scholarly journals Cryptosporidiosis in patients with diarrhea and chronic liver diseases

2014 ◽  
Vol 8 (12) ◽  
pp. 1584-1590 ◽  
Author(s):  
Nasser Mousa ◽  
Ahmed Abdel-Razik ◽  
Hala El-Nahas ◽  
Atef El-Shazly ◽  
Mohammad Abdelaziz ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Diseases ◽  
Meld Score ◽  
Chronic Liver ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cryptosporidium Infection ◽  
Chronic Liver Diseases ◽  
Pugh Class ◽  
Class C ◽  
Precipitating Factor

Introduction: The aim of this study was to evaluate the epidemiology and clinical significance of Cryptosporidium in patients with diarrhea and chronic liver diseases. Methodology: The study included 150 patients with chronic liver diseases and diarrhea, and 50 subjects with diarrhea as a control group. Stool samples were screened for the presence of Cryptosporidium by microscopic examination after modified Ziehl-Neelsen staining and detection of Cryptosporidium coproantigen by enzyme-linked immunosorbent assay (ELISA). Results: The prevalence of Cryptosporidium infection in patients with chronic liver diseases was 30% (45/150) versus 14% (7/50) in controls. Cryptosporidium infection increased with the progression of chronic liver diseases from Child-Pugh class A to Child-Pugh class C (p<  0.001) and from model for end-stage liver disease (MELD) score ≤ 9 to MELD score > 9 (p< 0.031). Nine patients in Child-Pugh class C with diarrhea associated with Cryptosporidium infection developed hepatic encephalopathy, and only diarrhea was identified as a precipitating factor for hepatic encephalopathy. Conclusions: Cryptosporidium is one of the important causes of diarrhea in patients with chronic liver diseases. The infection significantly increased with the progression of chronic liver diseases. In patients with advanced chronic liver diseases, Cryptosporidium infection may be a precipitating factor of hepatic encephalopathy.

scholarly journals Prevalence and Clinical Significance of Immunoglobulin A Antibodies against Tissue Transglutaminase in Patients with Diverse Chronic Liver Diseases

2005 ◽  
Vol 12 (8) ◽  
pp. 941-948 ◽  
Author(s):  
Anastasios E. Germenis ◽  
Efthalia E. Yiannaki ◽  
Kalliopi Zachou ◽  
Violeta Roka ◽  
Sotirios Barbanis ◽  
...  
Keyword(s):  
Liver Disease ◽  
Clinical Significance ◽  
Liver Diseases ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Chronic Liver ◽  
Intestinal Biopsy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Liver Diseases ◽  
Hla Dq

ABSTRACT The prevalence of celiac disease (CD) and the prevalence and clinical significance of anti-tissue transglutaminase (tTG) antibodies (tTGAbs) in a large series of patients with chronic liver diseases were assessed. We studied 738 patients (462 with chronic viral hepatitis, 117 with autoimmune liver diseases, 113 with alcoholic or nonalcoholic fatty liver disease, and 46 with other liver disorders) and 1,350 healthy controls (HC). Immunoglobulin A (IgA) tTGAbs were measured by enzyme-linked immunosorbent assay and a microsphere-based flow cytometric assay. Positive sera were investigated for IgA antiendomysial antibodies (EmA). IgA tTGAb-positive subjects were invited to undergo a small-intestinal biopsy and HLA-DQ allele typing. Four of 1,350 HC (0.3%) tested tTGAb+ EmA+ and underwent a biopsy (CD confirmation in all). Four of 738 liver disease patients tested tTGAbs+ EmA+ (0.54%; not statistically significant). Two were HCV infected (1.24%; not statistically significant), and two had transaminasemia of unknown origin. Forty-three patients tested tTGAbs+ EmA− (5.8%; P < 0.001 compared to HC). Inhibition experiments verified the existence of specific IgA anti-tTG reactivity. Twenty-six of 43 patients underwent a biopsy (all negative for CD). Binary logistic regression analysis revealed age (P = 0.008), cirrhosis (P = 0.004), alkaline phosphatase (P = 0.026), and antinuclear antibodies (P = 0.012) as independent risk factors for tTGAb reactivity among the patients. It was concluded that CD prevalence is the same in HC and patients with chronic liver diseases. The prevalence of tTGAbs is higher in hepatic patients compared to HC, but their specificity for CD diagnosis in this group of patients is low. tTGAbs in patients appear to be associated with the presence of autoimmunity, cirrhosis, and cholestasis, irrespective of the origin of the liver disease.

