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Acute Liver Failure

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https://www.readbyqxmd.com/read/29341979/wilson-s-disease-in-children-a-position-paper-by-the-european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-committee
#1
Piotr Socha, Wojciech Janczyk, Anil Dhawan, Ulrich Baumann, Lorenzo D'Antiga, Stuart Tanner, Raffaele Iorio, Pietro Vajro, Roderick Houwen, Björn Fischler, Antal Dezsofi, Nedim Hadzic, Loreto Hierro, Jörg Jahnel, Valérie McLin, Valerio Nobili, Francoise Smets, Henkjan J Verkade, Dominique Debray
BACKGROUND: Clinical presentations of Wilson's disease (WD) in childhood ranges from asymptomatic liver disease to cirrhosis or acute liver failure, while neurological and psychiatric symptoms are rare. The basic diagnostic approach includes serum ceruloplasmin and 24h-urinary copper excretion. Final diagnosis of WD can be established using a diagnostic scoring system based on symptoms, biochemical tests assessing copper metabolism and molecular analysis of mutations in the ATP7B gene...
October 26, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29341965/osmotic-shifts-cerebral-edema-and-neurologic-deterioration-in-severe-hepatic-encephalopathy
#2
Eric Michael Liotta, Anna L Romanova, Bryan D Lizza, Laura J Rasmussen-Torvik, Minjee Kim, Brandon Francis, Rajbeer Singh Sangha, Timothy J Carroll, Daniel Ganger, Daniela P Ladner, Andrew M Naidech, James J Paparello, Shyam Prabhakaran, Farzaneh A Sorond, Matthew B Maas
OBJECTIVES: We sought to determine the effect of acute electrolyte and osmolar shifts on brain volume and neurologic function in patients with liver failure and severe hepatic encephalopathy. DESIGN: Retrospective analysis of brain CT scans and clinical data. SETTING: Tertiary care hospital ICUs. PATIENTS: Patients with acute or acute-on-chronic liver failure and severe hepatic encephalopathy. INTERVENTIONS: Clinically indicated CT scans and serum laboratory studies...
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29341528/-n-acetylcysteine%C3%A2-effective-treatment-in-severe-alcoholic-hepatitis%C3%A2
#3
Isaline Verdon, Laurent Spahr, Jacques Serratrice
The use of N-acetylcysteine is of unknown significance when it comes to acute liver failure of other origin but for paracetamol overdose. Current data state its beneficial use when added to standard treatment for acute alcoholic hepatitis, whereas this attitude is less clear for hepatitis of variable other origin. This review of literature attends to evaluate and reveal the possible interest of adding N-acetylcysteine to standard care of acute liver failure due to alcoholism or other non-paracetamol linked causes...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341357/a-multicenter-pilot-survey-to-clarify-the-clinical-features-of-patients-with-acute-on-chronic-liver-failure-in-japan
#4
Nobuaki Nakayama, Hayato Uemura, Yoshihito Uchida, Tomoaki Tomiya, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa, Satoshi Mochida
AIMS: To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, a multicenter pilot survey was conducted to examine usefulness of oversea criteria in patients with chronic liver diseases manifesting acute decompensation. METHODS: Patients fulfilling the APASL, EASL or Chinese Medical Association (CMA) criteria for decompensation were enrolled from 8 institutes, and the clinical features were evaluated. RESULTS: Among 112 patients, 109 patients (97...
January 17, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29336434/acg-clinical-guideline-alcoholic-liver-disease
#5
Ashwani K Singal, Ramon Bataller, Joseph Ahn, Patrick S Kamath, Vijay H Shah
Alcoholic liver disease (ALD) comprises a clinical-histologic spectrum including fatty liver, alcoholic hepatitis (AH), and cirrhosis with its complications. Most patients are diagnosed at advanced stages and data on the prevalence and profile of patients with early disease are limited. Diagnosis of ALD requires documentation of chronic heavy alcohol use and exclusion of other causes of liver disease. Prolonged abstinence is the most effective strategy to prevent disease progression. AH presents with rapid onset or worsening of jaundice, and in severe cases may transition to acute on chronic liver failure when the risk for mortality, depending on the number of extra-hepatic organ failures, may be as high as 20-50% at 1 month...
