scholarly journals Natural history and predictors of poor outcomes in acute liver injury patients in a setting without liver transplant facility

2019 ◽  
Vol 2 (2) ◽  
pp. 6
Author(s):  
Alizeh Abbas
Keyword(s):  
Liver Injury ◽  
Natural History ◽  
Total Bilirubin ◽  
Acute Liver Injury ◽  
High Burden ◽  
Significant Burden ◽  
History Of ◽  
Causes Of Mortality ◽  
Poor Outcomes ◽  
Very High

Hepatitis is one of the leading causes of mortality globally and Pakistan, too, has a very high burden of liver disease and associated morbidity and mortality. Significant burden combined with lack of adequate transplant facilities make it crucial to understand predictors and natural history of more severe stages of liver damage or inflammation, such as acute liver injury, as is the aim of this study. Even though it is known that Acute Liver Injury (ALI) is defined as INR ≥ 2.0, ALT ≥ 10X ULN, and Total Bilirubin ≥ 3 mg/dl, there is a dearth of literature on factors and prognosis associated with ALI.

scholarly journals The Natural History of Severe Acute Liver Injury

2017 ◽  
Vol 112 (9) ◽  
pp. 1389-1396 ◽  
Author(s):  
David G Koch ◽  
J L Speiser ◽  
V Durkalski ◽  
R J Fontana ◽  
T Davern ◽  
...  
Keyword(s):  
Liver Injury ◽  
Natural History ◽  
Acute Liver Injury ◽  
History Of

Explore the mechanism of Swertia mussotii Franch. for hepatoprotective effects with iTRAQ-LC-MS/MS

2020 ◽  
Vol 23 ◽  
Author(s):  
Haixia Yun ◽  
Xinyu Wu ◽  
Yiwei Ding ◽  
Wendou Xiong ◽  
Xianglan Duan ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Carbon Tetrachloride ◽  
Liver Injury ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Total Bilirubin ◽  
Acute Liver Injury ◽  
Proteome Analysis ◽  
Ppi Networks ◽  
Hepatoprotective Effects

Background and Objective : A Tibetan traditional herb named Swertia mussotii Franch., also called “Zangyinchen” by the local people of Qinghai-Tibet area, has been used to protect the liver from injury for many years. However, the curative effect and molecular mechanism of the herb have not been demonstrated clearly. Materials and Methods: In our study, serum alanine aminotransferase, aspartate aminotransferase, total bilirubin levels were examined after S. mussotii Franch. treatment in the acute liver injury of the carbon tetrachloride-induced rat model. Then, Proteome Analysis was applied to explore the potential mechanism of SMT for hepatoprotective effects after iTRAQLC-MS/MS analysis (isobaric tag for relative and absolute quantification-liquid chromatograph-mass spectrometer with tandem mass spectrometry). Results: Serum results showed, alanine aminotransferase, aspartate aminotransferase, total bilirubin levels of rats with acute liver injury were all improved with SMT treatment. Moreover, Proteome Analysis suggested that, with S. Mussotii Franch. treatment, the levels of lipid catabolic process and lipid homeostasis were all enhanced. And the results of protein-protein interaction (PPI) analysis illustrated that these proteins assembled in PPI networks were found almost significantly enriched in response to lipid, negative regulation of lipase activity, response to lipopolysaccharide etc. Furthermore, the downregulated MRP14 and MRP8 proteins were found involved in the lipid metabolism, which may indicate the mechanism of SMT protection liver from ALI induced by carbon tetrachloride. Conclusion: SMT herb could play a role in hepatoprotection and alleviate the effect of acute liver injury by impacting the lipid metabolism associated biological process.

scholarly journals Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yun Cui ◽  
Yijun Shan ◽  
Rongxin Chen ◽  
Chunxia Wang ◽  
Yucai Zhang
Keyword(s):  
Liver Injury ◽  
Pediatric Patients ◽  
Total Bilirubin ◽  
Elevated Serum ◽  
Total Bilirubin Level ◽  
Pediatric Intensive Care ◽  
Serum Levels ◽  
Serum Total Bilirubin ◽  
Kaplan Meier ◽  
Poor Outcomes

