scholarly journals Unsolved issues of pregnancy in liver cirrhosis

2019 ◽  
Vol 91 (4) ◽  
pp. 114-117
Author(s):  
A Iskrenov Kotzev ◽  
L Stoyanov Tanchev ◽  
Ch Savov Pavlov ◽  
S Yotov Tanchev
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Vital Signs ◽  
Abnormal Uterine Bleeding ◽  
Chronic Viral Hepatitis ◽  
Uterine Bleeding ◽  
Variceal Hemorrhage ◽  
Decompensated Liver Cirrhosis ◽  
Viral Hepatitis C ◽  
Life Threatening

Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy. We are presenting a clinical case with 34 years old pregnant woman with Child-Pugh class C cirrhosis and untreated chronic viral hepatitis C. The patient was admitted in emergency with abortus imminens, vaginal bleeding, anemia, thrombocytopenia and impaired hemostasis. The pregnancy was interrupted in the Department of obstetrics and gynecology due to the high risk for mother’s life. Later the patient developed severe disseminated intravascular coagulation (DIC) syndrome with life-threatening uterine bleeding. The DIC syndrome and the bleeding were resolved after therapy in intensive care unit and the patient was discharged from the hospital with stable vital signs.

scholarly journals Disorders of hemostasis as the main pathogenetic mechanism in the development of menopausal abnormal uterine bleeding

2019 ◽  
Vol 100 (4) ◽  
pp. 589-594
Author(s):  
O V Chechulina ◽  
T E Kurmanbaev ◽  
L M Tukhvatullina ◽  
E A Khairullina ◽  
I G Mustafin
Keyword(s):  
Postmenopausal Women ◽  
Late Onset ◽  
Abnormal Uterine Bleeding ◽  
Chronic Viral Hepatitis ◽  
Reproductive Period ◽  
Uterine Bleeding ◽  
Coagulation System ◽  
Clinical Observations ◽  
Viral Hepatitis C ◽  
Abnormal Bleeding

The article presents our own clinical observations of cases of abnormal uterine bleeding in postmenopausal women, where the main cause was the pathology of hemostasis: a patient after liver transplantation for cirrhosis with chronic viral hepatitis C, and a patient with primary idiopathic thrombocytopenic purpura which manifested at a later age. Among the most common causes of abnormal uterine bleeding in postmenopausal women are hyperplasia and endometrial cancer, leiomyoma, are adenomyosis are distinguished. Pathology of the hemostasis system as the main cause of abnormal uterine bleeding, prevails in the pubertal and reproductive period. In the literature available we did not find any publications concerning uterine bleeding in postmenopausal patients against the background of the pathology of the blood coagulation system. This article illustrates the significance of hemostasis disorders both secondary and primary in the origin of abnormal bleeding in postmenopausal period. Careful collection of anamnesis, an indication of the occurrence of petechial rash, gingival bleeding should alert the doctor. It should also be remembered that “suddenly arisen” immune cytopenias and late-onset thrombosis are often manifestations of the hematological paraneoplastic syndrome and require the exclusion of neoplasia, first of all, of the hematopoietic system. These clinical observations allow recommending a mandatory examination of the hemostatic system in patients with postmenopausal bleeding.

Portal vein thrombosis as a complication of coronavirus infection against the background of chronic viral hepatitis

2021 ◽  
Vol 2 (88) ◽  
pp. 66-70
Author(s):  
A.V. Kuznetsova ◽  
◽  
A.V. Ivolgina ◽  
Ye.V. Dubotolkina ◽  
T.Ye. Makarova ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Portal Vein ◽  
Viral Hepatitis ◽  
Abdominal Ultrasound ◽  
Chronic Viral Hepatitis ◽  
Outpatient Basis ◽  
Vein Thrombosis ◽  
Viral Hepatitis C ◽  
Coronavirus Infection

The article presents an extract from an outpatient case history card of a 47-year-old patient observed at the Central Hospital for Chronic Hepatitis C. In 2017, he received a course of therapy for this disease (Pegasis in combination with ribavirin). A sustained virological response (SVR) has been achieved. According to elastometry data dated 12/13/2017 – the degree of fibrosis F4 Metavir, 13.1 KPa. In January 2021, he suffered a coronavirus infection (according to the CT scan of the lungs, the lesion was 20 %). The disease proceeded against the background of chronic viral hepatitis C complicated by liver cirrhosis. He was treated symptomatically on an outpatient basis. He did not receive anticoagulant therapy. In February 2021, abdominal ultrasound (ABP) revealed a thrombus in the portal vein. The presence of a thrombus in the portal vein contributes to the further progression of liver cirrhosis

scholarly journals THE CASE OF DEATH FROM LIVER CIRRHOSIS IN THE FEMALE PATIENT WITH HIV INFECTION AND INFILTRATIVE PULMONARY TUBERCULOSIS

