Hepatitis during Chloroguanide Prophylaxis

1998 ◽  
Vol 32 (10) ◽  
pp. 1023-1025 ◽  
Author(s):  
Lonneke MM Oostweegel ◽  
Jos H Beijnen ◽  
Jan Willem Mulder
Keyword(s):  
Alkaline Phosphatase ◽  
Liver Disease ◽  
Cholestatic Liver Disease ◽  
Test Results ◽  
Drug Induced ◽  
Once Daily ◽  
Case Summary ◽  
Function Test ◽  
Considerable Morbidity ◽  
Glutamyl Transferase

OBJECTIVE: To describe a case of severe hepatitis that we attribute to the use of chloroguanide. CASE SUMMARY: A patient was admitted with fever and jaundice. This man had recently returned from Indonesia and was still using chloroguanide 200 mg once daily for 6 weeks. Evaluation of the liver function test results was consistent with cholestatic liver disease (alkaline phosphatase 158 U/L, aspartate aminotransferase 33 U/L, alanine aminotransferase 58 U/L increasing up to 183 U/L, γ-glutamyl transferase 96 U/L). This condition was thought to be caused by chloroguanide. A biopsy of the liver indicated drug-induced hepatitis. DISCUSSION: To our knowledge, this is the first report in the literature of cholestatic hepatitis associated with chloroguanide prophylaxis. In our patient, chloroguanide-induced hepatotoxicity can be considered as a combined allergic and idiosyncratic manifestation. CONCLUSIONS: This case shows that it is possible to develop drug-induced hepatitis with considerable morbidity while taking chloroguanide prophylaxis.

Quantitative fractionation of alkaline phosphatase isoenzymes according to their thermostability.

1976 ◽  
Vol 22 (1) ◽  
pp. 42-48 ◽  
Author(s):  
C PetitClerc
Keyword(s):  
Alkaline Phosphatase ◽  
Liver Disease ◽  
Phosphatase Activity ◽  
Alkaline Phosphatase Activity ◽  
Normal Serum ◽  
Transferase Activity ◽  
Gamma Glutamyl Transferase ◽  
Heat Labile ◽  
Alkaline Phosphatase Isoenzymes ◽  
Glutamyl Transferase

Abstract Continuous monitoring of heat denaturation of a mixture of alkaline phosphatase isoenzymes at 60 degrees C and pH 7.5 permits the simultaneous direct identification and quantitation of three isoenzymes: the placental isoenzyme, the L-phenylalanine-sensitive intestinal isoenzyme, and the liver isoenzyme (hepatocytic). The isoenzyme that is principally of bone origin cannot be identified as such without the help of other diagnostic aids and the patient's medical history. All human tissues contain alkaline phosphatase, many organs more than one of the isoenzymes. Liver alkaline phosphatase, which constitutes 40-50% of normal serum alkaline phosphatase activity, was measured in the serum of persons with various liver diseases. Its activity exceeded normal in all types of liver disease; in 80% of cases this increase was accompanied by increased gamma-glutamyl-transferase activity, but the quantitative correlationship (r = 0.54) was not as good as expected if both enzymes come from the same source and are indices of liver dieases. Liver alkaline phosphatase activity increases in the blood early in liver disease, before most liver tests show abnormalities. The other major isoenzyme of normal serum probably represents a mixture of isoenzymes from bone and reticulo-endothelial and vascular tissues, which all contain the same "very heat-labile" alkaline phosphatase. Cord blood and children's sera contain mostly this very heat-labile isoenzyme.

scholarly journals Role of the Microbiota and Antibiotics in Primary Sclerosing Cholangitis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
James H. Tabibian ◽  
Jayant A. Talwalkar ◽  
Keith D. Lindor
Keyword(s):  
Inflammatory Bowel Disease ◽  
Liver Disease ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Clinical Evidence ◽  
Cholestatic Liver Disease ◽  
Concise Review ◽  
Inflammatory Bowel ◽  
Considerable Morbidity

Primary sclerosing cholangitis (PSC) is an idiopathic, progressive, cholestatic liver disease with considerable morbidity and mortality and no established pharmacotherapy. In addition to the long-recognized association between PSC and inflammatory bowel disease, several lines of preclinical and clinical evidence implicate the microbiota in the etiopathogenesis of PSC. Here we provide a concise review of these data which, taken together, support further investigation of the role of the microbiota and antibiotics in PSC as potential avenues toward elucidating safe and effective pharmacotherapy for patients afflicted by this illness.

scholarly journals Biomarkers to Assess Liver Function in Various Types of Liver Diseases

