scholarly journals Case Report On Hepatorenal Syndrome

2021 ◽  
Vol 11 (4) ◽  
Keyword(s):  
Case Report ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Hepatorenal Syndrome ◽  
Early Stage ◽  
Clinical History ◽  
Chronic Liver ◽  
Renal Vasoconstriction ◽  
Stage Of Diagnosis ◽  
Physical Findings

Hepatorenal syndrome (HRS) is a potentially reversible renal impairment where the kidney function is stopped due to renal vasoconstriction resulting from extreme vasodilation. This case report describes a 64 year old female with Decompensated Chronic Liver Disease. Her clinical history and physical findings shows a decreased renal function secondary to chronic liver disease and was later diagnosed as HRS. HRS can be managed effectively with Terlipressin, Midodrine, Albumin. Such combination therapy at the early stage of diagnosis can prevent further complications. Keywords: HRS, CLD, Albumin, Terlipressin, Midodrine.

scholarly journals Helicobacter pylori Infection as a Risk Factor for Hepatocellular Carcinoma: A Case-Control Study in Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hailemichael Desalegn Mekonnen ◽  
Henok Fisseha ◽  
Tewodros Getinet ◽  
Fisseha Tekle ◽  
Peter R. Galle
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Case Control Study ◽  
Clinical History ◽  
Case Control ◽  
Chronic Liver ◽  
P Value ◽  
H Pylori ◽  
Control Study

Background and Aims.Hepatocellular carcinoma is a major cause of cancer death worldwide, accounting for over half a million deaths per year. Its incidence varies with geographic locations and the type of etiologic factors. In Ethiopia, unidentified causes of liver disease are of sizeable proportion. Recent studies have shown an association of H. pylori infection with different spectrums of chronic liver disease. This study was conducted at St. Paul’s Hospital Millennium Medical College in Ethiopia and assesses liver cancer and the association with H. pylori infection.Method.A prospective case-control study conducted on patients with chronic liver disease presenting with a suspicious liver lesion and diagnosed to have HCC in the Gastrointestinal (GI) Clinic of St. Paul’s Hospital MMC from Dec 30, 2016, to Nov 1, 2017 G.C. Descriptive surveys on clinical history and physical examination and laboratory profiles were obtained, and the clinical course of the patients including the type of treatment was followed prospectively. Control cases were taken from adult patients without evidence of liver disease in the internal medicine clinic coming for routine evaluation. After collection data were analyzed using SPSS version 23 and associations were assessed using chi-square test. Binary logistic regression was used to assess the association of HCC with different variables and H. pylori infection. All variables with p-value <0.05 were considered as statistically significant.Results.One hundred twenty patients were analyzed with equal representation of cases and controls. The majority of patients with HCC were male with a mean age of 36 years. Older age adjusted Odds Ratio (AOR) (95%CI, p-value) 1.07(1.03-1.09, <0.001), viral hepatitis B (AOR) (95%CI, p-value) 6.19 (1.92-19.93, 0.002), and H. pylori infection (AOR) (95%CI, p-value) 5.22 (2.04–13.31, <0.001) were statistically significantly associated with HCC.Conclusion.H. pylori infection is associated with HCC in this case-control study. This study supports the emerging evidence of H. pylori association with other extra-gastric manifestations.

scholarly journals Growth rate of early-stage hepatocellular carcinoma in patients with chronic liver disease

2015 ◽  
Vol 21 (3) ◽  
pp. 279 ◽  
Author(s):  
Chansik An ◽  
Youn Ah Choi ◽  
Dongil Choi ◽  
Yong Han Paik ◽  
Sang Hoon Ahn ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Growth Rate ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Early Stage ◽  
Chronic Liver

Targeting the gut-liver-immune axis to treat cirrhosis

Gut ◽  
2020 ◽  
pp. gutjnl-2020-320786 ◽  
Author(s):  
Thomas Henry Tranah ◽  
Lindsey A Edwards ◽  
Bernd Schnabl ◽  
Debbie Lindsay Shawcross
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Bacterial Infections ◽  
Hepatorenal Syndrome ◽  
Intestinal Barrier ◽  
Chronic Liver ◽  
Decompensated Cirrhosis ◽  
Barrier Dysfunction ◽  
Bacterial Peritonitis ◽  
Gut Barrier Function

Cirrhotic portal hypertension is characterised by development of the decompensating events of ascites, encephalopathy, portal hypertensive bleeding and hepatorenal syndrome, which arise in a setting of cirrhosis-associated immune dysfunction (CAID) and define morbidity and prognosis. CAID describes the dichotomous observations that systemic immune cells are primed and display an inflammatory phenotype, while failing to mount robust responses to pathogen challenge. Bacterial infections including spontaneous bacterial peritonitis are common complications of advanced chronic liver disease and can precipitate variceal haemorrhage, hepatorenal syndrome and acute-on-chronic liver failure; they frequently arise from gut-derived organisms and are closely linked with dysbiosis of the commensal intestinal microbiota in advanced chronic liver disease.Here, we review the links between cirrhotic dysbiosis, intestinal barrier dysfunction and deficits of host-microbiome compartmentalisation and mucosal immune homoeostasis that occur in settings of advanced chronic liver disease. We discuss established and emerging therapeutic strategies targeted at restoring intestinal eubiosis, augmenting gut barrier function and ameliorating the mucosal and systemic immune deficits that characterise and define the course of decompensated cirrhosis.

