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Fulminant hepatic failure

Alejandro José García Ferreira, Aida Ortega Alonso, Julia Cobos Rodríguez, Paula Bardón de Tena, Miguel Calderón Cid, Alberto Manuel García García, María Dolores García Escaño, Ramiro Alcántara Benitez, Encarnacíon Clavijo Frutos, Miren García-Cortés, Raúl Andrade
In 2016, an outbreak of hepatitis A was identified in the Malaga province among patients with specific epidemiological characteristics, which were predominantly males. This is a report of 51 subjects with acute hepatitis A and a mean age of 35.7 years, 90% were male and 55% of cases were men who had had sex with other men within the last two months. Half of them required hospitalization for significant coagulopathy at diagnosis and no cases progressed to fulminant failure or encephalopathy. Four patients had ascites at the time of diagnosis...
March 12, 2018: Revista Española de Enfermedades Digestivas
Nehal El-Koofy, Hanan M Fouad, Mona E Fahmy, Heba Helmy, Olfat Shaker, Hanaa M El-Karaksy, Nabil Mohsen
BACKGROUND AND STUDY AIMS: Hepatobiliary cholestatic disorders produce excess copper (Cu) retention in the liver, which is toxic and may cause hepatitis, fulminant hepatic failure, cirrhosis and death. In this study, we measured hepatic Cu and tested its correlation with serum Cu (S. Cu) and serum ceruloplasmin (S. ceruloplasmin) in cholestatic infants. PATIENTS AND METHODS: 41 cholestatic infants were enrolled as cases and 11 healthy infants as control subjects...
March 6, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
P Kashyap, M Deka, S Medhi, S Dutta, K Kashyap, N Kumari
Hepatitis A virus (HAV) which causes liver disease is recognized by Toll-like receptors (TLRs) through the viral nucleic acid, initiating the host defense response. The study aims to analyze the role of TLR4 rs11536889 polymorphism in the pathogenesis of hepatitis A cases from Assam. There was significant correlation between TLR4 SNP G/C (rs11536889) and between acute viral hepatitis (AVH) A cases and controls. The correlation of the 3 different genotypes GG, GC and CC of TLR4 rs11536889 with the TLR4 mRNA expression level in all the HAV cases groups have been found to be statistically significant (p <0...
2018: Acta Virologica
Marina Gazdic, Bojana Simovic Markovic, Aleksandar Arsenijevic, Nemanja Jovicic, Aleksandar Acovic, C Randall Harrell, Crissy Fellabaum, Valentin Djonov, Nebojsa Arsenijevic, Miodrag L Lukic, Vladislav Volarevic
One of the therapeutic options for the treatment of fulminant hepatitis is re-population of intrahepatic regulatory cells since their pool is significantly reduced during acute liver failure. Although it is known that mesenchymal stem cells (MSCs), which have beneficent effects in the therapy of fulminant hepatitis, may promote expansion of T regulatory cells (Tregs) and B regulatory cells (Bregs), the role of these regulatory cells in MSC-mediated attenuation of acute liver injury is unknown. Herewith, we described the molecular mechanisms involved in the crosstalk between MSCs and liver regulatory cells and analyzed the potential of MSC-based therapy for the expansion of intrahepatic regulatory cells in mouse model of acute liver failure...
March 3, 2018: Liver Transplantation
Satoru Joshita, Kaname Yoshizawa, Takeji Umemura, Hiromasa Ohira, Atsushi Takahashi, Kenichi Harada, Nguyen Canh Hiep, Koichi Tsuneyama, Masayoshi Kage, Masayuki Nakano, Jong-Hon Kang, Kazuhiko Koike, Mikio Zeniya, Tetsuya Yasunaka, Akinobu Takaki, Takuji Torimura, Masanori Abe, Osamu Yokosuka, Atsushi Tanaka, Hajime Takikawa
BACKGROUND: Autoimmune hepatitis (AIH) is characterized by progressive inflammation and necrosis of hepatocytes and eventually leads to a variety of phenotypes, including acute liver dysfunction, chronic progressive liver disease, and fulminant hepatic failure. Although the precise mechanisms of AIH are unknown, environmental factors may trigger disease onset in genetically predisposed individuals. Patients with the recently established entity of AIH with acute presentation often display atypical clinical features that mimic those of acute hepatitis forms even though AIH is categorized as a chronic liver disease...
February 23, 2018: Journal of Gastroenterology
Angela L Chiew, Christian Gluud, Jesper Brok, Nick A Buckley
BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites...