2019 ◽  
pp. 28-31
Author(s):  
Pradeep G ◽  
Vikram B ◽  
Sharma DVHS
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Obstructive Jaundice ◽  
Viral Hepatitis ◽  
Liver Function Test ◽  
Alcoholic Liver Disease ◽  
Liver Diseases ◽  
Serum Levels ◽  
Function Test ◽  
Glutamyl Transferase

Background: It is estimated that liver diseases are among the top ten killer diseases in India, causing deaths every year. Besides, there are those who suffered from chronic liver problems needing recurrent hospitalization and prolonged medical attention, which leaves them physically, mentally, emotionally and financially devastated. Methodology: The study included (n=80) various liver disease patients admitted to the General Medicine department and controls (n=20) subjects were having normal health within the age group of 30-55 years. Serum levels of bilirubin, Aspartate Transaminase, Alanine Amino Transferase, Alkaline Phosphatase and Gamma Glutamyl Transferase parameters were studied among the subjects suffering from cirrhosis, alcoholic liver disease, viral hepatitis, obstructive jaundice type of liver diseases. Result: The results of this study showed that the increase in serum levels of Bilirubin, AST, ALT, ALP and GGT in various types of liver diseases i.e Obstructive jaundice, Cirrhosis of the liver, Viral hepatitis, Alcoholic Liver disease when compared with controls. Conclusion: Biochemistry laboratory investigations i.e. Liver Function Test (LFT) are a simple, easy measure of tools which can early diagnose the various types of liver diseases. Keywords: Liver diseases; Liver Bio-markers;  Liver Function Test.

scholarly journals Evaluation of Serum Zinc Status and Serum Alkaline Phosphatase Activity in Alcoholic Liver Disease Patients - A Hospital Based Study from Chennai, Tamil Nadu

2021 ◽  
Vol 8 (24) ◽  
pp. 2100-2105
Author(s):  
Uma T ◽  
Nirmaladevi P ◽  
Shanthi R ◽  
Mahalakshmi R
Keyword(s):  
Alkaline Phosphatase ◽  
Liver Disease ◽  
Phosphatase Activity ◽  
Alcoholic Liver Disease ◽  
Alkaline Phosphatase Activity ◽  
Serum Zinc ◽  
Meld Score ◽  
Gamma Glutamyl Transferase ◽  
Zinc Status ◽  
Glutamyl Transferase

BACKGROUND Alcoholism remains to be the major cause of morbidity and mortality throughout the world. Consuming alcohol is the potent etiological factor for the development of alcoholic liver diseases (ALD), ranging from fatty liver to hepatocellular carcinoma with varying rates of development in both genders depending on the quality, quantity, and duration of the drink. Zinc deficiency has been documented with the progression of alcoholic liver disease. It is also a well-known fact that zinc is a co-factor for enzyme alkaline phosphatase. This study aims to assess the zinc status and alkaline phosphatase activity in patients with various stages of alcoholic liver disease, correlate zinc with alkaline phosphatase activity, albumin, gamma glutamyl transferase activity, MELD score and duration of alcohol intake and analysing the need for evaluating zinc in these patients. METHODS This comparative observational study involves group I healthy controls and group II patients diagnosed to have ethanol related decompensated liver disease with or without portal hypertension for more than three years from the Department of Medical Gastroenterology, Government Medical College Hospital. 5 ml of venous blood in fasting state was collected from both groups and assayed for serum zinc, and serum alkaline phosphatase activity. The data was statistically analysed. RESULTS The study results demonstrate that higher percentage of patients with alcoholic liver disease have low serum zinc levels than healthy controls. Zinc when compared with variables like serum albumin, duration of alcohol intake, MELD score, serum gamma glutamyl transferase and alkaline phosphatase in the case and control groups were found to be statistically significant. CONCLUSIONS There is decrease in serum zinc level and increased alkaline phosphatase activity in patients with alcoholic liver disease. The statistically significant data is a strong rationale for evaluating the zinc status and thereby supplementing zinc to patients with alcoholic liver disease. KEYWORDS Alcoholic Liver Disease, Zinc, Alkaline Phosphatase, MELD Score

How to interpret and manage abnormal liver blood test results in older people

2021 ◽  
pp. 1-8
Author(s):  
Mohsan Subhani ◽  
Abhishek Sheth ◽  
Bilal Ahmad ◽  
Stephen Ryder
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Test Results ◽  
Older Population ◽  
The Metabolic Syndrome ◽  
Function Tests ◽  
Function Test ◽  
Common Observation

