scholarly journals Denosumab-Induced Immune Hepatitis

Biomedicines ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 76
Author(s):  
Viviana Ostrovsky ◽  
Stephen Malnick ◽  
Shahar Ish-Shalom ◽  
Nadya Ziv Sokolowskaia ◽  
Ady Yosepovich ◽  
...  
Keyword(s):  
Endocrine Therapy ◽  
Plasma Cells ◽  
Premature Menopause ◽  
Human Antibody ◽  
Gamma Glutamyl Transferase ◽  
Mineral Density ◽  
Drug Induced ◽  
Duct Carcinoma ◽  
Bile Duct Proliferation ◽  
Glutamyl Transferase

Denosumab–Prolia®, Xgeva® (Amgen) is a fully human antibody to the receptor activator of the nuclear factor-K ligand (RANKL). Hepatotoxicity is extremely rare, with only one reported case of immune origin. We present a second case of hepatotoxicity resulting from an immune reaction to denosumab. A 43-year-old female was referred to the Endocrinology, Diabetes & Metabolism Department for treatment of low bone mineral density (BMD) following endocrine therapy with letrozole and lucrin because of breast cancer. She developed premature menopause at the age of 36 years when she underwent a left lumpectomy due to an infiltrating duct carcinoma of the breast (T1 NO MO) and was subsequently started on endocrine therapy. Denosumab was started to prevent osteoporosis. On the third year after starting on denosumab and one month after she received the last injection, she became ill. The routine biochemical analysis showed that the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) rose appreciatively to 10 times the upper limit of normal (ULN). The gamma-glutamyl transferase (GGT) level was elevated slightly to 67 U/L (0–38 U/L). The serum gamma-globulin level was elevated to 1.72 g/dL (0.7–1.6 gr/dl), while the total bilirubin (TB) and serum albumin levels were normal. A liver biopsy revealed a moderate to severe chronic inflammatory infiltrate containing MUM-1 positive plasma cells. In addition, numerous CD-3 positive small T lymphocytes and few CD-20 positive B lymphocytes and eosinophils were seen in the portal tracts. Moderate to severe interface hepatitis, bile duct proliferation and mild portal fibrosis were also identified. The results could be consistent with the diagnosis of drug-induced liver injury (DILI).

scholarly journals Evaluation of the Acute Hepatoprotective Potential of Hydroethanolic Extract of Duranta erecta L. Parts

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Shadrack Donkor ◽  
Christopher Larbie ◽  
Gustav Komlaga ◽  
Benjamin Obukowho Emikpe
Keyword(s):  
Glutathione Transferase ◽  
Gamma Glutamyl Transferase ◽  
Drug Induced ◽  
Standard Drug ◽  
Major Health Problem ◽  
Major Health ◽  
Liver Structure ◽  
Serum Biochemical ◽  
Glutamyl Transferase ◽  
Hydroethanolic Extract

Liver disease is a major health problem and its treatment is costly in most developing countries with attendant adverse effects. This study aimed at determining the acute hepatoprotective efficacy of Duranta erecta hydroethanolic extracts of leaves, ripe and unripe fruits against CCl4-, and acetaminophen-induced hepatotoxicity in animals. Materials and Methods. CCl4 (1 mL/kg body weight in olive oil) and acetaminophen (500 mg/kg b.wt) were used to induce hepatotoxicity in the animals. Animals were treated with extracts at 250 mg/kg b.wt and standard drug, silymarin (100 mg/kg), for 7 days. Hepatoprotective efficacy was assessed by assaying serum biochemical markers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (γGT), bilirubin (Bil), antioxidative biomarkers including reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione transferase (GST), superoxide dismutase (SOD), malondialdehyde (MDA), hydrogen peroxidase (H202), and nitric oxide (NO), as well as histological observations. Results. Exposure of the animals to CCl4 and acetaminophen resulted in liver injury as evidenced by elevated ALT, AST, ALP, γGT, Bil, MDA, H2O2, and NO levels with resultant derangement in liver microarchitecture. Pretreatment with hydroethanolic extracts, particularly ripe fruits of Duranta erecta, led to a reduction in these indicators and an increase in GSH, GPx, GST, and SOD levels. Biochemical data were supported by improvement in liver structure. Conclusion. The findings suggest that hydroethanolic Duranta erecta ripe fruits extract possesses hepatoprotective and antioxidative activities against CCl4- and acetaminophen-induced toxicity and could be developed as a potent agent for drug-induced liver diseases.

scholarly journals Androgenic anabolic steroid-induced liver injury: two case reports assessed for causality by the updated Roussel Uclaf Causality Assessment Method (RUCAM) score and a comprehensive review of the literature

