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cryptogenic cirrhosis

G Aswathy, Prasanth Dharmarajan, Ananth Ram Sharma, V K Sasikumar, M R Vasudevan Nampoothiri
Cirrhosis is the final stage of most of the chronic liver diseases and is most invariably complicated by portal hypertension resulting in ascites. A case of chronic liver disease with portal hypertension (cryptogenic cirrhosis), managed at Amrita School of Ayurveda is discussed in this paper. The clinical picture was that of an uncomplicated cirrhotic ascites. Snehapāna (therapeutic oral administration of lipids) followed by virecana (purgation) was done after an initial course of nityavirecana (daily purgation)...
April 2016: Ancient Science of Life
Oliviero Riggio, Stefania Gioia, Ilaria Pentassuglio, Valeria Nicoletti, Michele Valente, Giulia d'Amati
The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis...
2016: Hepatic Medicine: Evidence and Research
Walid Faraj, Ghina El Nounou, Abdallah Abou Al Naaj, Nancy Nakhoul, Ali Haydar, Mohammad Khalife
Liver transplantation provides an important, often life-saving treatment for end-stage liver disease. Osteoporosis post-liver transplantation has been described in adults; however, this has not been described in the pediatric population to date. We present a case of a 13-year-old female patient who underwent an orthotopic liver transplant for cryptogenic liver cirrhosis. Her immunosuppressants were tacrolimus and prednisone. Four months posttransplant, she started complaining of bilateral lower limb pain and limping while walking, progressing to a point where she was almost immobile...
August 22, 2016: Progress in Transplantation
Ido Laish, Batya Mannasse-Green, Ruth Hadary, Fred M Konikoff, Aliza Amiel, Yona Kitay-Cohen
BACKGROUND/AIMS: Non-alcoholic fatty liver disease (NAFLD) and cryptogenic cirrhosis (CC), which is largely a late sequela of NAFLD, are considered pre-neoplastic conditions that might progress to hepatocellular carcinoma. Aneuploidy, telomere aggregates and synchronization of replication were evaluated as markers of genetic instability in these patients. METHODOLOGY: Peripheral blood lymphocytes from 22 patients with NAFLD, 20 patients with CC and 20 age-matched healthy controls were analyzed...
November 15, 2016: Gene
Amitabh Singh, Rachna Seth, Anand Gupta, Shalimar, Baibaswata Nayak, Subrat Kumar Acharya, Prasenjit Das
Chronic hepatitis E virus (HEV) infection is increasingly being reported in immunosuppressed individuals with HIV, patients with haematological malignancy and transplant recipients. The diagnosis of cirrhosis and liver failure post chronic HEV is controversial due to lack of standard diagnostic criteria. The treatment benefits of ribavirin in chronic HEV of genotype 1 are not well reported. We report a case of chronic HEV infection of genotype 1 leading to chronic liver disease in a child cured of acute leukaemia...
August 10, 2016: Gastroenterology Report
Aldo J Montano-Loza, Paul Angulo, Judith Meza-Junco, Carla M M Prado, Michael B Sawyer, Crystal Beaumont, Nina Esfandiari, Mang Ma, Vickie E Baracos
BACKGROUND AND AIMS: Obesity is frequently associated with cirrhosis, and cirrhotic patients may develop simultaneous loss of skeletal muscle and gain of adipose tissue, culminating in the condition of sarcopenic obesity. Additionally, muscle depletion is characterized by both a reduction in muscle size and increased proportion of muscular fat, termed myosteatosis. In this study, we aimed to establish the frequency and clinical significance of sarcopenia, sarcopenic obesity and myosteatosis in cirrhotic patients...
May 2016: Journal of Cachexia, Sarcopenia and Muscle
Raluca Pais, A Sidney Barritt, Yvon Calmus, Olivier Scatton, Thomas Runge, Pascal Lebray, Thierry Poynard, Vlad Ratziu, Filomena Conti
Because of global epidemics of obesity and type 2 diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing both in Europe and the United States, becoming one of the most frequent causes of chronic liver disease and predictably, one of the leading causes of liver transplantation both for end-stage liver disease and hepatocellular carcinoma. For most transplant teams around the world this will raise many challenges in terms of pre- and post-transplant management. Here we review the multifaceted impact of NAFLD on liver transplantation and will discuss: (1) NAFLD as a frequent cause of cryptogenic cirrhosis, end-stage chronic liver disease, and hepatocellular carcinoma; (2) prevalence of NAFLD as an indication for liver transplantation both in Europe and the United States; (3) the impact of NAFLD on the donor pool; (4) the access of NAFLD patients to liver transplantation and their management on the waiting list in regard to metabolic, renal and vascular comorbidities; (5) the prevalence and consequences of post-transplant metabolic syndrome, recurrent and de novo NAFLD; (6) the alternative management and therapeutic options to improve the long-term outcomes with particular emphasis on the correction and control of metabolic comorbidities...
