Pub Date : 2017-09-28DOI: 10.4172/2167-0889.1000222
M. Tahir, P. Burkard
The drug induced liver injury by antipsychotics is a well reported subject in the medical literature. The hepatotoxic effects have been reported by atypical antipsychotic drugs like clozapine, risperidone and olanzapine [1]. The Quetiapine induced hepatocellular damage is relatively a rare incident. It is an atypical antipsychotic agent proven to be effective for the management of negative and positive symptoms of the psychosis [2]. It is a dibenzothiazepine derivative which works by mediating through a combined antagonism of dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors. Although considering its wide therapeutic range up to 750mg/day, it has a low side effect profile [3]. The common side effects reported are asymptomatic liver enzymes elevation, pancytopenia and thrombotic thrombocytopenic purpura [4]. The rare side effects reported are Neuroleptic malignant syndromes [5] and cardiac abnormalities in some of the patients. In our case report, we will describe the incident of acute liver injury caused by quetiapine in our patient, which if not identified and treated earlier can cause significant morbidity and mortality.
{"title":"Seroquel Induced Liver Injury","authors":"M. Tahir, P. Burkard","doi":"10.4172/2167-0889.1000222","DOIUrl":"https://doi.org/10.4172/2167-0889.1000222","url":null,"abstract":"The drug induced liver injury by antipsychotics is a well reported subject in the medical literature. The hepatotoxic effects have been reported by atypical antipsychotic drugs like clozapine, risperidone and olanzapine [1]. The Quetiapine induced hepatocellular damage is relatively a rare incident. It is an atypical antipsychotic agent proven to be effective for the management of negative and positive symptoms of the psychosis [2]. It is a dibenzothiazepine derivative which works by mediating through a combined antagonism of dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors. Although considering its wide therapeutic range up to 750mg/day, it has a low side effect profile [3]. The common side effects reported are asymptomatic liver enzymes elevation, pancytopenia and thrombotic thrombocytopenic purpura [4]. The rare side effects reported are Neuroleptic malignant syndromes [5] and cardiac abnormalities in some of the patients. In our case report, we will describe the incident of acute liver injury caused by quetiapine in our patient, which if not identified and treated earlier can cause significant morbidity and mortality.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"33 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82178231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-25DOI: 10.4172/2167-0889.1000220
T. Iwamoto, M. Maeda, I. Saeki, I. Hidaka, T. Ishikawa, T. Takami, I. Sakaida
Objective: Tolvaptan is an oral vasopressin V2 receptor antagonist that became available as therapy for decompensated hepatic cirrhosis-induced ascites in 2013. It has now been more than 3 years since hepatic edema was included in the indication. We investigated use of tolvaptan in our department, including long-term administration, discontinuation, and re-administration after discontinuation. Methods: The subjects were 62 patients with hepatic edema treated with tolvaptan between september 2013 and december 2016. Physical parameters and blood data during hospitalization and the course thereafter were investigated retrospectively. Results: The median age was 71.2 (49-87) years old, the mean Child-Pugh score was 9.5 ± 1.7, background liver Hepatitis C virus /Hepatitis B virus/Alcohol/Non-alcoholic steatohepatitis/Others=38/5/6/5/8, and 41 patients were complicated by hepatocellular carcinoma. Tolvaptan was initiated at 3.75 mg in all patients, and the dose was increased to 7.5 mg if the effect was insufficient after administration for 3 days. Patients who lost ≥ 1.5 kg weight after tolvaptan administration for one week were defined as early responders (39/62, 62.9%). The median duration of tolvaptan administration was 96 (7-992) days. Tolvaptan was continued in 46 patients at the outpatient clinic. In 5 patients, tolvaptan was discontinued because ascites improved, but 3 required readministration. Of the 46 patients who received continuous tolvaptan, 18 died, but 14 did not require removal of ascites by puncture or Cell−free and Concentrated Ascites Reinfusion Therapy before death. In an analysis of outcomes by Log-rank test, there was no significant relationship with Child-Pugh score or Model for End-Stage Liver Disease score, but significant effects of hepatocellular carcinoma and continuous tolvaptan. In multivariate analysis using Cox proportional hazards regression analysis, hepatocellular carcinoma (hazard ratio 3.366) and continuous tolvaptan (hazard ratio 7.291) were identified as significant independent factors related to outcome. Conclusion: Continuous administration of tolvaptan may enable long-term control of hepatic edema and improve the outcome of patients with hepatic cirrhosis.
