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Clinical review and literature analysis of hepatic epithelioid angiomyolipoma in alcoholic cirrhosis: A case report
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作者 Jing-Qiang Guo Jia-Hui Zhou +2 位作者 Kun Zhang Xin-Liang Lv Chao-Yong Tu 《World Journal of Clinical Cases》 SCIE 2024年第14期2382-2388,共7页
BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the pre... BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the presence of liver diseases such as hepatitis cirrhosis.This article reviewed the diagnosis and treatment of a patient with HEA and alcoholic cirrhosis,and analyzed the literature,in order to improve the understanding of this disease.CASE SUMMARY A 67-year-old male patient with a history of alcoholic cirrhosis was admitted due to the discovery of a space-occupying lesion in the liver.Based on the patient’s history,laboratory examinations,and imaging examinations,a malignant liver tumor was considered and laparoscopic partial hepatectomy was performed.Postoperative pathology showed HEA.During outpatient follow-up,the patient showed no sign of recurrence.CONCLUSION HEA is difficult to make a definite diagnosis before surgery.HEA has the poten-tial for malignant degeneration.If conditions permit,surgical treatment is recom-mended. 展开更多
关键词 Hepatic epithelioid angiomyolipoma alcoholic cirrhosis Magnetic resonance imaging Computed tomography IMMUNOHISTOCHEMISTRY Misdiagnose analysis Case report
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Liver decompensation after rapid weight loss from semaglutide in a patient with non-alcoholic steatohepatitis -associated cirrhosis 被引量:1
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作者 Matthew Peverelle Jonathan Ng +2 位作者 James Peverelle Ryan D.Hirsch Adam Testro 《World Journal of Gastroenterology》 SCIE CAS 2023年第47期6165-6167,共3页
There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonistssuch as semaglutide worldwide for weight loss and management of non-alcoholicsteatohepatitis (NASH). remains a paucity of safety data in th... There is rapidly increasing uptake of GLP-1 (glucagon-like peptide-1) agonistssuch as semaglutide worldwide for weight loss and management of non-alcoholicsteatohepatitis (NASH). remains a paucity of safety data in the vulnerable NASHcirrhotic population. We report herein the first documented case of liver decompensationand need for liver transplant waitlisting in a patient with NASHcirrhosistreated with semaglutide. Rapid weight loss led to the development ofascites and hepatic encephalopathy and an increase in the patients Model forEndstage Liver Disease-Na (MELD-Na) score from 11 to 22. Aggressive nutritionalsupplementation was commenced and the semaglutide was stopped. Overthe following months she regained her weight and her liver recompensated andher MELD-Na decreased to 13, allowing her to be delisted from the transplantwaitlist. This case serves as a cautionary tale to clinicians using semaglutide in thecirrhotic population and highlights the need for more safety data in this patientgroup. 展开更多
关键词 Semaglutide Non-alcoholic steatohepatitis cirrhosis Non-alcoholic steatohepatitis cirrhosis Glucagon-like peptide 1 agonists Weight loss
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Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects? 被引量:4
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作者 Luis Aparisi Luis Sabater +6 位作者 Juan Del-Olmo Juan Sastre Miguel-Angel Serra Ricardo Campello Daniel Bautista Abdalla Wassel José-Manuel Rodrigo 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第40期6171-6179,共9页
AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology,after excluding any other causes.METHODS: One hundred and forty consecutive alcoholic patients we... AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology,after excluding any other causes.METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53),LC (n = 57),and asymptomatic alcoholic (n = 30).Clinical,biochemical and morphological characteristics,Child-Pugh index,indocyanine green test,and fecal pancreatic elastase-1 test were assessed.RESULTS: In patients with cirrhosis,major clinical manifestations of CP such as pancreatic pain and steatorrhea,as well as imaging alterations of CP such as calcifications,duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases,and elastase-1 test was altered in only 7%,and severely altered in none.In patients with CP,clinical characteristics of cirrhosis such as ascites,encephalopathy and gastrointestinal hemorrhage were present in one case,Child-Pugh grade > A in 5.7%,and altered indocyanine green test in 1.9% cases.In asymptomatic alcoholism,there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%,respectively,but other characteristics of cirrhosis or CP were absent.An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients.CONCLUSION: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology,but an inverse correlation between pancreatic and liver function tests.These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis. 展开更多