2020 ◽  
Vol 7 (1) ◽  
pp. e000549
Author(s):  
Robin Daniel Abeles ◽  
Matthew Foxton ◽  
Shahid Khan ◽  
Robert Goldin ◽  
Belinda Smith ◽  
...  
Keyword(s):  
Liver Injury ◽  
Causality Assessment ◽  
Case Reports ◽  
Kidney Injury ◽  
Assessment Method ◽  
Gamma Glutamyl Transferase ◽  
Drug Induced ◽  
Comprehensive Review ◽  
Glutamyl Transferase ◽  
Androgenic Steroids

BackgroundAnabolic androgenic steroids (AAS) usage is widespread and increasing. AAS drug-induced liver injury (DILI) is recognised but its clinical course and management is poorly described. We report 2 cases of AAS DILI with associated renal dysfunction, managed successfully with oral corticosteroids.MethodsA comprehensive review identified 50 further cases to characterise the clinical and biochemical course. Causality grading was calculated using the updated Roussel Uclaf Causality Assessment Method (RUCAM) score. Data are presented as median values.ResultsThe most common AAS taken was methyldrostanolone. Patients commonly present with jaundice and pruritus but may exhibit other constitutional symptoms. Patients presented 56 days after starting, and bilirubin peaked 28 days after stopping, AAS. Causality assessment was ‘unlikely’ in 1 (2%), ‘possible’ in 31 (60%) and ‘probable’ in 20 (38%). Peak values were: bilirubin 705 μmol/L, alanine transaminase 125 U/L, aspartate transaminase 71 U/L, alkaline phosphatase 262 U/L, gamma-glutamyl transferase 52 U/L, international normalised ratio 1.1. Liver biopsies showed ‘bland’ canalicular cholestasis. 43% of patients developed kidney injury (peak creatinine 225 μmol/L). Therapies included antipruritics, ursodeoxycholic acid and corticosteroids. No patients died or required liver transplantation.ConclusionsPhysicians are likely to encounter AAS DILI. Causality assessment using the updated RUCAM should be performed but defining indications and proving efficacy for therapies remains challenging.

Monitoring of liver function in major depressive disorder treated with SSRI

2016 ◽  
Vol 33 (S1) ◽  
pp. S158-S158
Author(s):  
P. Ifteni ◽  
A. Teodorescu
Keyword(s):  
Major Depressive Disorder ◽  
Liver Function ◽  
Depressive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Gamma Glutamyl Transferase ◽  
Major Depressive ◽  
Drug Induced ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Glutamyl Transferase

BackgroundMajor depressive disorder is one of the most prevalent psychiatric illnesses in the world affecting more than 12% of men and more than 21% of women in their lifetime. Selective serotonin reuptake inhibitors (SSRIs) are worldwide prescribed to treat depression. SSRIs drugs can cause drug-induced liver injury (DILI).AimsThe aim of the study was to evaluate the liver function in patients treated with SSRI in order to detect DILI.MethodsAll the patients with first major depressive episode treated with the same SSRI antidepressant for at least 3 months between September 2013 and September 2015 were entered into the study. The hepatic function panel included aminotransferases, total and direct bilirubin, albumin, total protein, gamma glutamyl transferase (GGT), LDH cholesterol, hepatitis B virus (HBV), and hepatitis C virus (HCV).ResultsOf 134 subjects with MDD according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) who met inclusion criteria, 98 patients entered into study. Seventy-seven (76.5%) were treated with SSRI for at least 3 months with mean age were 45.4 (SD = 6.3), 65 women (66.3%). Five patients (5.1%) were newly diagnosed with hepatitis, and 10 (10.2%) presented elevated values of ALT, AST. The mean duration of depressive symptoms was 9.2 months (SD = 6.9).ConclusionsThe treatment with SSRI seems to be effective and safe in our sample. A relative small number of patients with MDD were diagnosed with viral hepatitis during this cross-sectional study. Further randomized and controlled trials are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051986628
Author(s):  
Jiaxin Li ◽  
Shijie Zhuo ◽  
Binghong Chen ◽  
Yang Liu ◽  
Hong Wu
Keyword(s):  
Obstructive Jaundice ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Serum Total Bilirubin ◽  
Gamma Glutamyl Transferase ◽  
Malignant Obstructive Jaundice ◽  
Duct Carcinoma ◽  
The Mean ◽  
Glutamyl Transferase