January 16, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29336092/development-and-validation-of-a-scoring-system-to-predict-progression-to-acute-on-chronic-liver-failure-in-patients-with-acute-exacerbation-of-chronic-hepatitis-b
#6
Yi Ren, Lulu Liu, Ying Li, Fangwan Yang, Yihuai He, Yanping Zhu, Xinxin Hu, Shide Lin
AIM: The aim of this study was to develop and validate a scoring system to predict the progression to acute-on-chronic liver failure (ACLF) in patients with acute exacerbation (AE) of chronic hepatitis B (CHB). METHODS: The baseline characteristics of 474 patients with AE of CHB were retrospectively reviewed; 280 and 194 patients were randomly assigned to the derivation and validation cohorts, respectively. Univariate risk factors associated with ACLF development were entered into a multivariate logistic regression...
January 15, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29334786/acute-on-chronic-liver-failure-in-chronic-hepatitis-b-an-update
#7
Rui-Hong Zhao, Yu Shi, Hong Zhao, Wei Wu, Ji-Fang Sheng
Acute-on-chronic liver failure is a common pattern of end-stage liver disease in clinical practice and occurs frequently in patients with chronic hepatitis B or HBV-related cirrhosis. New progress in recent years leads to a better understanding of this disease. Areas covered: This review updates the current comprehensive knowledge about HBV-ACLF from epidemiological studies, experimental studies, and clinical studies and provide new insights into the definition, diagnostic criteria, epidemiology, nature history, pathogenesis, treatment and prognostication of HBV-ACLF...
January 16, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29333071/factors-associated-with-waiting-time-on-the-liver-transplant-list-an-analysis-of-the-united-network-for-organ-sharing-unos-database
#8
Judy A Trieu, Mohammad Bilal, Bashar Hmoud
Background: Liver transplantation (LT) is an important treatment for acute liver failure and end-stage liver disease. In 2002, the model for end-stage liver disease (MELD) score was incorporated to prioritize patients awaiting LT. Although there is data on how the MELD score affects waiting times, there is a paucity of literature regarding other components. We aimed to evaluate the factors affecting LT waiting times in the United States. Methods: Using the United Network for Organ Sharing (UNOS) database, patients aged 12-75 years listed for LT over the years 2002-2015 were included...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29331651/activation-of-p62-keap1-nrf2-antioxidant-pathway-in-the-early-stage-of-acetaminophen-induced-acute-liver-injury-in-mice
#9
Zhenyu Shen, Yu Wang, Zhenhui Su, Ruirui Kou, Keqin Xie, Fuyong Song
Acetaminophen (APAP) overdose can cause severe liver failure even death. Nearly half of drug-induced liver injury is attributed to APAP in the US and many European countries. Oxidative stress has been validated as a critical event involved in APAP-induced liver failure. p62/SQSTM1, a selective autophagy adaptor protein, is reported to regulate Nrf2-ARE antioxidant pathway in response to oxidative stress. However, the exact role of p62-keap1-Nrf2 antioxidant pathway in APAP-induced hepatotoxicity remains unknown...
January 10, 2018: Chemico-biological Interactions
https://www.readbyqxmd.com/read/29331477/atypical-presentation-of-pregnancy-related-hemolytic-uremic-syndrome
#10
Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer A Schaub
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29327526/dengue-induced-hepatic-injury
#11
Darshil Shah, Pravin Rathi
Dengue has a significant impact on the disease burden in the population residing in tropical countries. It is transmitted by the bite of Aedes mosquito. The virus have got some hepatotoxic effects. Most of the cases are asymptomatic. However, it should be considered as one of the causes of Acute Liver Failure in endemic countries. Our article focuses on the pathogenesis, manifestations, investigations and, the treatment options for dengue related hepatic dysfunction.