关键词 alcoholic chronic pancreatitis alcoholicliver cirrhosis ALCOHOLISM Pancreatic function Hepaticfunction
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Towards an evaluation of alcoholic liver cirrhosis and nonalcoholic fatty liver disease patients with hematological scales 被引量:6
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作者 Agata Michalak Halina Cichoz-Lach +4 位作者 Malgorzata Guz Joanna Kozicka Marek Cybulski Witold Jeleniewicz Andrzej Stepulak 《World Journal of Gastroenterology》 SCIE CAS 2020年第47期7538-7549,共12页
BACKGROUND Seeking potentially novel blood markers of liver fibrosis and steatosis is constantly of crucial importance.Despite a growing number of studies in this field of hepatology,a certain role of hematological in... BACKGROUND Seeking potentially novel blood markers of liver fibrosis and steatosis is constantly of crucial importance.Despite a growing number of studies in this field of hepatology,a certain role of hematological indices in the course of liver disorders has not been fully elucidated,yet.AIM To evaluate a diagnostic accuracy of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and mean platelet volume-to-platelet-ratio(MPR)in the course of alcoholic liver cirrhosis(ALC)and nonalcoholic fatty liver disease(NAFLD).METHODS One hundred forty-two patients with ALC,92 with NAFLD and 68 persons in control group were enrolled in the study.Hematological indices(NLR,PLR and MPR),indirect and direct markers of liver fibrosis(aspartate transaminase to alkaline transaminase ratio,aspartate transaminase to platelet ratio index,fibrosis-4,gamma-glutamyl transpeptidase to platelet ratio,procollagen Ⅰ carboxyterminal propeptide,procollagen Ⅲ aminoterminal propeptide,transforming growth factor-α,platelet-derived growth factor AB,laminin)were measured in each person.Model for end-stage liver disease(MELD)score in ALC group and NAFLD fibrosis score together with BARD score were calculated in NAFLD patients.Receiver operating characteristic(ROC)curves and area under the curve(AUC)values were applied to assess the sensitivity and specificity of examined markers and to evaluate proposed cut-offs of measured indices in the course of ALC and NAFLD.RESULTS MPR and NLR values in ALC patients were significantly higher in comparison to control group;PLR level was significantly lower.MPR and PLR correlated with assessed indirect and direct markers of liver fibrosis.MPR,NLR and PLR correlated with MELD score.NLR level in NAFLD patients was significantly higher in comparison to controls.MPR correlated with indirect markers of liver fibrosis and NAFLD fibrosis score.AUC values and proposed cut-offs for NLR,PLR and MPR in ALC patients were:0.821(>2.227),0.675(<70.445)and 0.929(>0.048),respectively.AUC values and proposed cut-offs for NLR,PLR and MPR in NAFLD group were:0.725(>2.034),0.528(>97.101)and 0.547(>0.038),respectively.CONCLUSION Hematological markers are inseparably connected with serological indices of liver fibrosis in ALC and NAFLD patients.MPR and NLR turned out to be the most powerful parameters in ALC patients. 展开更多
关键词 Hematological markers alcoholic liver cirrhosis Nonalcoholic fatty liver disease Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Mean platelet volume-to-platelet-ratio
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Distinctive aspects of peptic ulcer disease,Dieulafoy'slesion,and Mallory-Weiss syndrome in patients withadvanced alcoholic liver disease or cirrhosis 被引量:26
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作者 Borko Nojkov Mitchell S Cappell 《World Journal of Gastroenterology》 SCIE CAS 2016年第1期446-466,共21页
AIM:To systematically review the data on distinctive aspects of peptic ulcer disease(PUD),Dieulafoy’s lesion(DL),and Mallory-Weiss syndrome(MWS)in patients with advanced alcoholic liver disease(a ALD),including alcoh... AIM:To systematically review the data on distinctive aspects of peptic ulcer disease(PUD),Dieulafoy’s lesion(DL),and Mallory-Weiss syndrome(MWS)in patients with advanced alcoholic liver disease(a ALD),including alcoholic hepatitis or alcoholic cirrhosis.METHODS:Computerized literature search performed via Pub Med using the following medical subject heading terms and keywords:"alcoholic liver disease","alcoholic hepatitis","alcoholic cirrhosis","cirrhosis","liver disease","upper gastrointestinal bleeding","nonvariceal upper gastrointestinal bleeding","PUD",‘‘DL’’,‘‘Mallory-Weiss tear",and"MWS’’.RESULTS:While the majority of acute gastrointestinal(GI)bleeding with a ALD is related