scholarly journals Fibrinogen-Fibrin Monomer Complexes in Cirrhosis of The Liver

1977 ◽  
Author(s):  
S. Coccheri ◽  
G. Palareti ◽  
M. Poggi ◽  
G. Oca
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Plasma Samples ◽  
Severe Liver ◽  
Decompensated Liver Cirrhosis ◽  
Chronic Active Liver Disease ◽  
Fibrin Monomer ◽  
Cirrhotic Patients ◽  
Normal Controls

Positivity of paracoagulation tests in a previously studied group of 80 patients with chronic active liver disease did not exceed 5-10% of the cases. In the present study, plasma samples from 20 cases of decompensated liver cirrhosis, assessed by liver biopsy, were investigated by means of agarose cromatography. Fibrinogen related materials were measured immunologically and by Staphylococcal Clumping Test.First appearance of fibrinogen-like materials occurred at earlier fractions in cirrhotic patients in comparison with normal controls. The relative amount of soluble fibrin monomer complexes (SFMC) as referred to total fibrinogen was significantly increased. No correlation was found between the amount of SFMC and the severity of fibrinogen polymerisation defect.Circulating SFMC are therefore present in severe liver cirrhosis. However, DIC may not be the only proposed explanation for this finding.

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

scholarly journals Patterns of dendritic cell and monocyte subsets are associated with disease severity and mortality in liver cirrhosis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chandra Chiappin Cardoso ◽  
Camila Matiollo ◽  
Carolina Hilgert Jacobsen Pereira ◽  
Janaina Santana Fonseca ◽  
Helder Emmanuel Leite Alves ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Dendritic Cell ◽  
Disease Severity ◽  
Advanced Liver Disease ◽  
Hla Dr ◽  
Acute Decompensation ◽  
Cirrhotic Patients ◽  
Classical Monocytes

AbstractLiver cirrhosis is often complicated by an immunological imbalance known as cirrhosis-associated immune dysfunction. This study aimed to investigate disturbances in circulating monocytes and dendritic cells in patients with acute decompensation (AD) of cirrhosis. The sample included 39 adult cirrhotic patients hospitalized for AD, 29 patients with stable cirrhosis (SC), and 30 healthy controls (CTR). Flow cytometry was used to analyze monocyte and dendritic cell subsets in whole blood and quantify cytokines in plasma samples. Cirrhotic groups showed higher frequencies of intermediate monocytes (iMo) than CTR. AD patients had lower percentages of nonclassical monocytes than CTR and SC. Cirrhotic patients had a profound reduction in absolute and relative dendritic cell numbers compared with CTR and showed higher plasmacytoid/classical dendritic cell ratios. Increased plasma levels of IL-6, IL-10, and IL-17A, elevated percentages of CD62L+ monocytes, and reduced HLA-DR expression on classical monocytes (cMo) were also observed in cirrhotic patients. Patients with more advanced liver disease showed increased cMo and reduced tissue macrophages (TiMas) frequencies. It was found that cMo percentages greater than 90.0% within the monocyte compartment and iMo and TiMas percentages lower than 5.7% and 8.6%, respectively, were associated with increased 90-day mortality. Monocytes and dendritic cells are deeply altered in cirrhotic patients, and subset profiles differ between stable and advanced liver disease. High cMo and low TiMas frequencies may be useful biomarkers of disease severity and mortality in liver cirrhosis.

scholarly journals Effect of taurine administration for muscle cramp in chronic liver disease. A case of decompensated liver cirrhosis in which muscle cramp disappeared after oral administration of taurine.

Kanzo ◽  
1990 ◽  
Vol 31 (12) ◽  
pp. 1464-1469 ◽  
Author(s):  
Yasushi MATSUZAKI ◽  
Naomi TANAKA ◽  
Takashi YAMAGUCHI ◽  
Yoshimichi CHUGANJI ◽  
Masaaki NISHI ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Oral Administration ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Muscle Cramp ◽  
Decompensated Liver Cirrhosis

scholarly journals Low Serum 25-Hydroxy Vitamin D (25-OHD) and Hepatic Encephalopathy in HCV-Related Liver Cirrhosis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Mohamed Abd Ellatif Afifi ◽  
Ahmed Mohamed Hussein ◽  
Mahmoud Rizk
Keyword(s):  
Vitamin D ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Wide Spectrum ◽  
The Other ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Cirrhotic Patients ◽  
Low Serum