{"title":"Long-Term Administration and Outcomes of Tolvaptan for Hepatic Edema","authors":"T. Iwamoto, M. Maeda, I. Saeki, I. Hidaka, T. Ishikawa, T. Takami, I. Sakaida","doi":"10.4172/2167-0889.1000220","DOIUrl":"https://doi.org/10.4172/2167-0889.1000220","url":null,"abstract":"Objective: Tolvaptan is an oral vasopressin V2 receptor antagonist that became available as therapy for decompensated hepatic cirrhosis-induced ascites in 2013. It has now been more than 3 years since hepatic edema was included in the indication. We investigated use of tolvaptan in our department, including long-term administration, discontinuation, and re-administration after discontinuation. \u0000Methods: The subjects were 62 patients with hepatic edema treated with tolvaptan between september 2013 and december 2016. Physical parameters and blood data during hospitalization and the course thereafter were investigated retrospectively. \u0000Results: The median age was 71.2 (49-87) years old, the mean Child-Pugh score was 9.5 ± 1.7, background liver Hepatitis C virus /Hepatitis B virus/Alcohol/Non-alcoholic steatohepatitis/Others=38/5/6/5/8, and 41 patients were complicated by hepatocellular carcinoma. Tolvaptan was initiated at 3.75 mg in all patients, and the dose was increased to 7.5 mg if the effect was insufficient after administration for 3 days. Patients who lost ≥ 1.5 kg weight after tolvaptan administration for one week were defined as early responders (39/62, 62.9%). The median duration of tolvaptan administration was 96 (7-992) days. Tolvaptan was continued in 46 patients at the outpatient clinic. In 5 patients, tolvaptan was discontinued because ascites improved, but 3 required readministration. Of the 46 patients who received continuous tolvaptan, 18 died, but 14 did not require removal of ascites by puncture or Cell−free and Concentrated Ascites Reinfusion Therapy before death. In an analysis of outcomes by Log-rank test, there was no significant relationship with Child-Pugh score or Model for End-Stage Liver Disease score, but significant effects of hepatocellular carcinoma and continuous tolvaptan. In multivariate analysis using Cox proportional hazards regression analysis, hepatocellular carcinoma (hazard ratio 3.366) and continuous tolvaptan (hazard ratio 7.291) were identified as significant independent factors related to outcome. \u0000Conclusion: Continuous administration of tolvaptan may enable long-term control of hepatic edema and improve the outcome of patients with hepatic cirrhosis.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"91 ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72550293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-20DOI: 10.4172/2167-0889.1000218
R. Niranjan, Ritambhara Gls, K. Mishra, S. Vijayaraghavalu, A. Goel, Munish Kumar
Rituraj Niranjan1*, Ritambhara2, Kaushal Prasad Mishra1, Sivakumar Vijayaraghavalu3, Amit Goel4 and Munish Kumar2,5 1Department of Biological Sciences and Bioengineering (BSBE), Indian Institute of Technology, Kanpur, Uttar Pradesh, India 2Department of Biochemistry, University of Allahabad, Allahabad, Uttar Pradesh, India 3Cleveland Lerner College of Medicine, Case western Reserve University, Cancer Nanomedicine Program, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
{"title":"The Role of MicroRNA-21 and Autophagy in Liver Fibrosis","authors":"R. Niranjan, Ritambhara Gls, K. Mishra, S. Vijayaraghavalu, A. Goel, Munish Kumar","doi":"10.4172/2167-0889.1000218","DOIUrl":"https://doi.org/10.4172/2167-0889.1000218","url":null,"abstract":"Rituraj Niranjan1*, Ritambhara2, Kaushal Prasad Mishra1, Sivakumar Vijayaraghavalu3, Amit Goel4 and Munish Kumar2,5 1Department of Biological Sciences and Bioengineering (BSBE), Indian Institute of Technology, Kanpur, Uttar Pradesh, India 2Department of Biochemistry, University of Allahabad, Allahabad, Uttar Pradesh, India 3Cleveland Lerner College of Medicine, Case western Reserve University, Cancer Nanomedicine Program, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82402831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-12DOI: 10.4172/2167-0889-C1-014