to portal hypertension,about 30%-40%of acute GI bleeding in patients with a ALD is unrelated to portal hypertension.Such bleeding constitutes an important complication of a ALD because of its frequency,severity,and associated mortality.Patients with cirrhosis have a markedly increased risk of PUD,which further increases with the progression of cirrhosis.Patients with cirrhosis or a ALD and peptic ulcer bleeding(PUB)have worse clinical outcomes than other patients with PUB,including uncontrolled bleeding,rebleeding,and mortality.Alcohol consumption,nonsteroidal anti-inflammatory drug use,and portal hypertension may have a pathogenic role in the development of PUD in patients with a ALD.Limited data suggest that Helicobacter pylori does not play a significant role in the pathogenesis of PUD in most cirrhotic patients.The frequency of bleeding from DL appears to be increased in patients with a ALD.DL may be associated with an especially high mortality in these patients.MWS is strongly associated with heavy alcohol consumption from binge drinking or chronic alcoholism,and is associated with a ALD.Patients with a ALD have more severe MWS bleeding and are more likely to rebleed when compared to non-cirrhotics.Preendoscopic management of acute GI bleeding in patients with a ALD unrelated to portal hypertension is similar to the management of a ALD patients with GI bleeding from portal hypertension,because clinical distinction before endoscopy is difficult.Most patients require intensive care unit admission and attention to avoid over-transfusion,to correct electrolyte abnormalities and coagulopathies,and to administer antibiotic prophylaxis.Alcoholics should receive thiamine and be closely monitored for symptoms of alcohol withdrawal.Prompt endoscopy,after initial resuscitation,is essential to diagnose and appropriately treat these patients.Generally,the same endoscopic hemostatic techniques are used in patients bleeding from PUD,DL,or MWS in patients with a ALD as in the general population.CONCLUSION:Nonvariceal upper GI bleeding in patients with a ALD has clinically important differences from that in the general population without a ALD,including:more frequent and more severe bleeding from PUD,DL,or MWS. 展开更多
关键词 alcoholic liver DISEASE alcoholic hepatitis cirrhosis Portal hypertension PEPTIC ULCER DISEASE Mallory-Weiss syndrome DIEULAFOY lesion Endoscopictherapy
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Rare leptin in non-alcoholic fatty liver cirrhosis:A case report
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作者 Yao-Bin Nong Hong-Na Huang +7 位作者 Jing-Jing Huang Yuan-Qin Du Wen-Xuan Song De-Wen Mao Yue-Xue Zhong Rong-Huo Zhu Xi-Yu Xiao Rui-Xi Zhong 《World Journal of Clinical Cases》 SCIE 2022年第28期10293-10300,共8页
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)-related cirrhosis is mainly caused by NAFLD by causing inflammation which leads to fibrosis.The role of leptin in NAFLD-related cirrhosis has been rarely reported.CA... BACKGROUND Non-alcoholic fatty liver disease(NAFLD)-related cirrhosis is mainly caused by NAFLD by causing inflammation which leads to fibrosis.The role of leptin in NAFLD-related cirrhosis has been rarely reported.CASE SUMMARY This study presents the case of a 65-year-old male patient who was referred to The First Affiliated Hospital of Guangxi University of Chinese Medicine,Guangxi,Chi-na,for diagnosis and treatment for liver cirrhosis.Initially,the cause of liver cirrhosis was unknown.After radiology,laboratory examination,pathological results and analysis of the patient’s signs and symptoms,the case was finally diagnosed with final NAFLD-related cirrhosis.Although this study reports a single case,the findings might expand the understanding of leptin’s role in NAFLD-related cirrhosis and might provide a basis for the clinical diagnostic criteria,pathological features and treatment of NAFLD-related cirrhosis.CONCLUSION Although the occurrence of marasmus NAFLD-related cirrhosis is rare,it needs to be distinguished from other liver diseases,including viral hepatitis,drug-induced liver disease,Wilson’s disease and autoimmune liver disease.Aggressive treatment is needed to prevent the progression of NAFLD-related cirrhosis. 展开更多
关键词 Non-alcoholic fatty cirrhosis Leptin type Nonalcoholic fatty liver disease Case report
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Correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis 被引量:14
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作者 Hideaki Takahashi Ryuta Shigefuku +7 位作者 Yoshihito Yoshida Hiroki Ikeda Kotaro Matsunaga Nobuyuki Matsumoto Chiaki Okuse Shigeru Sase Fumio Itoh Michihiro Suzuki 《World Journal of Gastroenterology》 SCIE CAS 2014年第45期17065-17074,共10页
AIM: To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis (AL-LC).