Aims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI).Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between December 2012 and December 2015. Serum TBIL concentration was determined within 72 h after PICU admission.Results. Seventy-two patients with SALI were included in this study. The overall mortality rate was 36.1% (26/72). The serum levels of TBIL of patients were significantly higher in the nonsurvivor group than the survivor group.Coxregression analysis indicated that the elevated serum TBIL level within 72 hours after admission was an independent risk factor of mortality in patients with SALI. Furthermore, the area under the receiver-operating characteristic (ROC) curve (AUC) for TBIL was 0.736 (95% confidence interval (CI): 0.614–0.858,P=0.001), in which the optimal cut-off value was 64.5 μmol/L. The combined index named “TBIL” and “TBA” showed an AUC of 0.745 (0.626–0.865) for predicting the prognosis in patients with SALI. In addition, the Kaplan–Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher serum TBIL levels (≥64.5 μmol/L) or higher value of TBIL and TBA (≥−0.8902).Conclusions. Elevated serum TBIL level is associated with poor outcomes in pediatric SALI.

scholarly journals Novel Therapies in Glioblastoma

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
James Perry ◽  
Masahiko Okamoto ◽  
Michael Guiou ◽  
Katsuyuki Shirai ◽  
Allison Errett ◽  
...  
Keyword(s):  
Natural History ◽  
Molecular Biology ◽  
Targeted Therapies ◽  
Conventional Treatment ◽  
Tumor Biology ◽  
Treatment Resistance ◽  
Novel Therapies ◽  
History Of Disease ◽  
History Of ◽  
Poor Outcomes

Conventional treatment of glioblastoma has advanced only incrementally in the last 30 years and still yields poor outcomes. The current strategy of surgery, radiation, and chemotherapy has increased median survival to approximately 15 months. With the advent of molecular biology and consequent improved understanding of basic tumor biology, targeted therapies have become cornerstones for cancer treatment. Many pathways (RTKs, PI3K/AKT/mTOR, angiogenesis, etc.) have been identified in GBM as playing major roles in tumorigenesis, treatment resistance, or natural history of disease. Despite the growing understanding of the complex networks regulating GBM tumors, many targeted therapies have fallen short of expectations. In this paper, we will discuss novel therapies and the successes and failures that have occurred. One clear message is that monotherapies yield minor results, likely due to functionally redundant pathways. A better understanding of underlying tumor biology may yield insights into optimal targeting strategies which could improve the overall therapeutic ratio of conventional treatments.

scholarly journals Bicalutamide-Associated Acute Liver Injury and Migratory Arthralgia: A Rare but Clinically Important Adverse Effect

2018 ◽  
Vol 12 (2) ◽  
pp. 266-270 ◽  
Author(s):  
Helga M. Gretarsdottir ◽  
Elin Bjornsdottir ◽  
Einar S. Bjornsson
Keyword(s):  
Prostate Cancer ◽  
Liver Injury ◽  
Causality Assessment ◽  
Acute Liver Injury ◽  
Assessment Method ◽  
Hepatitis Viruses ◽  
Drug Induced ◽  
History Of ◽  
Upper Abdomen ◽  
Liver Tests

We describe a case of acute liver injury and migratory arthralgia in a patient receiving bicalutamide treatment for prostate cancer. A 67-year-old male with metastatic prostate cancer presented with a 6-day history of migratory arthralgia. He had been undergoing treatment with bicalutamide for 4 months; 3 weeks prior to symptom appearance the bicalutamide dose had been increased. He had no other symptoms. Liver tests and inflammatory markers were markedly elevated. Serology for hepatitis viruses A, B, and C, CMV, and EBV and autoimmune causes were all negative, and an ultrasound of the upper abdomen was normal. There was no history of blood transfusion, intravenous drug abuse, or alcohol abuse. Due to the suspicion of a drug-induced symptomatology, bicalutamide was discontinued and the patient started on 30 mg prednisolone daily. Three weeks later he was symptom free and after 6 weeks his liver tests were almost normal. The Roussel Uclaf Causality Assessment Method (RUCAM) suggested a high probability of liver injury. Bicalutamide has very rarely been reported as a causative agent for liver injury and to our knowledge never for migratory polyarthralgia. The migratory polyarthralgia was attributed to bicalutamide due to the absence of other etiological factors and the disappearance of symptoms after discontinuation of the drug. To our knowledge, this is the first published case report of migratory arthralgia and concomitant liver injury attributed to bicalutamide.