Ageing impairs liver function and reduces the liver's regenerative capacity. With the predicted increase in the older population, the burden of liver disease will proportionally rise in this age group. Elevated levels of liver enzymes in an otherwise asymptomatic older individual (≥65 years) are a common observation and positively associated with the metabolic syndrome, whereas a decline in albumin levels is linked with a rise in all-cause and liver-specific mortality. Deranged liver function tests do not always indicate liver disease, nor do normal liver function tests exclude liver disease. Therefore, clinicians need to consider individual patient risk factors during the assessment of abnormal liver function tests. This article discusses various liver function tests, their pathophysiology, and the approach to interpret and manage common abnormalities in liver function test results and liver disease in the older population.

scholarly journals Ursodeoxycholic acid for treatment of cholestasis in patients with hepatic amyloidosis

2009 ◽  
Vol 66 (6) ◽  
pp. 482-486 ◽  
Author(s):  
Dominik Faust ◽  
Bora Akoglu ◽  
Gordana Ristic ◽  
Vladan Milovic
Keyword(s):  
Alkaline Phosphatase ◽  
Ursodeoxycholic Acid ◽  
Intrahepatic Cholestasis ◽  
Serum Alkaline Phosphatase ◽  
Specific Binding ◽  
Polarized Light ◽  
Renal Amyloidosis ◽  
Cholestatic Liver Disease ◽  
Hepatic Amyloidosis ◽  
Glutamyl Transferase

Background. Amyloidosis represents a group of different diseases characterized by extracellular accumulation of pathologic fibrillar proteins in various tissues and organs. Severe amyloid deposition in the liver parenchyma has extrahepatic involvement predominantly in the kidney or heart. We evaluated the effect of ursodeoxycholic acid, in four patients with severe hepatic amyloidosis of different etiologies, who presented with increased alkaline phosphatase and ?-glutamyl transferase. Case report. The study included four patients who presented with amyloidosis-associated intrahepatic cholestasis. Three of them had renal amyloidosis which developed 1-3 years before cholestasis occurred, the remaining one having intrahepatic cholestasis as the primary sign of the disease. Amyloidosis was identified from liver biopsies in all patients by its specific binding to Congo red and green birefringence in polarized light. The biochemical nature and the class of amyloid deposits were identified immunohistochemically. In addition to their regular treatment, the patients received 750 mg ursodeoxycholic acid per day. After 2-4 weeks all patients had a significant decrease of serum alkaline phosphatase and ?-glutamyl transferase, and their general status significantly improved. Conclusion. Treatment with ursodeoxycholic acid may be beneficial in patients with hepatic amyloidosis, and do extend indications for the use of ursodeoxycholic acid in amyloidotic cholestatic liver disease.

scholarly journals Oxidative Stress as Estimated by Gamma-Glutamyl Transferase Levels Amplifies the Alkaline Phosphatase-Dependent Risk for Mortality in ESKD Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Claudia Torino ◽  
Francesco Mattace-Raso ◽  
Jan L. C. M. van Saase ◽  
Maurizio Postorino ◽  
Giovanni Luigi Tripepi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Alkaline Phosphatase ◽  
Liver Disease ◽  
Biological Effects ◽  
Sensitivity Analyses ◽  
Gamma Glutamyl Transferase ◽  
Risk Of Death ◽  
Systemic Oxidative Stress ◽  
Glutamyl Transferase ◽  
End Stage

Alkaline phosphatase (Alk-Phos) is a powerful predictor of death in patients with end-stage kidney disease (ESKD) and oxidative stress is a strong inducer of Alk-Phos in various tissues. We tested the hypothesis that oxidative stress, as estimated by a robust marker of systemic oxidative stress likeγ-Glutamyl-Transpeptidase (GGT) levels, may interact with Alk-Phos in the high risk of death in a cohort of 993 ESKD patients maintained on chronic dialysis. In fully adjusted analyses the HR for mortality associated with Alk-Phos (50 IU/L increase) was progressively higher across GGT quintiles, being minimal in patients in the first quintile (HR: 0.89, 95% CI: 0.77–1.03) and highest in the GGT fifth quintile (HR: 1.13, 95% CI: 1.03–1.2) (Pfor the effect modification = 0.02). These findings were fully confirmed in sensitivity analyses excluding patients with preexisting liver disease, excessive alcohol intake, or altered liver disease biomarkers. GGT amplifies the risk of death associated with high Alk-Phos levels in ESKD patients. This observation is compatible with the hypothesis that oxidative stress is a strong modifier of the adverse biological effects of high Alk-Phos in this population.

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