关键词 alcoholic liver cirrhosis Hepatic tissue blood flow Liver function Indocyanine green Xenon computed tomography
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Favorable clinical outcome of nonalcoholic liver cirrhosis patients with coronary artery disease:A population-based study 被引量:6
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作者 Ming-Chang Tsai Tzu-Wei Yang +4 位作者 Chi-Chih Wang Yao-Tung Wang Wen-Wei Sung Ming-Hseng Tseng Chun-Che Lin 《World Journal of Gastroenterology》 SCIE CAS 2018年第31期3547-3555,共9页
AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40... AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients. 展开更多
关键词 NONalcoholic liver cirrhosis CORONARY ARTERY disease POPULATION-BASED study
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Incidence, risk factors and outcome of de novo tumors in liver transplant recipients focusing on alcoholic cirrhosis 被引量:6
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作者 Carlos Jiménez-Romero Iago Justo-Alonso +5 位作者 Félix Cambra-Molero Jorge Calvo-Pulido álvaro García-Sesma Manuel Abradelo-Usera Oscar Caso-Maestro Alejandro Manrique-Municio 《World Journal of Hepatology》 CAS 2015年第7期942-953,共12页
Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in c... Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions(inflammatory bowel disease, Barrett's esophagus). A significantly more frequent incidence of upper aerodigestive(UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and postOLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT. 展开更多
关键词 De novo malignancies De novo tumorstobacco consumption alcoholic cirrhosis De novocancer Liver transplant
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Budd-Chiari like syndrome in decompensated alcoholic steatohepatitis and liver cirrhosis 被引量:3
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作者 Carlos Robles-Medranda Hannah Lukashok +2 位作者 Beatriz Biccas Vera L Pannain Homero S Fogaa 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第40期6564-6566,共3页
A rare case of pseudo-Budd-Chiari Syndrome in a patientwith decompensated alcoholic liver disease is reported.Although clinical and radiological findings suggestedBudd-Chiari Syndrome, the liver biopsy revealedmicrono... A rare case of pseudo-Budd-Chiari Syndrome in a patientwith decompensated alcoholic liver disease is reported.Although clinical and radiological findings suggestedBudd-Chiari Syndrome, the liver biopsy revealedmicronodular cirrhosis and absence of histological signsof hepatic outflow obstruction. 展开更多
关键词 Pseudo Budd-Chiari Budd-Chiari syndrome Liver cirrhosis alcoholic steatohepatitis
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Spontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis:A case report 被引量:3
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作者 Chun-Yan Chang Chen Liu +3 位作者 Fang-Fang Duan Hang Zhai Shan-Shan Song Song Yang 《World Journal of Clinical Cases》 SCIE 2022年第30期11172-11177,共6页
BACKGROUND Hepatic myelopathy(HM)is a rare neurological complication of advanced cirrhosis.Prognosis of patients with HM is generally poor without timely liver transplantation or interventional therapy.Self-resolving ... BACKGROUND Hepatic myelopathy(HM)is a rare neurological complication of advanced cirrhosis.Prognosis of patients with HM is generally poor without timely liver transplantation or interventional therapy.Self-resolving HM in patients with alcoholic cirrhosis has never been reported.CASE SUMMARY A 53-year-old man with alcoholic cirrhosis and recurrent overt hepatic encephalopathy for 1 year was admitted for lower extremity weakness,slow movement,and stumbling gait.The patient was diagnosed with HM after excluding other causes of spastic paraparesis.The patient refused liver transplantation.However,the patient kept total abstinence and received a multidisciplinary treatment for complications of decompensated cirrhosis.The symptoms of HM resolved gradually after 2 years of treatment.All complications of alcoholic cirrhosis resolved after 4 years of follow-up.CONCLUSION The case demonstrates that HM can resolve in patients without liver transplantation after total abstinence and systemic management of complications. 展开更多