Background. Patients with liver cirrhosis experience a large variety of metabolic disorders associated with more hepatic decompensation. Hepatic encephalopathy (HE) is a significant complication in liver cirrhosis patients, presenting a wide spectrum of neuropsychological symptoms. A deficiency of 25-hydroxy vitamin D (25-OHD) in the general population is associated with a loss of cognitive function, dementia, and Alzheimer’s disease. Aim of the Study. Our study aims to check the relationship between low serum 25-OHD and HE in patients with HCV-related liver cirrhosis and assess its link with patient mortality. Patients and Methods. This study was observationally carried out on 100 patients with HCV-related liver cirrhosis. The patients were divided into 2 groups: Group A—included 50 HCV-related cirrhotic patients with HE, and Group B—included 50 HCV-related cirrhotic patients without HE. Assessment of disease severity using the end-stage liver disease (MELD) model and Child Turcotte Pugh (CTP) scores were done, and 25-OHD levels were measured. Comparison of vitamin D levels in different etiologies and different CTP categories was made using one-way ANOVA. Pearson’s correlation between the level of vitamin D and other biomarkers was applied. Results. There was a statistically significant Vitamin D level difference between the two groups. A lower level of vitamin D was observed in the HE group where the severe deficiency was 16%, while it was 6% in the other group and the moderate deficiency was 24% in HE group as compared to 10% in the other group. The insufficient vitamin D level represented 46% of the non-HE group while none of the HE group falls in this category. Vitamin D level was statistically higher in Grade 1 HE than in Grade 2 which is higher than in Grades 3 to 4. Vitamin D level was also significantly higher in those who improved from HE as compared to those who died. Conclusion. The lower levels of 25-OHD were associated with the higher incidence of HE in cirrhotic HCV patients. The worsening vitamin D deficiency was associated with increased severity of the liver disease, so vitamin D may be considered a prognostic factor for the severity of liver cirrhosis and high mortality rate in HE patients.

Fibrin Monomer Polymerization in Liver Disease

1975 ◽  
Author(s):  
G. Green ◽  
I. W. Dymock ◽  
Jean M. Thomson ◽  
L. Poller
Keyword(s):  
Liver Disease ◽  
Normal Liver ◽  
Acute Liver Damage ◽  
Normal Liver Function ◽  
Primary Hepatoma ◽  
True Incidence ◽  
Coagulation Defect ◽  
Fibrin Monomer ◽  
Hepatocellular Disease ◽  
Normal Controls

Despite a few reports of abnormal fibrin monomer polymerization in liver disease, particularly primary hepatoma, the true incidence of this phenomenon remains to be determined. The unexplained frequency of prolongation of the thrombin-fibrinogen and reptilase times in such patients suggest it is more common than previously suspected.Over a hundred patients with hepatocellular dysfunction or jaundice have been screened for evidence of abnormal fibrinogen polymerization by a calorimetric method utilizing reptilase. The results have been compared with normal controls and patients with diverse diseases but normal liver function.Of the patients with primary hepatocellular disease such as cirrhosis and acute liver damage over a quarter exhibited abnormal fibrinogen polymerization. In addition these same patients had prolonged thrombin-fibrinogen and reptilase times, this latter test being the most reliable single index of the presence of abnormal polymerization.In patients with jaundice due to extra-hepatic biliary obstruction abnormal fibrin monomer polymerization was not observed.These findings may have important implications in the aetiology of the coagulation defect of liver disease.

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 A study of liver biopsies and liver disease among hemophiliacs

Blood ◽  
1985 ◽  
Vol 66 (2) ◽  
pp. 367-372 ◽  
Author(s):  
LM Aledort ◽  
PH Levine ◽  
M Hilgartner ◽  
P Blatt ◽  
JA Spero ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Chronic Active Hepatitis ◽  
Ad Hoc ◽  
Clinical Information ◽  
Severe Liver ◽  
Severe Liver Disease ◽  
Liver Biopsies ◽  
Clinically Significant ◽  
The Relationship

Abstract Hepatic histologic materials (biopsy or autopsy) and associated clinical data from 155 hemophiliacs were collected by an ad hoc hemophilia study group and analyzed retrospectively in an effort to determine the spectrum of liver disease in this population and to examine the relationship between the severity of liver disease and treatment history. Clinical information on the frequency of complications from 126 biopsies in 115 hemophilic patients provided a unique opportunity to assess the safety of liver biopsy in such patients. The incidence of cirrhosis (15%) and chronic active hepatitis (7%) was lower than previously reported. The frequency of severe liver disease (chronic active hepatitis or cirrhosis) in patients receiving large pooled concentrates was no greater than in patients treated principally with cryoprecipitate or plasma. The risks of liver biopsy in this setting are relatively high: clinically significant hemorrhage followed 12.5% of the procedures.