Objective This study was performed to summarize our experience and investigate the safety and efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice. Methods Thirteen patients with malignant obstructive jaundice who underwent laparoscopic modified loop cholecystojejunostomy from March 2015 to March 2016 were retrospectively reviewed. The patients’ characteristics, operation time, postoperative intestinal recovery time, length of hospital stay, postoperative bilirubin level, and complications were analyzed. Results The patients were followed up as outpatients for 2 years. Nine patients with pancreatic head carcinoma, one patient with periampullary carcinoma, and three patients with distal bile duct carcinoma successfully underwent laparoscopic modified loop cholecystojejunostomy. The mean operation time was 176 ± 45 minutes, and the mean length of hospital stay was 9.5 ± 2.8 days. The serum total bilirubin concentration and gamma-glutamyl transferase concentration significantly decreased on postoperative day 7. The median follow-up time was 7 months. No patients developed bile leakage or required a reoperation. Conclusions Laparoscopic modified loop cholecystojejunostomy is not only safe and minimally invasive, but it is also feasible for patients with malignant obstructive jaundice.

scholarly journals Coronavirus Disease-19 and Liver Injury

2020 ◽  
Vol 8 (T1) ◽  
pp. 154-157
Author(s):  
Gontar Alamsyah Siregar ◽  
Ginanda Putra Siregar ◽  
Darmadi Darmadi ◽  
Riska Habriel Ruslie
Keyword(s):  
Liver Injury ◽  
Liver Enzymes ◽  
Gamma Glutamyl Transferase ◽  
Converting Enzyme ◽  
Drug Induced ◽  
Angiotensin Converting Enzyme 2 ◽  
Cytopathic Effects ◽  
Elevated Liver Enzymes ◽  
Apoptotic Activity ◽  
Glutamyl Transferase

Coronavirus Disease (COVID)-19 is a pandemic since March 11, 2020. The total case is more than a half million worldwide. Liver injury is quite common in COVID-19 patients. Direct viral infection is possible due to the presence of angiotensin converting enzyme 2 in cholangiocytes and hepatocytes. Other proposed mechanisms are virus-induced cytopathic effects, inflammation process, hypoxia and shock, increased apoptotic activity, increased positive end expiratory effect, and drug-induced. The manifestation of liver injury is mild and transient with elevated liver enzymes, bilirubin, and gamma-glutamyl transferase levels. Deterioration of liver function can occur in subjects with COVID-19 and underlying liver injury. The management is principally supportive. Hepatoprotective drugs may be administered in severe cases.

Recovery from LCDD-associated Severe Liver Cholestasis: a Case Report and Literature Review

2016 ◽  
Vol 25 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Benoit Brilland ◽  
Johnny Sayegh ◽  
Anne Croue ◽  
Frank Bridoux ◽  
Jean-François Subra ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Light Chain ◽  
Intrahepatic Cholestasis ◽  
Relevant Literature ◽  
Gamma Glutamyl Transferase ◽  
Light Chain Deposition Disease ◽  
Deposition Disease ◽  
Uncommon Presentation ◽  
Light Chain Deposition ◽  
Glutamyl Transferase

Light chain deposition disease (LCDD) is a rare multisystemic disorder associated with plasma cell proliferation. It mainly affects the kidney, but liver and heart involvement may occur, sometimes mimicking the picture of systemic amyloidosis. Liver disease in LCDD is usually asymptomatic and exceptionally manifests with severe cholestatic hepatitis. We report the case of a 66-year-old female with κ-LCDD and cast nephropathy in the setting of symptomatic multiple myeloma who, after a first cycle of bortezomib-dexamethasone chemotherapy, developed severe and rapidly worsening intrahepatic cholestasis secondary to liver κ-light chain deposition. Intrahepatic cholestasis was attributed to LCDD on the basis of the liver histology and exclusion of possible diagnoses. Chemotherapy was maintained and resulted in progressive resolution of cholestasis. We report here an uncommon presentation of LCDD, with prominent liver involvement that fully recovered with bortezomib-based chemotherapy, and briefly review the relevant literature. Abbreviations: AKI: Acute kidney injury; ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; CMV: Cytomegalovirus; EBV: Epstein–Barr virus; GGT: gamma-glutamyl transferase; HSV: Herpes simplex virus; LC: light chain; LCDD: Light chain deposition disease; MIDD: Monoclonal immunoglobulin deposition disease; MM: Multiple myeloma.