July 30, 2016: Journal of Hepatology
Abu Bakar Hafeez Bhatti, Faisal Saud Dar, Syeda Shaheera Hashmi, Haseeb Zia, Munir Iqbal Malik, Najmul Hassan Shah
OBJECTIVE: To determine the outcomes of paediatric living donor liver transplantation (LDLT) recipients from Pakistan in terms of 90-day morbidity and mortality. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Shifa International Hospital, Islamabad, Pakistan, between April 2012 and April 2015. METHODOLOGY: All patients in paediatric age group (≤ 17 years) who underwent LDLT with a minimum follow-up of 3 months, were included...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Amit Goel, Shankar Lal Jat, Avani Sasi, Vimal Kumar Paliwal, Rakesh Aggarwal
BACKGROUND AND AIM: Restless leg syndrome (RLS) has recently been shown to be increased in patients with liver cirrhosis (LC). We prospectively studied the prevalence and severity of RLS, and the effect of its presence on the quality of life (QoL) in Indian patients with LC. METHODS: Adult patients with stable LC (n = 121; 98 male; median age 47 [range 18-68] years; Child-Pugh class A/B/C 59/39/23), were prospectively enrolled along with a group of healthy, adult controls (n = 121; 84 male; median age 42 [19-70] years)...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Umberto Vespasiani-Gentilucci, Paolo Gallo, Fiorella Piemonte, Elisabetta Riva, Aldostefano Porcari, Ferruccio Vorini, Giulia Tozzi, Livia Piccioni, Giovanni Galati, Antonio De Vincentis, Simone Carotti, Sergio Morini, Jessica D'Amico, Silvia Angeletti, Claudio Pedone, Antonio Picardi
Liver cirrhosis is characterized by a severe acquired reduction of LAL-activity, the precise causes and consequences of which need to be further addressed. DBS-determined lysosomal enzyme activities seem to be affected by white blood cell and platelet counts, and the specificity of these tests can be reduced when applied to determined populations, such as cirrhotics.
2016: PloS One
Girish Kumar Pati, Ayaskanta Singh, Bijay Misra, Debasis Misra, Haribhakti Seba Das, Chittaranjan Panda, Shivaram Prasad Singh
BACKGROUND AND OBJECTIVES: Acute-On-Chronic liver failure (ACLF) is an emerging entity. The present study was undertaken to analyze the clinical profile and natural course of ACLF patients. PATIENTS AND METHODS: ACLF was defined as per Asia Pacific Association for the Study of Liver consensus criteria 2009. Patients fulfilling these criteria with some deviations were included and prospectively evaluated for clinical profile, etiologies of acute decompensation (AD) and underlying chronic liver disease, and short-term natural course [3 months]...
March 2016: Journal of Clinical and Experimental Hepatology
Rohan C Siriwardana, Madunil Anuk Niriella, Anuradha Supun Dassanayake, Chandika Anuradha Habarakada Liyanage, Bhagya Gunetilleke, Hithanadura Janaka de Silva
Non-alcoholic fatty liver disease (NAFLD) seems to recur in at least one third of patients transplanted for non-alcoholic steatohepatitis (NASH)-related cirrhosis. While, NASH recurrence does not seem to affect overall graft and patient survival up to 10 years, cardiovascular and infection-related morbidity and mortality seem to be increased in these patients. This report looks at the graft histology in patients who were transplanted for NASH-related cirrhosis after short-term follow up. We report a high prevalence of recurrent NAFLD in liver grafts post-transplant among five patients...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Antonio Orlacchio, Fabrizio Chegai, Sebastiano Fabiano, Stefano Merolla, Valentina Funel, Francesca Di Giuliano, Matteo Manuelli, Giuseppe Tisone, Simona Francioso, Mario Angelico, Giampiero Palmieri, Giovanni Simonetti
AIM: To assess the diagnostic performance of magnetic resonance imaging (MRI) with gadoxetic acid in the identification of hepatocellular carcinoma (HCC) nodules by comparison with histological findings. METHODS: In a cohort of patients suffering from cirrhosis of various etiologies (chronic hepatitis C virus (HCV) or hepatitis B virus (HBV), alcohol abuse, cryptogenic forms), we selected 17 patients affected by HCC who were eligible for liver transplantation on the basis of a computed-tomography (CT) total-body examination...