February 23, 2018: Cochrane Database of Systematic Reviews
Drishti Tolani, Ira Shah
Hepatitis E virus (HEV) is an enterically transmitted infection that is typically self-limited. It spreads by fecally contaminated water within endemic areas. Hepatitis E infection occurs in both sporadic and epidemic forms in developing countries. HEV infection is usually subclinical in children but in a pregnant woman, it manifests commonly as fulminant hepatic failure. A few cases of acute liver failure caused primarily by HEV infection in children have been reported. We present a case of fulminant hepatitis E in a 1-year-old child...
July 2017: Journal of Family Medicine and Primary Care
Robert S Venick, Douglas G Farmer, Jose R Soto, Jorge Vargas, Hasan Yersiz, Fady M Kaldas, Vatche G Agopian, Jonathan R Hiatt, Sue V McDiarmid, Ronald W Busuttil
BACKGROUND: Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experiences and aimed to identify unique pre-operative predictors of early graft and patient survival for primary (1º-pLTx) and re-transplantation (Re-pLTx). STUDY DESIGN: An IRB approved, retrospective study of all consecutive, isolated pLTx patients ≤ 18 years of age was conducted...
February 1, 2018: Journal of the American College of Surgeons
Y Hirata, Y Sanada, T Urahashi, Y Ihara, N Yamada, N Okada, T Katano, S Otomo, K Ushijima, K Mizuta
BACKGROUND: Antibody drugs have been used to treat steroid-resistant rejection (SRR) after liver transplantation. Although anti-thymocyte globulin has been used for SRR after liver transplantation in place of muromonab-CD3 since 2011 in Japan, the effectiveness of anti-thymocyte globulin after pediatric living-donor liver transplantation (LDLT) has not yet been reported. The aim of this study was to evaluate the effectiveness of antibody drug treatment for SRR after pediatric LDLT in our single center...
January 2018: Transplantation Proceedings
Haidy Mohammed Zakaria, Tahany Abdel-Hamid Salem, Hanaa Ahmed El-Araby, Rawan Mohammed Salama, Doaa Yousry Elbadry, Ahmad Mohamed Sira, Mohammed Abdul-Hafeez Ali, Menan El-Sayed Salem, Basma Mahmoud Abd-Alaaty, Shaimaa Samy Goda, Sara Mohammed Eltaras, Fatma Omar Khalil, Sahar Shahein Abou-Zeinah, Mostafa Mohamed Sira
Fulminant hepatic failure is a life-threatening disease. Hepatitis A virus (HAV) can cause fulminant hepatic failure and death in about 0.2% of cases. Extensive destruction of infected hepatocytes by immune-mediated lysis is thought to be the cause. We aimed to evaluate the use of steroid therapy in children with fulminant HAV. This study included 33 children with fulminant HAV in two groups. Steroid group; comprised of 18 children who received prednisolone (1 mg/kg/d) or its equivalent dose of methylprednisolone and the non-steroid group; comprised another 15 children who did not receive steroid therapy...
February 3, 2018: Journal of Viral Hepatitis
Adam M Szewc, Steve Taylor, Gary D Cage, Jeffery Jacobsen, Ozlem Pinar Bulut, Daphne E de Mello
A previously healthy 11-year-old Caucasian boy presented with a 2-week history of nonspecific symptoms of nausea and nonbilious, nonbloody emesis. He developed significant jaundice and hepatic encephalopathy within 1 week of beginning symptoms and was discovered to have fulminant liver failure. Extensive work-ups for underlying etiologies included serologic evaluation for underlying chronic liver diseases, toxicology screening, inborn errors of metabolism, and infectious diseases. The results of the entire assessment were negative except for human herpesvirus 6B, which was detected in the liver by quantitative real-time polymerase chain reaction and immunohistochemical analysis...
January 30, 2018: Laboratory Medicine
Rubén Peña-Vélez, Enory Almanza-Miranda
In pediatrics, autoimmune hepatitis and sclerosing cholangitis are liver disorders with an immunological damage mechanism. Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression. It is an eminently pediatric disease with a prevalent condition in young women. Therapy should be instituted promptly to prevent rapid deterioration, promote remission of disease and long-term survival...
September 2017: Boletín Médico del Hospital Infantil de México
Bushra Moiz, Sidra Asad Ali
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder affecting some 400 million people worldwide. Though clinically silent, it may result in hemolysis on oxidative stress induced by drugs or infections. Viral hepatitis A with coexisting G6PD deficiency can be devastating associated with severe hemolysis, anemia, renal failure, and hepatic encephalopathy.