scholarly journals Immune Responses to Bile-Tolerant Helicobacter Species in Patients with Chronic Liver Diseases, a Randomized Population Group, and Healthy Blood Donors

2002 ◽  
Vol 9 (6) ◽  
pp. 1160-1164 ◽  
Author(s):  
Olga Ananieva ◽  
Ingrid Nilsson ◽  
Tamara Vorobjova ◽  
Raivo Uibo ◽  
Torkel Wadström
Keyword(s):  
Cell Surface ◽  
Liver Diseases ◽  
Blood Donors ◽  
Population Group ◽  
Cross Reactivity ◽  
Chronic Liver ◽  
Antibody Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Liver Diseases ◽  
H Pylori

ABSTRACT Bile-tolerant Helicobacter species such as Helicobacter pullorum, Helicobacter bilis, and Helicobacter hepaticus are associated with hepatic disorders in animals and may be involved in the pathogenesis of chronic liver diseases (CLD) in humans. Antibody responses to cell surface proteins of H. pullorum, H. bilis, and H. hepaticus in serum samples from patients with CLD, a randomized population group, and healthy blood donors were evaluated by using enzyme linked immunosorbent assay (ELISA). The results were compared with the antibody responses to Helicobacter pylori. For analysis of a possible cross-reactivity between bile-tolerant Helicobacter species and H. pylori, sera from a subpopulation of each group were absorbed with a whole-cell extract of H. pylori and retested by ELISA. Results before absorption showed that the mean value of the ELISA units for H. pullorum was significantly higher in patients with CLD than in healthy blood donors (P = 0.01). Antibody reactivity to cell surface protein of H. hepaticus was also significantly higher in the CLD patients than in the healthy blood donors and the population group (P = 0.005 and P = 0.002, respectively). Following the absorption, antibody responses to H. pullorum decreased significantly in all three groups (P = 0.0001 for CLD patients, P = 0.0005 for the population group, and P < 0.0001 for the blood donors), indicating that cross-reactivity between H. pylori and other Helicobacter spp. occurs. The antibody responses to H. hepaticus and H. bilis in CLD patients remained high following absorption experiments compared to ELISA results before absorption. The significance of this finding requires further investigations.

A comparative study to determine the short-term mortality and clinical improvement in hepatic encephalopathy using either rifaximin and or lactulose

2021 ◽  
Vol 12 (3) ◽  
pp. 46-50
Author(s):  
Uttam Biswas ◽  
Shyamal Kanti Pal ◽  
Pallabi Ray Chaudhuri ◽  
Debanjan Roychowdhury ◽  
Abhranil Dhar ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Clinical Outcome ◽  
Clinical Improvement ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Precipitating Factors ◽  
Chronic Liver Diseases ◽  
Short Term ◽  
Significant Difference ◽  
Short Term Mortality

Background: Hepatic encephalopathy can be reversed by correcting precipitating factors and efficiently managed by lactulose and or rifaximin. Aims and Objective: The aim of this study to compare the effectiveness of three different modes of treatment in our study populations. Materials and Methods: Ninety patients of decompensated chronic liver diseases were selected and randomised to treat with either lactulose or rifaximin or both lactulose and rifaximin (30 patients in each group) for 7 days. Clinical outcome and short term mortality were noted in each group of treatment. This study was to review the comparison of the effectiveness of Rifaximin (1200mg/day , in 3 divided doses ) alone or in combination with Lactulose (60gram/day ,in divided doses) or Lactulose (60gram/day) alone to reduce the short term mortality and clinical improvement in hepatic encephalopathy of any grade of any cause in adult (>18 years) admitted patients of decompensated chronic liver diseases. Result: Clinical improvement was noted in all three modes of treatment but there is no statistically significant difference in clinical improvement of hepatic encephalopathy when compared amongst each of three modes of treatment. There was obvious reduction of short term mortality or clinical down gradation of hepatic encephalopathy grade after 7 days treatment using lactulose or rifaximin or combined lactulose and rifaximin but there was no statistically significant difference in this regard among these three modes of treatment. Conclusion: All three modes of treatment are equally effective though combination therapy is little better.