2013 ◽  
Vol 18 (1) ◽  
pp. 49-54
Author(s):  
I. Yu. Babaeva ◽  
M. G. Avdeeva ◽  
N. P. Shevchenko ◽  
V. V Kulagin ◽  
G. V Chumachenko ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Chronic Viral Hepatitis ◽  
Age Group ◽  
Viral Hepatitis C ◽  
Comparative Results ◽  
Age Range ◽  
Chronic Viral Hepatitis C

The paper presents comparative results of estimation of mortality from HIV infection, tuberculosis (TB), fibrosis and cirrhosis of the liver of nonalcoholic nature according to age group for the residents of the Krasnodar region for the period 2006 to 2011. The average age range of the probable development of death from HIV infection was 35-39, from tuberculosis - 45-49 and from liver cirrhosis 55-59 years. Given clinical case is demonstrating the importance of the underestimation of hepatitis "C" complicating diagnosis of cirrhosis in patients with HIV infection, suffering from secondary diseases: pulmonary tuberculosis, cytomegalovirus, toxoplasmosis, herpes infection, candidiasis. After a comprehensive review of the examples the authors provide recommendations for monitoring and management of patients with ТВ and HIV infection and chronic viral hepatitis "C".

scholarly journals Splenomegaly and thrombocytopenia in patients with liver cirrhosis

2010 ◽  
Vol 67 (2) ◽  
pp. 166-169 ◽  
Author(s):  
Jelena Djordjevic ◽  
Petar Svorcan ◽  
Dusica Vrinic ◽  
Branka Dapcevic
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Hepatic Dysfunction ◽  
Spleen Size ◽  
Hepatitis Viruses ◽  
Decompensated Liver Cirrhosis ◽  
Splenic Sequestration ◽  
Frequent Finding

Backgroud/Aim. Splenomegaly is a frequent finding in patients with liver cirrhosis and portal hypertension and may cause hypersplenism. The occurrence of thrombocytopenia in those patients can be considered as an event with multiple etiologies. Two mechanisms may act alone or synergistically with splenic sequestration. One is central which involves either myelosuppression because of hepatitis viruses or the toxic effects of alcohol abuse on the bone marrow. The second one involves the presence of antibodies against platelets. It also depends upon the stage and etiology of liver disease. The aim of the study was to investigate a correlation between the platelet count and spleen size and the risk factors for thrombocytopenia in patients with liver cirrhosis. Methods. We studied 40 patients with decompensated liver cirrhosis who were hospitalized in the Department of Gastroenterohepatology. The liver function was graded according to Child Pugh score. Spleen size was defined ultrasonografically on the basis of craniocaudal length. Suspicion of portal hypertension was present when longitudinal spleen length was more than 11 cm. Thrombocytopenia was determined by platelet count under 150 000/mL. Results. We did not find any significant correlation between hepatic dysfunction and spleen size (p = 0.9), and between hepatic dysfunction and thrombocytopenia (p = 0.17). Our study did not find any significant correlation between spleen size and peripheral platelet count (p = 0.5), but we found a significant correlation between thrombocytopenia and etiology of cirrhosis - decreased platelet count was more common among patients with cirrhosis of alcoholic etiology than in other etiologies of cirrhosis (p = 0.001). Conclusion. According to our study, liver cirrhosis, portal hypertension and thrombocytopenia could be present even in the absence of enlarged spleen suggesting the involvement of other mechanisms of decreasing platelet account.

Chronic viral hepatitis C. Approach to therapy

2021 ◽  
Vol 87 (1) ◽  
pp. 37-41
Author(s):  
T. Ye. Makarova ◽  
◽  
N.N. Dudareva ◽  
N.N. Poletaeva ◽  
E.A. Medvedeva ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Viral Hepatitis C ◽  
High Incidence ◽  
Chronic Viral Hepatitis C

The problem of chronic viral hepatitis C currently remains relevant due to the high incidence, frequent outcomes in liver cirrhosis, high disability of the population, and expensive treatment. The article discusses timely approaches to the treatment of chronic viral hepatitis C, using interferon-free therapy regimens.