Paul Desmond
{"title":"Hepatitis B Infection is now 30 times more common in UK than US children","authors":"Paul Desmond","doi":"10.4172/2167-0889-C1-014","DOIUrl":"https://doi.org/10.4172/2167-0889-C1-014","url":null,"abstract":"","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84372897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-06DOI: 10.4172/2167-0889.1000217
Yoshinori Ozono, Yuka Takaishi, Mai Tsuchimochi, Kenichi Nakamura, Hiroo Abe, Tadashi Miike, K. Kusumoto, Hisayoshi Iwakiri, Mitsue Sueta, Yoshihiro Tahara, Shojiro Yamamoto, S. Hasuike, K. Nagata, K. Shimoda
Objective: Rapid virological response (RVR), defined as undetectable serum hepatitis C virus (HCV) RNA at week 4, is a useful predictor of sustained virological response (SVR) to peginterferon (PEG-IFN) plus ribavirin (RBV) therapy and protease inhibitor (telaprevir (TVR)/simeprevir (SMV)) based triple therapy for patients infected with genotype 1 HCV. The aim of this study was to predict SVR using viral response within 2 weeks of therapy initiation. Methods: Fifty-two HCV genotype 1b patients with high viral loads treated with protease inhibitor (TVR/SMV)- based triple therapy were analysed. Thirty-seven patients were treated with TVR-based triple therapy and 15 with SMV-based triple therapy. HCV RNA levels were measured at the following points: the day of therapy initiation, at days 1 and 3, and at weeks 1 and 2. Results: SVR was achieved in 87% (45/52) of patients. There was no difference in SVR rate between the TVRbased triple therapy group (92%) and the SMV-based triple therapy group (73%) (P=0.1726). Univariate analysis of contributors to SVR showed a significant effect of liver fibrosis, platelet count, aspartate transaminase, α-fetoprotein in terms of pre-treatment factors, and HCV RNA load at week 2, reduction of HCV RNA at day 1 and week 2, RVR, and PEG-IFN adherence in terms of on-treatment factors. By multivariate analysis, platelet count and HCV RNA load at week 2 were independently associated with high SVR rate. Conclusion: HCV RNA level at week 2 was the most useful predictor of SVR after TVR/SMV-based triple therapy in patients with genotype 1 HCV.
{"title":"Prediction of Sustained Virological Response to Telaprevir/Simeprevir-Based Triple Therapy in Patients with Genotype 1 Hepatitis C Virus Using Super-Early Viral Response within 2 Weeks","authors":"Yoshinori Ozono, Yuka Takaishi, Mai Tsuchimochi, Kenichi Nakamura, Hiroo Abe, Tadashi Miike, K. Kusumoto, Hisayoshi Iwakiri, Mitsue Sueta, Yoshihiro Tahara, Shojiro Yamamoto, S. Hasuike, K. Nagata, K. Shimoda","doi":"10.4172/2167-0889.1000217","DOIUrl":"https://doi.org/10.4172/2167-0889.1000217","url":null,"abstract":"Objective: Rapid virological response (RVR), defined as undetectable serum hepatitis C virus (HCV) RNA at week 4, is a useful predictor of sustained virological response (SVR) to peginterferon (PEG-IFN) plus ribavirin (RBV) therapy and protease inhibitor (telaprevir (TVR)/simeprevir (SMV)) based triple therapy for patients infected with genotype 1 HCV. The aim of this study was to predict SVR using viral response within 2 weeks of therapy initiation. \u0000Methods: Fifty-two HCV genotype 1b patients with high viral loads treated with protease inhibitor (TVR/SMV)- based triple therapy were analysed. Thirty-seven