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29327522/clinical-profile-and-outcome-of-pregnant-patients-with-acute-hev-hepatitis-during-water-borne-epidemic-in-himachal-pradesh-a-hospital-based-study
#12
Asha Ranjan, Surinder Thakur, Jatinder Mokta, Rajesh Bhawani, Varsha Ranjan
Background: Recent outbreak of HEV hepatitis epidemic in Himachal Pradesh in Shimla caused significant morbidity and mortality especially among pregnant patients. Overall mortality is 0.5- 4% in patients developing acute hepatic failure (ALF) and is significantly higher in pregnant patients (20%). Present study conducted to observe clinical profile and outcome in pregnant patients. Methodology: this is a retrospective observational study done on admitted pregnant and post partum patients with acute HEV hepatitis during 3 months periods...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29325729/amatoxin-containing-mushroom-poisonings-species-toxidromes-treatments-and-outcomes
#13
REVIEW
James H Diaz
Amatoxins are produced primarily by 3 species of mushrooms: Amanita, Lepiota, and Galerina. Because amatoxin poisonings are increasing, the objective of this review was to identify all amatoxin-containing mushroom species, present a toxidromic approach to earlier diagnoses, and compare the efficacies and outcomes of therapies. To meet these objectives, Internet search engines were queried with keywords to select peer-reviewed scientific articles on amatoxin-containing mushroom poisoning and management. Descriptive epidemiological analyses have documented that most mushroom poisonings are caused by unknown mushrooms, and most fatal mushroom poisonings are caused by amatoxin-containing mushrooms...
January 8, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29325296/-clinical-features-and-treatment-of-acute-fatty-liver-of-pregnancy-complicated-by-acute-liver-failure
#14
H F Xiong, J Y Liu, L M Guo, C S Li, J B Tan, Y F Liu, Y Sun, L Pu, P Xiang, M Zhang
No abstract text is available yet for this article.
December 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29325280/-clinical-value-of-anti-liver-kidney-microsomal-1-antibody-in-patients-with-liver-disease
#15
Y Han, H P Yan, H Y Liao, L M Sun, Y L Huang, C Y Huang, H P Zhang, X D Zhang, X Q Bian, M X Ren, X F Du, Y M Liu
Objective: To investigate the clinical and laboratory features of patients with liver disease and positive anti-liver/kidney microsomal-1 (anti-LKM-1) antibody, and to provide a reference for clinical diagnosis and differential diagnosis. Methods: The clinical data of patients with positive anti-LKM-1 antibody who were treated in our hospital from 2006 to 2016 were collected, and clinical and laboratory features were analyzed and compared. An analysis was also performed for special cases. Results: The measurement of related autoantibodies was performed for about 100 thousand case-times, and 15 patients were found to have positive anti-LKM-1 antibody...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29325220/profile-risk-factors-and-outcome-of-acute-kidney-injury-in-pediatric-acute-on-chronic-liver-failure
#16
Bikrant Bihari Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
There are no studies on acute kidney injury (AKI) in pediatric acute-on-chronic liver failure (ACLF). This study was planned with aim to describe the clinical presentation and outcome of AKI among pediatric ACLF patients METHODS: Data of all children 1-18 years of age presenting with ACLF (APASL definition) was reviewed. AKI was defined as per KDIGO guidelines. Poor outcome was defined as death or need for liver transplant within 3 months of development of AKI RESULTS: A total of 84 children with ACLF presented to us in the study period...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29325178/modulation-of-o-glcnac-levels-in-the-liver-impacts-acetaminophen-induced-liver-injury-by-affecting-protein-adduct-formation-and-glutathione-synthesis
#17
Steven R McGreal, Bharat Bhushan, Chad Walesky, Mitchell R McGill, Margitta Lebofsky, Sylvie E Kandel, Robert D Winefield, Hartmut Jaeschke, Natasha E Zachara, Zhen Zhang, Ee Phie Tan, Chad Slawson, Udayan Apte
Overdose of acetaminophen (APAP) results in acute liver failure. We have investigated the role of a post-translational modification of proteins called O-GlcNAcylation, where the O-GlcNAc transferase (OGT) adds and O-GlcNAcase (OGA) removes a single β-D-N-acetylglucosamine (O-GlcNAc) moiety, in the pathogenesis of APAP-induced liver injury. Hepatocyte specific OGT knockout mice (OGT KO), which have reduced O-GlcNAcylation, and WT controls were treated with 300 mg/kg APAP and the development of injury was studied over a time course from 0-24 hr...