Mo1426 – Natural History and Predictors of Poor Outcome Among Patients with Non-Acetaminophen Induced Acute Liver Injury

2019 ◽  
Vol 156 (6) ◽  
pp. S-1303-S-1304
Author(s):  
Ajeet Kumar ◽  
Shahab Abid ◽  
farheen Lubna ◽  
Maira M. Memon
Keyword(s):  
Liver Injury ◽  
Natural History ◽  
Acute Liver Injury ◽  
Poor Outcome

scholarly journals Acute liver injury and anorexia nervosa: a case report

2019 ◽  
Vol 13 (2) ◽  
pp. 128-131
Author(s):  
Simona Pascolini ◽  
Michele Cevolani ◽  
Federico Lari ◽  
Luigi Muratori ◽  
Marco Lenzi
Keyword(s):  
Body Weight ◽  
Anorexia Nervosa ◽  
Liver Injury ◽  
Parenteral Nutrition ◽  
Nutritional Assessment ◽  
Acute Liver Injury ◽  
Transaminase Level ◽  
Progressive Increase ◽  
Psychiatric Institute ◽  
History Of

Anorexia nervosa is an eating disorder characterized by restriction of energy intake leading to a significant decrease in body weight. While it is primarily a psychiatric disorder, numerous medical complications can occur. In this article we describe a case of a 25-year-old woman with a 12-year history of severe restrictive anorexia nervosa that was referred to the Emergency Service of our Hospital, transferred from a psychiatric institute, for severe weight loss, dehydration, and progressive increase in transaminases. During the hospital stay she developed an acute liver injury with an increase in transaminase level up to 40× the ULN. Infective and immunological causes of acute hepatitis were excluded. In the suspect of severe starvation acute liver injury, we performed a nutritional assessment and started parenteral nutrition. After 15 days of parenteral nutrition, she gained 2.5 kg of body weight and liver tests were drastically reduced and nearly normal.

scholarly journals Diphenhydramine as a Cause of Drug-Induced Liver Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Yunseok Namn ◽  
Yecheskel Schneider ◽  
Isabelle H. Cui ◽  
Arun Jesudian
Keyword(s):  
Liver Injury ◽  
Acute Liver Injury ◽  
Chromosomal Translocation ◽  
Altered Mental Status ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Patient Reported ◽  
History Of ◽  
Concomitant Medications ◽  
Unites States

Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history of 13/14-chromosomal translocation presented with fevers, vomiting, and jaundice. Aspartate-aminotransferase and alanine-aminotransferase levels peaked above 20,000 IU/L and 5,000 IU/L, respectively. He developed coagulopathy but without altered mental status. Patient reported taking up to 400 mg diphenhydramine nightly, without concomitant acetaminophen, for insomnia. He denied taking other medications, supplements, antibiotics, and herbals. A thorough workup of liver injury ruled out viral hepatitis (including A, B, C, and E), autoimmune, toxic, ischemic, and metabolic etiologies including Wilson’s disease. A liver biopsy was consistent with DILI without evidence of iron or copper deposition. Diphenhydramine was determined to be the likely culprit. This is the first reported case of diphenhydramine-induced liver injury without concomitant use of acetaminophen.

scholarly journals Rifampicin for Treatment of Cholestatic Pruritus Caused by Drug-Induced Acute Liver Injury as Assessed by the RUCAM Classification

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ali R. Ahmadi ◽  
Maria Chicco ◽  
Marcel van den Berge
Keyword(s):  
Risk Factors ◽  
Liver Injury ◽  
Laboratory Testing ◽  
Acute Liver Injury ◽  
Anabolic Steroids ◽  
Black Market ◽  
Radiographic Imaging ◽  
Drug Induced ◽  
Liver And Kidney ◽  
History Of

A male bodybuilder of 39 years of age developed severe pruritus, nausea, and jaundice after injecting anabolic steroids purchased on the black market. The patient had no history of liver disease and no risk factors for viral hepatitis. Extensive laboratory testing, radiographic imaging, and liver biopsy excluded a majority of potential pathologies. The patient was diagnosed with drug-induced acute liver injury and secondary acute renal failure most likely caused by testosterone purchased on the black market. The pruritus caused insomnia and significant psychological distress. Treatment was initiated with cholestyramine and naltrexone for one week with no effect on the pruritus. Subsequently, all medications were stopped, and rifampicin was started. Pruritus resolved after starting rifampicin, and liver and kidney function improved rapidly and normalized within 5 months.

Sign in / Sign up

Export Citation Format

Share Document