patients were treated with TVR-based triple therapy and 15 with SMV-based triple therapy. HCV RNA levels were measured at the following points: the day of therapy initiation, at days 1 and 3, and at weeks 1 and 2. \u0000Results: SVR was achieved in 87% (45/52) of patients. There was no difference in SVR rate between the TVRbased triple therapy group (92%) and the SMV-based triple therapy group (73%) (P=0.1726). Univariate analysis of contributors to SVR showed a significant effect of liver fibrosis, platelet count, aspartate transaminase, α-fetoprotein in terms of pre-treatment factors, and HCV RNA load at week 2, reduction of HCV RNA at day 1 and week 2, RVR, and PEG-IFN adherence in terms of on-treatment factors. By multivariate analysis, platelet count and HCV RNA load at week 2 were independently associated with high SVR rate. \u0000Conclusion: HCV RNA level at week 2 was the most useful predictor of SVR after TVR/SMV-based triple therapy in patients with genotype 1 HCV.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85390481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-05DOI: 10.4172/2167-0889.1000216
Y. Al-Azzawi, Y. Al-Abboodi, Matthew Fasullo, A. Ridha, T. Naguib
Background: The prevalence of coronary artery disease in cirrhotic population is estimated to be low and the risk of bleeding in those who had percutaneous catheterization interventions (PCI) is not well studied yet. Our aim in this study is to determine the morbidity and mortality risks in cirrhotic patient undergoing PCI. Methods: We performed a retrospective analysis using the National Inpatient Sample (NIS) database for 2010. The NIS is the largest publicly available inpatient health care database in the United States. It contains data from more than 7 million hospital stays each year. People with Percutaneous coronary intervention (PCI) related admissions and a history of cirrhosis diagnosis were placed in the case group. Equivalent number of people with PCI related admissions and no history of cirrhosis were identified randomly and Case-Control (PCI with cirrhosis vs. PCI without cirrhosis) design is used. All genders, race was with age of 18-year-old and above was included. A binary multivariate Logistic regression statistical test was used to examine the probability difference adjusted odd ratio. IBM SPSS Statistics for Windows was used to execute the analysis. A confidence interval (CI) of 95% and P value less than 0.05 were determined to define significance. Results: A total of 1218 of PCI related admissions were identified. 609 PCI related admissions with cirrhosis (Cases group) and equivalent number of 609 admissions with PCI and no cirrhosis (Control group) were randomly selected. 83.5% of the cohort represented by white race followed by Hispanic and African-American percentages of 10% and 6.5% respectively. The mean age of the cohort was 60 years, 54% represented by male race. The mean length of stay was 1.06 in the non-cirrhosis group compared to the 1.65 days in the cirrhosis group. Tables 1 and 2 (0.3%) out of 609 PCI related admission and no history of cirrhosis group had an Upper Gastrointestinal bleeding (UGIB) Vs. 11 (1.8%) in the PCI related admission with history of cirrhosis group. Inpatient mortality in the PCI+ non Cirrhosis group was 0.3% vs. 1.8% in the PCI and Cirrhosis group. The probability of dying during hospitalization for PCI related admission and have history of cirrhosis is 5 times higher than having a PCI without history of Cirrhosis with an adjusted odd ratio of 5.5(P-Value 0.026). Conclusion: There is a significantly higher risk of gastrointestinal bleeding and mortality in cirrhotic patients compared to the non-cirrhotic patients who underwent PCI.