January 9, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29324279/inhibition-of-udp-glucose-dehydrogenase-by-6-thiopurine-and-its-oxidative-metabolites-possible-mechanism-for-its-interaction-within-the-bilirubin-excretion-pathway-and-6tp-associated-liver-toxicity
#18
Chamitha J Weeramange, Cassie M Binns, Chixiang Chen, Ryan J Rafferty
6-Thiopurine (6TP) is an actively prescribed drug in the treatment of various diseases ranging from Crohn's disease and other inflammatory diseases to acute lymphocytic leukemia and non-Hodgkin's leukemia. While 6TP has beneficial therapeutic uses, severe toxicities are also reported with its use, such as jaundice and liver toxicity. While numerous investigations into the mode in which toxicity originates has been undertaken. None have investigated the effects of inhibition towards UDP-Glucose Dehydrogenase (UDPGDH), an oxidative enzyme responsible for UDP-glucuronic acid (UDPGA) formation or UDP-Glucuronosyl transferase (UGT1A1), which is responsible for the conjugation of bilirubin with UDPGA for excretion...
December 30, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29322851/clinical-and-virological-implications-of-a1846t-and-c1913a-g-mutations-of-hepatitis-b-virus-genome-in-severe-liver-diseases
#19
Hong Zang, Zhihui Xu, Yan Liu, Xiaodong Li, Yihui Rong, Ling Jiang, Shaoli You, Jinhua Hu, Jun Zhao, Dongping Xu, Shaojie Xin
OBJECTIVE: Mutations occurring within different genes of hepatitis B virus (HBV) genome may have different clinical implications. This study aimed to observe the clinical and virological implications of the A1846T and C1913A/G mutations of HBV genome in the development and treatment outcome of severe liver diseases, which has not been previously determined. MATERIALS AND METHODS: A total of 438 cases of patients with liver diseases were retrospectively reviewed, including 146 with mild chronic hepatitis B infection (CHB-M), 146 with severe chronic hepatitis B infection (CHB-S), and 146 with acute-on-chronic liver failure (ACLF)...
January 11, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29321432/acute-onset-autoimmune-hepatitis-in-a-young-woman-with-type-1-diabetes-mellitus
#20
Satoshi Takai, Jun Inoue, Takayuki Kogure, Eiji Kakazu, Masashi Ninomiya, Tomoaki Iwata, Teruyuki Umetsu, Takuya Nakamura, Akitoshi Sano, Tooru Shimosegawa
Autoimmune hepatitis (AIH) and type 1 diabetes mellitus (T1DM) are thought to be induced by autoimmunity, but their coexistence has rarely been reported. We herein report a case in which a patient with T1DM developed acute-onset AIH. A 26-year-old woman, who had been diagnosed with T1DM in childhood, was transferred to our hospital because of acute liver failure of unknown etiology. The administration of corticosteroids including steroid pulse therapy was effective. Based on the histological finding of massive centrilobular necrosis and a good response to steroid therapy, we diagnosed the patient with acute-onset AIH...
January 11, 2018: Internal Medicine
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