scholarly journals The impact of PNPLA3 and TM6SF2 in cirrhosis related complications

2021 ◽  
Author(s):  
Haruki Uojima ◽  
Xue Shao ◽  
Taeang Arai ◽  
Yuji ogawa ◽  
Toru Setsu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Odds Ratio ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Fibrosis Progression ◽  
Cirrhotic Patients ◽  
The Impact

Patatin-like phospholipase domain-containing 3 (PNPLA3) and transmembrane 6-superfamily member 2 (TM6SF2) polymorphisms have major impact for fibrosis due to steatohepatitis. However, there are scant data about correlations between cirrhosis-related complications and the polymorphisms of these genes. Therefore, we aimed to determine the role of the PNPLA3 and TM6SF2 polymorphisms in fibrosis progression for patients with liver cirrhosis. A multicenter study was performed at six hospitals in Japan enrolling 400 patients with liver cirrhosis caused by virus (n = 157), alcohol (n = 104), nonalcoholic fatty liver disease (NAFLD) (n = 106), or autoimmune disease (n = 33). These cirrhotic patients included those with complications of variceal bleeding, hepatic ascites, and/or hepatic encephalopathy and those without. To assess the role of the PNPLA3 and TM6SF2 polymorphisms in patients with cirrhosis related complications, we calculated the odds ratio and relative risk for the rs738409 and rs58542926 polymorphisms. We also accessed whether or not the interaction between these two polymorphisms contributed to cirrhosis related complications. As a result, the odds ratio for complications in the NAFLD group significantly increased in the presence of the rs738409 GG genotype when the CC genotype was used as the reference. There were no significant risks between complications and the presence of the rs738409 G allele in the virus or alcohol groups. There were no significant risks of complications in the frequency of the rs58542926 T polymorphism regardless of the etiology of liver cirrhosis. The interaction between the trs738409 and rs58542926 polymorphisms had the highest odds ratio of 2.415 for complications in the rs738409 GG + rs58542926 (CT+TT) group when rs738409 (CC+CG) + TM6SF2 CC was used as the reference in the NAFLD group.

scholarly journals Relação entre disfunção cardiovascular e hepatopatia crônica através do teste de caminhada de 6 minutos / Relationship between cardiovascular dysfunction and chronic liver disease through the 6 minutes walk test

2019 ◽  
Vol 64 (1) ◽  
pp. 20
Author(s):  
Cláudia Debona Mocelin ◽  
Filipe Bissoli ◽  
Rafaella De Nadai ◽  
Ana Paula Hamer Sousa Clara ◽  
Felipe Bertollo Ferreira ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Minimum Distance ◽  
Average Distance ◽  
Inverse Correlation ◽  
Walk Test ◽  
Cardiovascular Dysfunction ◽  
Cirrhotic Patients ◽  
6 Minute Walk Test ◽  
Minute Walk