关键词 alcoholic cirrhosis Hepatic myelopathy Hepatic encephalopathy Spastic paraparesis THERAPEUTICS Case report
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Simple scoring system for predicting cirrhosis in nonalcoholic fatty liver disease 被引量:2
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作者 Takaomi Kessoku Yuji Ogawa +18 位作者 Masato Yoneda Kento Imajo Yoshio Sumida Yuichiro Eguchi Hideki Fujii Hideyuki Hyogo Masafumi Ono Yasuaki Suzuki Takumi Kawaguchi Kazuaki Chayama Saiyu Tanaka Kazuma Fujimoto Keizo Anzai Toshiji Saibara Michio Sata Yoshito Itoh Atsushi Nakajima Takeshi Okanoue Japan Study Group of NAFLD(JSG-NAFLD) 《World Journal of Gastroenterology》 SCIE CAS 2014年第29期10108-10114,共7页
AIM: To investigate a simple noninvasive scoring system for predicting liver cirrhosis in nonalcoholic fatty liver disease (NAFLD) patients.
关键词 Nonalcoholic fatty liver disease cirrhosis FIBROSIS PLATELET ALBUMIN Alanine aminotransferase ratio
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Elevated nitric oxide and 3',5' cyclic guanosine monophosphate levels in patients with alcoholic cirrhosis 被引量:1
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作者 Cíntia Siqueira Miguel Carneiro de Moura +1 位作者 Ana Júlia Pedro Paula Rocha 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第2期236-242,共7页
AIM: To evaluate whether serum levels of nitric oxide (NO ·) and plasma levels of cyclic guanosine monophosphate (cGMP) and total glutathione (GSH) are altered in patients with alcoholic cirrhosis and to examine ... AIM: To evaluate whether serum levels of nitric oxide (NO ·) and plasma levels of cyclic guanosine monophosphate (cGMP) and total glutathione (GSH) are altered in patients with alcoholic cirrhosis and to examine their correlation with the severity of liver disease.METHODS: Twenty-six patients with alcoholic liver cirrhosis were studied. Serum levels of NO · and plasma levels of cGMP and GSH were measured in 7 patients with compensated alcoholic cirrhosis (Child-Pugh A) and 19 patients with advanced cirrhosis (Child-Pugh B and C). The model for end-stage liver disease (MELD) score was evaluated. Sixteen healthy volunteers served as controls. Liver enzymes and creatinine levels were also tested.RESULTS: NO · and cGMP levels were higher in patients with Child-Pugh B and C cirrhosis than in Child-Pugh A cirrhosis or controls (NO ·: 21.70 ± 8.07 vs 11.70 ± 2.74; 21.70 ± 8.07 vs 7.26 ± 2.47 μmol/L, respectively; P < 0.001) and (cGMP: 20.12 ± 6.62 vs 10.14 ± 2.78; 20.12 ± 6.62 vs 4.95 ± 1.21 pmol/L, respectively; P < 0.001). Total glutathione levels were lower in patients with Child-Pugh B and C cirrhosis than in patients with Child-Pugh A cirrhosis or controls (16.04 ± 6.06 vs 23.01 ± 4.38 or 16.04 ± 6.06 vs 66.57 ± 26.23 μmol/L, respectively; P < 0.001). There was a significant correlation between NO · and cGMP levels in all patients with alcoholic cirrhosis. A significant negative correlation between reduced glutathione/glutathione disulfide and the MELD score was found in all cirrhotic patients.CONCLUSION: Our results suggest a role for oxidative stress in alcoholic liver cirrhosis, which is more significant in decompensated patients with higher levels of NO ·and cGMP and lower GSH levels than in compensated and control patients. Altered mediator levels in decompensated patients may influence the hemodynamic changes in and progression of liver disease. 展开更多
关键词 Oxidative stress Nitric oxide alcoholic cirrhosis FIBROSIS Model for end-stage liver disease
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Risk factors for hepatocellular carcinoma in cirrhosis due to nonalcoholic fatty liver disease: A multicenter, case-control study 被引量:1