Evaluation of Hematological and Biochemical Changes in Dromedary Camel during the Different Stages of Lactation

2020 ◽  
Vol 21 (3) ◽  
pp. 121-124
Author(s):  
Ahmed El-Sayed
Keyword(s):  
Organic Phosphorus ◽  
Hemoglobin Concentration ◽  
Controlled Study ◽  
Mean Corpuscular Hemoglobin ◽  
Dromedary Camel ◽  
Gamma Glutamyl Transferase ◽  
Corpuscular Hemoglobin ◽  
Stage Of Lactation ◽  
Group 2 ◽  
Glutamyl Transferase

Objective: To assess the potential hematobiochemical alterations in healthy dromedary camel during the different stages of lactation. Design: Randomized controlled study. Animals: Fifteen healthy female dromedary camels, with mean body weight of 499.6 kg and mean age of 20 years. Procedures: Camels were categorized into 3 groups' according to their stage of lactation: group 1, early lactation (1-3 months), group 2, mid-lactation (four-6 months) and group3, late lactation (≥ 7 months). Blood samples were collected from every animals for hematological and biochemical evaluation. Results: Total erythrocyte count (TEC), hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), total leukocytes (TLC), lymphocytes, neutrophils, monocytes, Calcium, glucose, aspartate aminotransferase (AST), alanine transaminase (ALT), gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) confirmed significant (p < 0.05) variation between different stages of lactation. However, non-notable (p > 0.05) dissimilarity were located in packed cell volume (PCV), mean corpuscular hemoglobin concentration (MCHC), in organic phosphorus (P), magnesium (Mg), cholesterol, total protein (TP), albumen, globulin, blood urea nitrogen (BUN) and creatinine kinase (CK) in the course of different ranges of lactation, Conclusion and clinical relevance: The results of this investigation may be useful as reference guide for dromedary camel to evaluate the metabolic health status at different stages of lactation.

Interactions Between Dental Composite Resins and Saliva A comparative biochemical in vitro study

2019 ◽  
Vol 56 (3) ◽  
pp. 529-533
Author(s):  
Mihaela Pantea ◽  
Diana Andreea Ighigeanu ◽  
Alexandra Totan ◽  
Maria Greabu ◽  
Daniela Miricescu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
In Vitro Study ◽  
Composite Resins ◽  
Vitro Study ◽  
Dental Composite ◽  
Gamma Glutamyl Transferase ◽  
Specific Protocol ◽  
Dental Composite Resins ◽  
Glutamyl Transferase

This in vitro study analyses the biochemical interaction between saliva and three types of dental composite resins (a direct resin, an indirect resin and a dual-cure resin used for cementation of indirect dental restorations). The resin samples were obtained following a specific protocol and in line with the producers� recommendations; the resin samples were incubated with saliva samples collected from 19 healthy volunteers. The obtained results showed that the tested composite resins did not produce significant changes in oxidative stress parameters that were analysed (albumin, uric acid, GGT / gamma glutamyl transferase, OXSR-1 / oxidative stress responsive kinase 1) and do not influence the inflammatory salivary status reflected by the levels of IL-6 - an inflammatory marker.

scholarly journals Biochemical abnormalities in COVID-19: a comparison of white versus ethnic minority populations in the UK

2021 ◽  
pp. jclinpath-2021-207446
Author(s):  
David R Taylor ◽  
Devon Buchanan ◽  
Wiaam Al-Hasani ◽  
Jessica Kearney ◽  
Tina Mazaheri ◽  
...  
Keyword(s):  
Intensive Care ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Troponin T ◽  
Minority Group ◽  
Patient Data ◽  
Minority Population ◽  
Gamma Glutamyl Transferase ◽  
Ethnic Minority Population ◽  
Glutamyl Transferase

AimsPublic Health England has identified that in COVID-19, death rates among ethnic minorities far exceeds that of the white population. While the increase in ethnic minorities is likely to be multifactorial, to date, no studies have looked to see whether values for routine clinical biochemistry parameters differ between ethnic minority and white individuals.MethodsBaseline biochemical data for 22 common tests from 311 SARS-CoV-2 positive patients presenting to hospital in April 2020 in whom ethnicity data were available was retrospectively collected and evaluated. Data comparisons between ethnic minority and white groups were made for all patient data and for the subset of patients subsequently admitted to intensive care.ResultsWhen all patient data were considered, the ethnic minority population had statistically significant higher concentrations of C reactive protein (CRP), aspartate aminotransferase and gamma-glutamyl transferase, while troponin T was higher in the white group. A greater proportion of ethnic minority patients were subsequently admitted to intensive care, but when the presenting biochemistry of this subset of patients was compared, no significant differences were observed between ethnic minority and white groups.ConclusionOur data show for the first time that routine biochemistry at hospital presentation in COVID-19 differs between ethnic minority and white groups. Among the markers identified, CRP was significantly higher in the ethnic minority group pointing towards an increased tendency for severe inflammation in this group.

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