CASE REPORT: Primary hepatic lymphoma associated with chronic liver disease

1997 ◽  
Vol 12 (3) ◽  
pp. 237-242 ◽  
Author(s):  
TAKAKAZU HIGUCHI ◽  
KAZUHIKO NOMOTO ◽  
HIRAKU MORI ◽  
HARUO NIIKURA ◽  
MITSUHIRO OMINE ◽  
...  
Keyword(s):  
Case Report ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Primary Hepatic Lymphoma

Liver resection for multifocal hepatocellular carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 355-355 ◽  
Author(s):  
Peter Tae Wan Kim ◽  
Jihyun Jang ◽  
Sandra Fischer ◽  
Paul David Greig ◽  
Steven Gallinger ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Liver Resection ◽  
Chronic Liver Disease ◽  
Early Stage ◽  
Chronic Liver ◽  
Term Survival ◽  
Liver Resections ◽  
Common Etiology ◽  
Multifocal Disease

355 Background: Liver resection for multifocal hepatocellular carcinoma (HCC) is controversial. This study was conducted to outline our institution’s experience with liver resection for multifocal HCC. Methods: A retrospective review of patients who underwent liver resections from 1992 to 2011 for histologically confirmed hepatocellular carcinoma was performed. Multifocal disease was defined as more than 1 histologically proven HCC found in the liver resection specimens. Results: Of the 386 liver resections performed for HCC, 47 were performed for multifocal disease. Mean age was 60+11 years, and most patients (92%) had chronic liver disease. Hepatitis B was the most common etiology (60%), followed by hepatitis C (26%), and other etiologies (15%). Most patients were Child’s class A (89%). Most patients had intermediate Barcelona Clinic Liver Cancer (BCLC) stage (stage B) tumors (81%) and a minority of patients had early stage tumors (BCLC stage A, 19%). Major hepatectomy (>2 segments) was performed in 87% with an in hospital mortality of 6.4%. Major complications (Clavien-Dindo scale >3) occurred in 4 patients (9%). Median length of stay was 7 days and the rate of liver failure was 4.3%. Mean tumor number was 3+2 and the size of the largest lesion was 5+3 cm. Cirrhosis was present in 51% of patients. Majority of tumors were moderately differentiated (60%) and vascular invasion was present in 42%. The recurrence rate was 57% and the liver was the most common site of recurrence (81%). Treatment of recurrences occurred in 74% of patients: ablation (33%), chemotherapy (11%), transarterial chemoembolization (11%), resection (7.4%), sorafenib/radiation (7.4%) and transplantation (3.7%). Median disease free interval was 8 months and the overall survival was 18 months Conclusions: Liver resection for multifocal HCC can be performed safely in patients with chronic liver disease. Long term survival can be achieved in these patients and it should be considered as an option.

scholarly journals Prognostic role of lipids, apolipoproteins in patients with resectable hepatocellular carcinoma

2020 ◽  
Author(s):  
Xiaochun Ni ◽  
Yong Yi ◽  
Yipeng Fu ◽  
Xiaoyan Cai ◽  
Gao Liu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Early Stage ◽  
Benign Lesion ◽  
Expression Patterns ◽  
Multivariable Analysis ◽  
Early Recurrence ◽  
Chronic Liver ◽  
Significant Differential Expression ◽  
Prognostic Stratification

Abstract Background: To further clarify the association between abnormal levels of serum lipid components as the main features of dyslipidaemia and hepatocellular cancinima, which remains unclear.Methods: We examined the serum level of lipids and apolipoproteins pattern in 471 patients undergoing curative resection for HCC, 193 patients with chronic liver disease, and 104 patients with benign liver diseases. We performed uni- and multivariate analyses to evaluate the predictive roles of lipids and apolipoproteins for recurrence and survival of HCC in a training cohort of 242 patients and then validated in a cohort of 229 patients.Results: The majority circuling lipid and apolipoprotein levels such as ApoA1, HDL, LDL in chronic liver disease and HCC were slight to significantly decreased as compared with those in benign lesion. But no significant differential expression patterns of lipids and apolipoproteins were observed between chronic liver hepatitis and HCC. Multivariable analysis identified ApoA1 as a key parameter related to recurrence and survival in both training and validation cohorts. Moreover, we further demonstrated that low ApoA1 was an independent prognostic factor of poor early recurrence in two cohorts.Conclusions: Although the alterations of circulating lipids and apolipoproteins were observed in HCC, none of lipids and apolipoproteins could serve as a diagnostic marker. Serum ApoA1 merits consideration as a novel prognostic marker for patients with HCC undergoing surgery, since it predicts early recurrence and survival, especially for early stage patients and may improve the prognostic stratification of patients for clinical management and promote HCC clinic outcomes.

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