背景:肝硬化人群中冠状动脉疾病的患病率估计较低，经皮导管介入治疗(PCI)患者出血的风险尚未得到很好的研究。我们在这项研究中的目的是确定接受PCI的肝硬化患者的发病率和死亡率风险。方法:我们使用2010年国家住院患者样本(NIS)数据库进行回顾性分析。NIS是美国最大的可公开获得的住院医疗保健数据库。它包含每年700多万次住院的数据。与经皮冠状动脉介入治疗(PCI)相关且有肝硬化诊断史的患者被置于病例组。随机选取同等数量的PCI相关入院且无肝硬化史的患者，采用病例-对照(PCI合并肝硬化vs. PCI无肝硬化)设计。所有性别，种族，年龄在18岁及以上。采用二元多元Logistic回归统计检验检验概率差校正奇比。使用IBM SPSS Statistics for Windows进行分析。以95%的置信区间(CI)和小于0.05的P值定义显著性。结果:共发现1218例PCI相关入院。随机选取609例PCI相关合并肝硬化入院患者(病例组)和609例同等数量的PCI合并合并无肝硬化入院患者(对照组)。白人占83.5%，其次是西班牙裔和非裔美国人，分别占10%和6.5%。队列的平均年龄为60岁，男性占54%。非肝硬化组的平均住院时间为1.06天，而肝硬化组为1.65天。表1和表2中609例PCI相关入院且无肝硬化史的患者(0.3%)发生上消化道出血(UGIB)，而有肝硬化史的PCI相关入院患者(11例)发生上消化道出血(1.8%)。PCI+非肝硬化组的住院死亡率为0.3%，PCI+肝硬化组为1.8%。有肝硬化病史的PCI患者住院期间死亡的概率是无肝硬化病史PCI患者的5倍，调整奇数比为5.5(p值为0.026)。结论:与接受PCI治疗的非肝硬化患者相比，肝硬化患者发生胃肠道出血和死亡率的风险明显更高。
{"title":"The Morbidity and Mortality Risks following Percutaneous Coronary Interventions in Cirrhosis","authors":"Y. Al-Azzawi, Y. Al-Abboodi, Matthew Fasullo, A. Ridha, T. Naguib","doi":"10.4172/2167-0889.1000216","DOIUrl":"https://doi.org/10.4172/2167-0889.1000216","url":null,"abstract":"Background: The prevalence of coronary artery disease in cirrhotic population is estimated to be low and the risk \u0000 of bleeding in those who had percutaneous catheterization interventions (PCI) is not well studied yet. Our aim in this \u0000 study is to determine the morbidity and mortality risks in cirrhotic patient undergoing PCI. \u0000Methods: We performed a retrospective analysis using the National Inpatient Sample (NIS) database for 2010. \u0000 The NIS is the largest publicly available inpatient health care database in the United States. It contains data from \u0000 more than 7 million hospital stays each year. People with Percutaneous coronary intervention (PCI) related \u0000 admissions and a history of cirrhosis diagnosis were placed in the case group. Equivalent number of people with PCI \u0000 related admissions and no history of cirrhosis were identified randomly and Case-Control (PCI with cirrhosis vs. PCI \u0000 without cirrhosis) design is used. All genders, race was with age of 18-year-old and above was included. A binary \u0000 multivariate Logistic regression statistical test was used to examine the probability difference adjusted odd ratio. IBM \u0000 SPSS Statistics for Windows was used to execute the analysis. A confidence interval (CI) of 95% and P value less \u0000 than 0.05 were determined to define significance. \u0000Results: A total of 1218 of PCI related admissions were identified. 609 PCI related admissions with cirrhosis \u0000 (Cases group) and equivalent number of 609 admissions with PCI and no cirrhosis (Control group) were randomly \u0000 selected. 83.5% of the cohort represented by white race followed by Hispanic and African-American percentages of \u0000 10% and 6.5% respectively. The mean age of the cohort was 60 years, 54% represented by male race. The mean \u0000 length of stay was 1.06 in the non-cirrhosis group compared to the 1.65 days in the cirrhosis group. Tables 1 and 2 (0.3%) out of 609 PCI related admission and no history of cirrhosis group had an Upper Gastrointestinal bleeding (UGIB) Vs. 11 (1.8%) in the PCI related admission with history of cirrhosis group. Inpatient mortality in the PCI+ non \u0000 Cirrhosis group was 0.3% vs. 1.8% in the PCI and Cirrhosis group. \u0000The probability of dying during hospitalization for PCI related admission and have history of cirrhosis is 5 times \u0000 higher than having a PCI without history of Cirrhosis with an adjusted odd ratio of 5.5(P-Value 0.026). \u0000Conclusion: There is a significantly higher risk of gastrointestinal bleeding and mortality in cirrhotic patients \u0000 compared to the non-cirrhotic patients who underwent PCI.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"52 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85138425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-10DOI: 10.4172/2167-0889.1000215
T. Shizuma
Cases of liver abscess complicated by portal vein thrombosis are relatively rare. We report a case of liver abscess caused by α-hemolytic streptococci and complicated by portal vein thrombosis. A 51-year-old male presented with fever and right hypochondralgia. He had watery diarrhoea and bloody stool for over 1 month before presentation. Laboratory tests showed elevated hepatobiliary enzymes, inflammation findings, and anemia. Abdominal imaging revealed liver abscess in the right lobe and thrombosis of right and left branches of the portal vein; no thrombosis was observed in the extrahepatic portal vein. Colonoscopy revealed nonspecific colitis without diverticula or malignancies, and no possible causes of liver abscess except for enterocolitis were detected. Clinical course and laboratory findings indicated that an amoebic liver abscess was unlikely. Blood and pus cultures were positive for α-hemolytic streptococci. A diagnosis of liver abscess caused by α-hemolytic streptococci and complicated by portal vein thrombosis was made. The size of the liver abscess reduced, and inflammation findings resolved with 3 weeks of antibiotic treatment and abscess drainage. Portal vein thrombosis disappeared after 2 week anticoagulant therapy.