January 2018: Clinical Case Reports
Verónica Botero, Víctor H García, Ana M Aristizabal, Catalina Gomez, Paola Perez, Luis A Caicedo, Gabriel J Echeverri
INTRODUCTION: Hepatitis A virus (HAV) causes an acute infection and is usually asymptomatic in children. When clinical manifestations appear, these include choluria, jaundice, and abdominal pain. Although infrequent, extra-hepatic manifestations related to HAV have been described affecting the heart, bone marrow, blood vessels, and others. CASE: A 10-year-old boy from a rural area presented with a 15-day history of malaise, fever, and jaundice; laboratory exams were compatible with HAV Infection...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Dong-Lei Wang, Wen-Ying Dai, Wen Wang, Ying Wen, Ying Zhou, Yi-Tong Zhao, Jian Wu, Pei Liu
BACKGROUND & AIMS: We have reported that tumor necrosis factor- (TNF-α) is critical for reduction of glomerular filtration rate (GFR) in rats with fulminant hepatic failure (FHF). The present study aims to evaluate the underlying mechanisms of decreased GFR during acute hepatic failure. METHODS: Rats with FHF induced by D-galactosamine plus lipopolysaccharide (GalN/LPS) were injected intravenously with recombinant lentivirus harboring shRNA against the protein kinase C-α (PKC-α) gene (Lenti-shRNA-PKC-α)...
January 10, 2018: American Journal of Physiology. Renal Physiology
Jin Li, Bo Chen, Liping Zhong, Feng Gao, Haibo Zhu, Fengzhong Wang
Both AMP-activated protein kinase (AMPK) agonist and inhibitor have been reported to protect against fulminant hepatitis, implying that AMPK may play a complicated role in the development of fulminant hepatitis. In this study, we exploited whether the novel AMPK agonist N6-(3-hydroxyphenyl)adenosine (named as M1) exerted protective effects on fulminant hepatitis and whether its beneficial effects were AMPK-dependent. Results showed that intraperitoneal injection of M1 improved liver function, ameliorated liver injury and finally raised the survival rate in D-galactosamine/lipopolysaccharide (GalN/LPS)-treated mice...
January 18, 2018: Cell Death & Disease
Maggie L Chow, David Kim, Sonia Kamath, David Peng, Minnelly Luu
A 3-month-old girl with Sturge-Weber syndrome presented with a morbilliform rash, eosinophilia, and fulminant liver failure to our tertiary pediatric hospital. She was diagnosed with drug reaction with eosinophilia and systemic symptoms complicated by viremia and evidence of viral hepatitis on liver biopsy. We discuss the role of viral reactivation in drug reaction with eosinophilia and systemic symptoms and the relevance of antiviral therapy in management.
January 15, 2018: Pediatric Dermatology
X Yang
Wilson disease (WD) is a rare and treatable genetic disorder. This paper describes the new advances and author's long-term experiences in the diagnosis of WD. The characteristics in clinical and routine tests are: the age of presentation can be quite broad, the WD could not be excluded based on age only; the patients usually have mild digestive symptoms but obvious chronic liver disease signs; liver function tests may reveal normal or a mild elevation in bilirubin, ALT and AST, but quite abnormal in serum albumin and prothrombin time in most patients; Coombs-negative hemolytic anemia, normal or markedly subnormal serum alkaline phosphatase (typically < 40 IU/L) are useful for the diagnosis of fulminant WD...
December 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Harleen Chela, Mohamad H Yousef, Abdelmajeed A Albarrak, Bhupinder S Romana, Dania N Hudhud, Veysel Tahan
The definitive treatment for end stage liver disease remains a liver transplant and hence livers are needed for these patients along with cases of acute fulminant liver failure. Hence livers are a scarce and highly valuable commodity in the current time. By extending the pool of donors to include the elderly livers, it allows for increased availability of donors and reduces the mortality that is associated with the waiting list itself. There is an increasing prevalence of end stage liver disease due to conditions like chronic hepatitis B and C, non-alcoholic steatohepatitis, alcoholic liver disease...
December 24, 2017: World Journal of Transplantation
Thao T Tran, Allen D Brinker, Monica Muñoz
Several endothelin receptor antagonists (ERAs) that were developed for the treatment of pulmonary arterial hypertension (PAH), including bosentan and sitaxentan, have been linked to clinically significant hepatocellular injury, as well as liver failure. We describe the first case of fulminant hepatitis to be reported in association with the ERA macitentan. This case was recently identified within the United States Food and Drug Administration Adverse Event Reporting System (FAERS) and and describes liver transplantation occuring 13 months following macitentan initiation in a young patient (23-years old) with idiopathic PAH New York Heart Association (NYHA) functional class III...
December 29, 2017: Pharmacotherapy
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