July 2016: La Radiologia Medica
E Nilsson, H Anderson, K Sargenti, S Lindgren, H Prytz
BACKGROUND: In Sweden, the most common causes of liver cirrhosis are alcohol overconsumption and hepatitis C. However, recent data on the clinical characteristics of Swedish patients with cirrhosis are scarce. AIMS: To determine the incidence, clinical presentation, aetiological spectrum and survival rates of liver cirrhosis in Southern Sweden from 2001 to 2011. METHODS: We used population-based medical registries to conduct a cohort study of all patients with liver cirrhosis in the southernmost region of Sweden with a population of 1...
June 2016: Alimentary Pharmacology & Therapeutics
Dimitrios Farmakiotis, Barry Zeluff
A 58-year-old man with cryptogenic cirrhosis was admitted to the intensive care unit with confusion after a fall at home. He had been taking a prolonged course of metronidazole (500 mg three times per day for >3 weeks) for Clostridium difficile infection. A few days before his hospitalization,..
April 14, 2016: New England Journal of Medicine
Łukasz Masior, Michał Grąt, Maciej Krasnodębski, Waldemar Patkowski, Marek Krawczyk
BACKGROUND: Cryptogenic cirrhosis (CC) is an indication for liver transplantation in 5-9% of recipients. Diagnosis is made when other diagnostic possibilities have been ruled out. The aim of this study was to present long-term outcomes of liver transplantation for CC. MATERIAL AND METHODS: There have been 1367 liver transplantations performed during the years 1994-2013 in the Department of General, Transplant and Liver Surgery at the Medical University of Warsaw...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Diego García-Compeán, José Alberto González-González, Fernando Javier Lavalle-González, Emmanuel Irineo González-Moreno, Jesús Zacarías Villarreal-Pérez, Héctor Jesús Maldonado-Garza
Diabetes mellitus (DM) that occurs because of chronic liver disease (CLD) is known as hepatogenous diabetes (HD). Although the association of diabetes and liver cirrhosis was described forty years ago, it was scarcely studied for long time. Patients suffering from this condition have low frequency of risk factors of type 2 DM. Its incidence is higher in CLD of viral, alcoholic and cryptogenic etiology. Its pathophysiology relates to liver damage, pancreatic dysfunction, interactions between hepatitis C virus (HCV) and glucose metabolism mechanisms and genetic susceptibility...
March 14, 2016: World Journal of Gastroenterology: WJG
Eyal Shteyer, Rivka Villenchik, Mahmud Mahamid, Nidaa Nator, Rifaat Safadi
Fatty liver has become the most common liver disorder and is recognized as a major health burden in the Western world. The causes for disease progression are not fully elucidated but lysosomal impairment is suggested. Here we evaluate a possible role for lysosomal acid lipase (LAL) activity in liver disease. To study LAL levels in patients with microvesicular, idiopathic cirrhosis and nonalcoholic fatty liver disease (NAFLD). Medical records of patients with microvesicular steatosis, cryptogenic cirrhosis and NAFLD, diagnosed on the basis of liver biopsies, were included in the study...
2016: International Journal of Molecular Sciences
Praveen Sharma, Rinkesh Bansal, Abdul Matin, Pankaj Tyagi, Naresh Bansal, Vikas Singla, Ashish Kumar, Anil Arora
INTRODUCTION: It is difficult to differentiate acute severe hepatitis (AH) with acute on chronic liver failure (ACLF). Aim was to study the role of transient elastography (Fibroscan) in identifying the patients with AH and ACLF. MATERIALS AND METHODS: Consecutive patients of severe AH or ACLF presented within two weeks of jaundice were enrolled. LSM and liver function tests were done at admission, week 1, 4 and at 6 months. Diagnosis of ACLF was based on documenting cirrhotic morphology on imaging and/or liver biopsy and follow-up of these patients for six months...
December 2015: Journal of Clinical and Experimental Hepatology
Ghulam Rehman Mohyuddin, Abdulraheem Yacoub
Primary myelofibrosis (PMF) commonly results in extramedullary hematopoiesis (EMH) in the spleen and liver as well as a variety of other organs. We present a first report of a unique presentation of PMF in a liver transplant recipient patient as EMH in the transplanted liver graft. A 76-year-old man with history of cryptogenic cirrhosis received cadaveric liver transplantation in 1996. He maintained a normal graft function and stable hematologic parameters until 2013 when he presented with anemia and progressive fatigue...
2016: Case Reports in Hematology
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