Detection of Anti-LKM-1(Anti-CYP2D6) by an: Enzyme-Linked Immunosorbent Assay in Adult Patients with Chronic Liver Diseases

Autoimmunity ◽  
1999 ◽  
Vol 30 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Hiroshi Miyakawa ◽  
Eriko Kikazawa ◽  
Kazuhiro Abe ◽  
Kentaro Kikuchi ◽  
Hirotoshi Fujikawa ◽  
...  
Keyword(s):  
Immunosorbent Assay ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Adult Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Liver Diseases

scholarly journals MELD score exception overemphasizes the benefits to hepatocellular carcinoma patients in transplant. A proposal to improve the rules

2017 ◽  
Vol 20 (4) ◽  
pp. 6-14
Author(s):  
Agnaldo Soares Lima ◽  
Nathália Nunes Godinho Lopes ◽  
Bárbara Buitrago Pereira ◽  
Leandro Ricardo Navarro Amado
Keyword(s):  
Liver Diseases ◽  
Alcoholic Cirrhosis ◽  
Meld Score ◽  
Chronic Liver ◽  
Organ Distribution ◽  
Chronic Liver Diseases ◽  
Patients With Cancer ◽  
End Stage ◽  
Transplanted Organs ◽  
Regional Variable

Purpose: In Model for End-stage Liver Disease (MELD)-based allocation systems patients with cancer and some other diseases are assigned a special score. The goal of this study was to assess the fairness of organ distribution by the MELD system among different groups of diseases. Methods: Retrospective study with adult patients between 2009 and 2013. Demographics and MELD scores were compared with the incidence of transplant or death, patient origin and disease groups. Results: 260 selected patients were submitted to transplant or died before the transplant. Their median age was 54.9 years (12.1 -73.9 years); 70.4% were men; 63.3% had chronic liver diseases (alcoholic cirrhosis 33.1%, C-virus cirrhosis 24.2%). Exception score was assigned to 26.5% of listed patients. These patients received 31% of transplanted organs and had lower pre-transplant mortality or dropout (14.2 times less) rates than the other patients (p <0.001). Receiving exception points resulted in a higher likelihood of being transplanted. Conclusion: The authors propose the use of a regional variable score for transplantation in special situations, which should be based on the median MELD score of the latest transplants for chronic liver diseases, to refrain from harming patients who have access to transplant according to the calculated MELD score.

scholarly journals Impact of Hepatic Encephalopathy on Clinical Characteristics and Adverse Outcomes in Prospective and Multicenter Cohorts of Patients With Acute-on-Chronic Liver Diseases

2021 ◽  
Vol 8 ◽  
Author(s):  
Liyuan Long ◽  
Hai Li ◽  
Guohong Deng ◽  
Xianbo Wang ◽  
Sihong Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Liver Diseases ◽  
Clinical Characteristics ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Independent Risk Factors ◽  
Grade 3

Importance: Hepatic encephalopathy is a severe complication, and its contribution to clinical adverse outcomes in patients with acute-on-chronic liver diseases from the East is unclear.Objective: We aimed to investigate the impact of hepatic encephalopathy on clinical characteristics and adverse outcomes in prospective and multicenter cohorts of patients with acute-on-chronic liver diseases.Design: We conducted a cohort study of two multicenter prospective cohorts.Setting: China.Participants: Acute-on-chronic liver disease patients with various etiologies.Exposure: The diagnosis and severity of hepatic encephalopathy were assessed using the West Haven scale.Main Outcome Measure: The correlation between clinical adverse outcomes and varying hepatic encephalopathy grades was analyzed in the target patients.Results: A total of 3,949 patients were included, and 340 of them had hepatic encephalopathy. The incidence of hepatic encephalopathy was higher in patients with alcohol consumption (9.90%) than in those with hepatitis B virus infection (6.17%). The incidence of 28- and 90-day adverse outcomes increased progressively from hepatic encephalopathy grades 1–4. Logistic regression analysis revealed that hepatic encephalopathy grades 3 and 4 were independent risk factors for the 28- and 90-day adverse outcome in the fully adjusted model IV. Stratified analyses showed similar results in the different subgroups. Compared to grades 1–2 and patients without hepatic encephalopathy, those with grade 3 hepatic encephalopathy had a significant increase in clinical adverse outcomes, independent of other organ failures.Conclusions and Relevance: Hepatic encephalopathy grades 3–4 were independent risk factors for 28- and 90-day adverse outcomes. Hepatic encephalopathy grade 3 could be used as an indicator of brain failure in patients with acute-on-chronic liver disease.

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