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作者 Kathleen E Corey Samer Gawrieh +10 位作者 Andrew S deLemos Hui Zheng Andrew E Scanga Jennifer W Haglund Jorge Sanchez Christopher J Danford Megan Comerford Krista Bossi Samina Munir Naga Chalasani Julia Wattacheril 《World Journal of Hepatology》 CAS 2017年第7期385-390,共6页
AIM To identify risk factors associated with hepatocellular carcinoma(HCC), describe tumor characteristics and treatments pursed for a cohort of individuals with nonalcoholic steatohepatitis(NASH) cirrhosis. METHODS W... AIM To identify risk factors associated with hepatocellular carcinoma(HCC), describe tumor characteristics and treatments pursed for a cohort of individuals with nonalcoholic steatohepatitis(NASH) cirrhosis. METHODS We conducted a retrospective case-control study of a well-characterized cohort of patients among five liver transplant centers with NASH cirrhosis with(cases) and without HCC(controls).RESULTS Ninety-four cases and 150 controls were included. Cases were significantly more likely to be male than controls(67% vs 45%, P < 0.001) and of older age(61.9 years vs 58 years, P = 0.002). In addition, cases were more likely to have had complications of end stage liver disease(83% vs 71%, P = 0.032). On multivariate analysis, the strongest association with the presence of HCC were male gender(OR 4.3, 95%CI: 1.83-10.3, P = 0.001) and age(OR = 1.082, 95%CI: 1.03-1.13, P = 0.001). Hispanic ethnicity was associated with a decreased prevalence of HCC(OR = 0.3, 95%CI: 0.09-0.994, P = 0.048). HCC was predominantly in the form of a single lesion with regional lymph node(s) and distant metastasis in only 2.6% and 6.3%, respectively. Fifty-nine point three percent of individuals with HCC underwent locoregional therapy and 61.5% underwent liver transplantation for HCC. CONCLUSION Male gender, increased age and non-Hispanic ethnicity are associated with HCC in NASH cirrhosis. NASH cirrhosis associated HCC in this cohort was characterized by early stage disease at diagnosis and treatment with locoregional therapy and transplant. 展开更多
关键词 Hepatocellular carcinoma Nonalcoholic fatty liver disease cirrhosis GENDER ETHNICITY
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Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension 被引量:1
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作者 Dan Zhang Tao Wang +4 位作者 Zhen-Dong Yue Lei Wang Zhen-Hua Fan Yi-Fan Wu Fu-Quan Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第11期2490-2499,共10页
BACKGROUND Portal hypertension(PHT)in patients with alcoholic cirrhosis causes a range of clinical symptoms,including gastroesophageal varices and ascites.The hepatic venous pressure gradient(HVPG),which is easier to ... BACKGROUND Portal hypertension(PHT)in patients with alcoholic cirrhosis causes a range of clinical symptoms,including gastroesophageal varices and ascites.The hepatic venous pressure gradient(HVPG),which is easier to measure,has replaced the portal venous pressure gradient(PPG)as the gold standard for diagnosing PHT in clinical practice.Therefore,attention should be paid to the correlation between HVPG and PPG.METHODS Between January 2017 and June 2020,134 patients with alcoholic cirrhosis and PHT who met the inclusion criteria underwent various pressure measurements during transjugular intrahepatic portosystemic shunt procedures.Correlations were assessed using Pearson’s correlation coefficient to estimate the correlation coefficient(r)and determination coefficient(R^(2)).Bland-Altman plots were constructed to further analyze the agreement between the measurements.Disagreements were analyzed using paired t tests,and P values<0.05 were considered statistically significant.RESULTS In this study,the correlation coefficient(r)and determination coefficient(R2)between HVPG and PPG were 0.201 and 0.040,respectively(P=0.020).In the 108 patients with no collateral branch,the average wedged hepatic venous pressure was lower than the average portal venous pressure(30.65±8.17 vs.33.25±6.60 mmHg,P=0.002).Hepatic collaterals were identified in 26 cases with balloon occlusion hepatic venography(19.4%),while the average PPG was significantly higher than the average HVPG(25.94±7.42 mmHg vs 9.86±7.44 mmHg;P<0.001).The differences between HVPG and PPG<5 mmHg in the collateral vs no collateral branch groups were three cases(11.54%)and 44 cases(40.74%),respectively.CONCLUSION In most patients,HVPG cannot accurately represent PPG.The formation of hepatic collaterals is a vital reason for the strong underestimation of HVPG. 展开更多