Introdução: A cirrose hepática é uma doença crônica que cursa com diversas repercussões sistêmicas, uma delas é a disfunção cardiovascular, caracterizada pela queda da resistência vascular periférica e pelo aumento compensatório do débito cardíaco. Tal disfunção manifesta-se principalmente em situações de estresse hemodinâmico, estando muitas vezes normal no repouso. Objetivo: Avaliar a aplicabilidade do Teste de Caminhada de 6 minutos (TC6min) como instrumento sugestivo de disfunção cardiovascular nos pacientes cirróticos, através da correlação entre o desempenho no teste e o status funcional do paciente. Material e Métodos: Trata-se de estudo observacional e transversal do tipo inquérito, realizado em vinte e nove pacientes cirróticos, submetidos ao TC6min. Foram avaliados a distância percorrida por eles e parâmetros clínicos antes e após o teste, sendo o resultado comparado de acordo com sua classificação funcional. Resultados: Dentre os pacientes classe A de Child-Pugh, 6 deles (26,09% do total dessa classe) não atingiram a distância mínima prevista para o TC6min. Ao se analisar a classe B de Child-Pugh, 5 deles (83,33% do total dessa classe) não atingiram a distância mínima. A média da distância percorrida para pacientes Child A foi de 631,5 m, enquanto o previsto foi de 587,2 m. Em relação aos pacientes Child B, a média da distância percorrida foi de 441,0 m, com distância prevista de 541,2m. Foi observada uma significativa correlação inversa entre a distância percorrida e o escore de Child-Pugh (p=0,001). Conclusão: A distância percorrida no teste de caminhada de 6 minutos apresentou correlação inversa com a classificação de Child-Pugh-Turcotte o que demonstra um prejuízo funcional paralelo à piora da doença hepática de base. Ao considerar que os pacientes do estudo não apresentavam comorbidades previamente diagnosticadas que pudessem justificar tal prejuízo, essa associação pode indicar disfunção cardiovascular. Esta, por sua vez, provavelmente está relacionada ao comprometimento sistêmico secundário à cirrose hepática.Descritores: Doenças cardiovasculares, Cardiomiopatias, Cirrose hepática. Triagem, Teste de caminhadaAbstractIntroduction: Hepatic cirrhosis is a chronic disease that has several systemic repercussions. One of them is the cardiovascular dysfunction, characterized by the decrease of the peripheral vascular resistance and the compensatory increase of the cardiac output. Such dysfunction manifests itself mainly in situations of hemodynamic stress, and is often normal at rest. Objective: To evaluate the applicability of the 6-minute walk test (6MinWT) as an instrument suggestive of cardiovascular dysfunction in cirrhotic patients, through correlation between the test performance and the functional status of the patient. Methods: This is an observational and cross-sectional study of the survey type, performed in twenty-nine cirrhotic patients submitted to 6MinWT. The distance walked by them and the clinical parameters before and after the test were evaluated, and  the results were compared according to their functional classification. Results: Among Child-Pugh A patients, 6 (26.09% of the total of this class) did not reach the minimum distance predicted for the 6MWT. Analyzing the Child-Pugh B, 5 of them (83.33% of the total of this class) did not reach the minimum distance. The mean distance performed by Child A patients was 631.5 m, while the predicted distance was 587.2 m. In relation to Child B patients, the average distance performed was 441.0 m, with an expected distance of 541.2 m. A significant inverse correlation was observed between the distance walked and the Child-Pugh score (p = 0.001). Conclusion: The distance walked in the 6-minute walk test showed an inverse correlation with the Child-Pugh-Turcotte classification, which demonstrates a functional impairment parallel to the worsening of the underlying liver disease. Considering that the studied patients did not present previously diagnosed comorbidities that could justify such impairment, this association may indicate cardiovascular dysfunction. This, in turn, is probably related to systemic involvement secondary to liver cirrhosis. Key words: Cardiovascular diseases, Cardiomyopathies, Liver cirrhosis, Triage, Walk test. 

scholarly journals Clinical application of ultrasonography-guided percutaneous liver biopsy and its safety over 18 years

2020 ◽  
Vol 26 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Young Chang ◽  
Jun Il Kim ◽  
Bora Lee ◽  
Sang Gyune Kim ◽  
Min Jung Jung ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Practice ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Final Diagnosis ◽  
Tertiary Hospital ◽  
Nonalcoholic Fatty Liver ◽  
Delayed Bleeding ◽  
The Past ◽  
Major Adverse Events

Background/Aims: Liver biopsy (LB) remains the gold standard for the evaluation of liver disease. However, over the past two decades, many noninvasive tests have been developed and utilized in clinical practice as alternatives to LB. The aim of this study was to evaluate the clinical use and safety of LB in the era of noninvasive assessment of liver fibrosis.Methods: This retrospective study included 1,944 consecutive cases of LB performed between 2001 and 2018 in a tertiary hospital. All of the LBs were conducted under ultrasonography guidance with 18-gauge cutting needles.Results: LBs were performed an average of approximately 108 times per year during the study period. Chronic hepatitis B (25.3%) and suspected malignancy (20.5%) were the two most common indications for LB. The use of LB for nonalcoholic fatty liver disease increased from 8.1% to 17.2% in the past 5 years compared to the last 10 years, while that for viral hepatitis decreased from 40.3% to 18.9%. Discordance rate between the suspected diagnosis and the final diagnosis was 2.6% (51 cases). The overall rate of major adverse events was 0.05% (one case), which involved delayed bleeding at the biopsy site. Liver cirrhosis was observed in 563 cases (28.9%), and the presence of cirrhosis did not affect the frequency of complications (<i>P</i>=0.289).Conclusions: LB is widely used in clinical practice as an irreplaceable diagnostic tool, even in the era of noninvasiveness. Ultrasonography-guided LB can be performed safely in patients with liver cirrhosis.

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