Antiviral therapy of liver cirrhosis in the outcome of chronic viral hepatitis C

2021 ◽  
pp. 89-97
Author(s):  
ANARKAN SHABOLOTOVNA TASHPOLOTOVA ◽  
GULMIRA SAIBILDAEVNA SURANBAEVA ◽  
MYSKAL MAMAZIAEVNA ABDIKERIMOVA ◽  
ALTYNAI BORUBAEVNA MYRZAKULOVA ◽  
ANARA SHAMSHIDINOVNA DJUMAGULOVA ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Antiviral Therapy ◽  
Chronic Viral Hepatitis ◽  
Viral Hepatitis C ◽  
Chronic Viral Hepatitis C

scholarly journals Biochemical Changes in Patients with Combined Chronic Schistosomiasis and Viral Hepatitis C Infections

2000 ◽  
Vol 16 (3-4) ◽  
pp. 111-118 ◽  
Author(s):  
Fawzia A. Fahim ◽  
Amr Y. Esmat ◽  
Gehan K. Hassan ◽  
Abeer Abdel-Bary
Keyword(s):  
Liver Cirrhosis ◽  
Reference Group ◽  
Biochemical Changes ◽  
Hcv Infection ◽  
Serum Total Protein ◽  
Decompensated Liver Cirrhosis ◽  
Indirect Bilirubin ◽  
Viral Hepatitis C ◽  
Chronic Hcv ◽  
Normal Controls

This study was undertaken to assess the biochemical changes induced in chronic schistosomiasis and/or chronic HCV, as well as to pinpoint the most significant parameters which could be used as dependable indices for the differentiation of single and coupled infections with or without liver cirrhosis. The selected patients were allocated into 2 broad groups: GrII (Schistosomiasis) which was subdivided into 3 subgroups: GrII(a) schistosomal patients with hepatosplenomegaly; GrII(b) hepatosplenic schistosomal patients with decompensated liver cirrhosis; GrII(c) schistosomal patients with no organomegaly. GrIII (Combined) comprised 2 subgroups: GrIII(a) schistosomal-HCV infection with decompensated liver cirrhosis; GrIII(b) schistosomal-HCV infection without liver cirrhosis. For statistical comparison normal healthy subjects were taken as a reference group (Gr I). Results showed that schistosomal patients without organomegaly manifested non significant changes in all studied parameters compared to normal controls. Highly significant elevations in serum ALT, AST, ALP and GGT activities were recorded in all other subgroups but the highest levels are reported in GrIIb. AST/ALT and direct/indirect bilirubin ratios were highest in GrIIIa (1.17 ± 0.26, 1.54 ± 0.37, respectively). Serum total protein and albumin levels showed the highest reduction (33 and 59%) concomitantly with the highest increase inγ-globulin level (75%) in GrIII(a). Blood total iron was significantly reduced in GrII(a,b) (15.6 and 12%) (8.8%) bilirubin, GGT and AST in this order are good discriminators between the different subgroups in GrII. On the other hand, ALT, AST, albumin, ALP, GGT, protein and direct bilirubin are the most significant indices to differentiate chronic schistosomiasis and the combined group with/or without liver cirrhosis.

scholarly journals Elastography in the diagnosis of portal hypertension in patients with liver cirrhosis

2017 ◽  
Vol 89 (2) ◽  
pp. 33-37
Author(s):  
E O Liusina ◽  
Ch S Pavlov ◽  
V T Ivashkin
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Portal Hypertension ◽  
Hepatitis C ◽  
Diagnostic Accuracy ◽  
Esophageal Varices ◽  
Alcoholic Liver Cirrhosis ◽  
Abdominal Ultrasonography ◽  
Blood Indices ◽  
Viral Hepatitis C

Aim. To establish the diagnostic accuracy of liver and spleen density (LD and SD) measurements in patients with compensated alcoholic liver cirrhosis (LC) in the diagnosis of portal hypertension. Subjects and methods. The investigation enrolled 83 patients with compensated alcoholic and viral (hepatitis C virus) LC. All the patients underwent LD and SD determinations, abdominal ultrasonography, and endoscopy to detect esophageal varices (EV), as well as examination of blood indices. Results. In viral LC, there were substantial LD differences in patients with and without EV. The patients with EV were ascertained to have higher LD [27.9 (21—45) kPa] than those without EV [19.5 (16—26.2) kPa]. SD was also significantly higher than that in the EV group than in the non-EV group (p

Emergent treatment of variceal bleeding in two infants

2008 ◽  
Vol 49 (8) ◽  
pp. 951-954 ◽  
Author(s):  
A. Park ◽  
W. Cwikiel
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Biliary Atresia ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
The Other ◽  
Bleeding Control ◽  
Vein Thrombosis ◽  
Life Threatening

Two infants with portal hypertension were treated on an emergency basis for life-threatening uncontrollable variceal bleeding. One 9-month-old girl had portal vein thrombosis, and the other 28-months-old girl had liver cirrhosis secondary to biliary atresia. Following percutaneous transhepatic embolization of the varices, successful bleeding control was achieved in both patients.

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