{"title":"A Case of liver abscess with Portal Vein Thrombosis caused by α-Hemolytic streptococci","authors":"T. Shizuma","doi":"10.4172/2167-0889.1000215","DOIUrl":"https://doi.org/10.4172/2167-0889.1000215","url":null,"abstract":"Cases of liver abscess complicated by portal vein thrombosis are relatively rare. We report a case of liver abscess caused by α-hemolytic streptococci and complicated by portal vein thrombosis. A 51-year-old male presented with fever and right hypochondralgia. He had watery diarrhoea and bloody stool for over 1 month before presentation. Laboratory tests showed elevated hepatobiliary enzymes, inflammation findings, and anemia. Abdominal imaging revealed liver abscess in the right lobe and thrombosis of right and left branches of the portal vein; no thrombosis was observed in the extrahepatic portal vein. Colonoscopy revealed nonspecific colitis without diverticula or malignancies, and no possible causes of liver abscess except for enterocolitis were detected. Clinical course and laboratory findings indicated that an amoebic liver abscess was unlikely. Blood and pus cultures were positive for α-hemolytic streptococci. A diagnosis of liver abscess caused by α-hemolytic streptococci and complicated by portal vein thrombosis was made. The size of the liver abscess reduced, and inflammation findings resolved with 3 weeks of antibiotic treatment and abscess drainage. Portal vein thrombosis disappeared after 2 week anticoagulant therapy.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"58 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91080393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-08DOI: 10.4172/2167-0889.1000214
H. Zakaria, M. Taha, E. Gad, H. Soliman, O. Hegazy, Talaat Zakareya, Mohamed Abbasy, D. Elazab, Doha Maher, Rasha Abdelhafiz, Hazem Abdelkawy, N. Gaballa, K. A. El-Ella, T. Ibrahim
Background: Portal vein thrombosis (PVT) in living donor liver transplantation (LDLT) is a surgical challenge with technical difficulty. The aim of this study was to analyze the operative planning for management of PVT in LDLT and the impact of PVT on the outcome in comparison to patients without PVT. Methods: Between July 2003 to August 2016, 213 patients underwent LDLT. The patients were divided into two groups with and without PVT. The preoperative, operative, and postoperative data were analysed. Results: Thirty six patients (16.9%) had different grades of PVT at time of liver transplantation (LT); grades I, II, III and IV were 18 (50%), 14 (38.9%), 3 (8.3%) and 1 patient (2.8%) respectively. The management of PVT was by; thrombectomy in 31 patients (86%), bypass graft in 2 patients (5.6%), portal replacement graft in 1 patient (2.8%), anastomosis with the left renal vein in 1 patient (2.8%) and with large collateral vein in 1 patient (2.8%). Overall postoperative PVT occurred in 10 patients (4.7%), 4 patients of them had preoperative PVT. The perioperative mortality in patients with PVT, and patients without PVT was 33.3%, and 20.3%, respectively (P=0.17). The 1-, 3-, 5-, and 7y survival in patients with PVT was 49.7%, 46.2%, 46.2%, 46.2% respectively and in patients without PVT it was 65%, 53.7%, 50.8%, 49% respectively (P=0.29). Conclusions: Preoperative PVT may not keep a patient from undergoing successful LT with comparable outcome to patients without PVT specially with partial PVT.
