephenomena of venous thrombosis are most pronounced both in the peribronchial CT(they exceed the indicator in the 3rd group by 1,2 times) and respiratory parts of the lungs(by 2,4 times) (p<0,05). Patients of the 2nd group had the highest values of the specificvolume of CT in the lungs among all groups under study (19,8 ± 0,37 (p <0,05)).Conclusions. The comorbidity of COPD in patients with NASH and obesity contributedto the higher degree of activation of the connective tissue components in the liverparenchyma in comparison with the NASH indicators against a background of obesitywithout COPD, with an increase in the volume of the connective tissue (in 1,9 times,p<0,05), specific volume collagen fibers (by 1,4 times, p<0,05), optical density ofcollagen fibers coloring (in 1,2 times, p<0,05).

Sign in / Sign up

Export Citation Format

Share Document