{"title":"Living Donor Liver Transplantation for Patients with Pre-existent Portal Vein Thrombosis","authors":"H. Zakaria, M. Taha, E. Gad, H. Soliman, O. Hegazy, Talaat Zakareya, Mohamed Abbasy, D. Elazab, Doha Maher, Rasha Abdelhafiz, Hazem Abdelkawy, N. Gaballa, K. A. El-Ella, T. Ibrahim","doi":"10.4172/2167-0889.1000214","DOIUrl":"https://doi.org/10.4172/2167-0889.1000214","url":null,"abstract":"Background: Portal vein thrombosis (PVT) in living donor liver transplantation (LDLT) is a surgical challenge with technical difficulty. The aim of this study was to analyze the operative planning for management of PVT in LDLT and the impact of PVT on the outcome in comparison to patients without PVT. Methods: Between July 2003 to August 2016, 213 patients underwent LDLT. The patients were divided into two groups with and without PVT. The preoperative, operative, and postoperative data were analysed. Results: Thirty six patients (16.9%) had different grades of PVT at time of liver transplantation (LT); grades I, II, III and IV were 18 (50%), 14 (38.9%), 3 (8.3%) and 1 patient (2.8%) respectively. The management of PVT was by; thrombectomy in 31 patients (86%), bypass graft in 2 patients (5.6%), portal replacement graft in 1 patient (2.8%), anastomosis with the left renal vein in 1 patient (2.8%) and with large collateral vein in 1 patient (2.8%). Overall postoperative PVT occurred in 10 patients (4.7%), 4 patients of them had preoperative PVT. The perioperative mortality in patients with PVT, and patients without PVT was 33.3%, and 20.3%, respectively (P=0.17). The 1-, 3-, 5-, and 7y survival in patients with PVT was 49.7%, 46.2%, 46.2%, 46.2% respectively and in patients without PVT it was 65%, 53.7%, 50.8%, 49% respectively (P=0.29). Conclusions: Preoperative PVT may not keep a patient from undergoing successful LT with comparable outcome to patients without PVT specially with partial PVT.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"117 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73046117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-23DOI: 10.4172/2167-0889-C1-010
Yuming Wang
{"title":"Renal involvement in patients with Hepatitis B","authors":"Yuming Wang","doi":"10.4172/2167-0889-C1-010","DOIUrl":"https://doi.org/10.4172/2167-0889-C1-010","url":null,"abstract":"","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76787301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-20DOI: 10.4172/2167-0889.1000213
Yasuhiro Nakamura, Y. Matsuzaki, K. Momose, K. Sasaki, M. Matsuda
Cyprostate acetate (CPA) has been used in the treatment of hyper sexuality, which is considered as carcinogenic agent and its use has been prohibited for children. We presented young patient having hepatocellular carcinoma (HCC) with medication history of CPA during childhood, which arose from normal background liver without virus infections and other causes of liver dysfunction. The patient had multiple tumours in the liver, and only the largest one was diagnosed as HCC and other resected ones were hemangioma and hamartoma.
{"title":"Hepatocellular Carcinoma with McCune Albright Syndrome","authors":"Yasuhiro Nakamura, Y. Matsuzaki, K. Momose, K. Sasaki, M. Matsuda","doi":"10.4172/2167-0889.1000213","DOIUrl":"https://doi.org/10.4172/2167-0889.1000213","url":null,"abstract":"Cyprostate acetate (CPA) has been used in the treatment of hyper sexuality, which is considered as carcinogenic agent and its use has been prohibited for children. We presented young patient having hepatocellular carcinoma (HCC) with medication history of CPA during childhood, which arose from normal background liver without virus infections and other causes of liver dysfunction. The patient had multiple tumours in the liver, and only the largest one was diagnosed as HCC and other resected ones were hemangioma and hamartoma.","PeriodicalId":16145,"journal":{"name":"Journal of Liver","volume":"508 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81713591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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