关键词 Portal hypertension Portal venous pressure gradient Hepatic venous pressure gradient alcoholic cirrhosis Hepatic collateral
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Clinical indicators for progression of nonalcoholic steatohepatitis to cirrhosis 被引量:2
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作者 Tasur Kumar Seen Muntazir Sayed +7 位作者 Muhammad Bilal Jonathan Vincent Reyes Priyanka Bhandari Vennis Lourdusamy Ahmed Al-khazraji Umer Syed Yasar Sattar Raghav Bansal 《World Journal of Gastroenterology》 SCIE CAS 2021年第23期3238-3248,共11页
Non-alcoholic fatty liver disease(NAFLD),is a disease spectrum characterized by fat accumulation in hepatocytes presenting as hepatic steatosis to advance disease with active hepatic inflammation,known as nonalcoholic... Non-alcoholic fatty liver disease(NAFLD),is a disease spectrum characterized by fat accumulation in hepatocytes presenting as hepatic steatosis to advance disease with active hepatic inflammation,known as nonalcoholic steatohepatitis.Chronic steatohepatitis will lead to progressive hepatic fibrosis causing cirrhosis and increased risk for developing hepatocellular carcinoma(HCC).Fatty liver disease prevalence has increased at alarming rates alongside obesity,diabetes and metabolic syndrome to become the second most common cause of cirrhosis after alcohol related liver disease worldwide.Given this rise in prevalence,it is becoming increasingly more important to find non-invasive methods to diagnose disease early and stage hepatic fibrosis.Providing clinicians with the tools to diagnose and treat the full spectrum of NAFLD will help prevent known complications such as cirrhosis and HCC and improve quality of life for the patients suffering from this disease.This article discusses the utility of current noninvasive liver function testing in the clinical progression of fatty liver disease along with the imaging modalities that are available.Additionally,we summarize available treatment options including targeted medical therapy through four different pathways,surgical or endoscopic intervention. 展开更多
关键词 Nonalcoholic fatty liver disease STEATOSIS HEPATITIS cirrhosis Hepatocellular carcinoma Liver function tests Imaging HISTOPATHOLOGY
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Development of risky varices in alcoholic cirrhosis with a well-maintained nutritional status
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作者 Hirayuki Enomoto Yoshiyuki Sakai +12 位作者 Yoshinori Iwata Ryo Takata Nobuhiro Aizawa Naoto Ikeda Kunihiro Hasegawa Chikage Nakano Takashi Nishimura Kazunori Yoh Akio Ishii Tomoyuki Takashima Hiroki Nishikawa Hiroko Iijima Shuhei Nishiguchi 《World Journal of Hepatology》 CAS 2015年第21期2358-2362,共5页
AIM: To compare the nutritional status between alcoholic compensated cirrhotic patients and hepatitis C virus(HCV)-related cirrhotic patients with portal hypertension.METHODS: A total of 21 patients with compensated c... AIM: To compare the nutritional status between alcoholic compensated cirrhotic patients and hepatitis C virus(HCV)-related cirrhotic patients with portal hypertension.METHODS: A total of 21 patients with compensated cirrhosis(14 with HCV-related cirrhosis and seven with alcoholic cirrhosis) who had risky esophageal varices were investigated. In addition to physical variables, including the body mass index, triceps skinfold thickness, and arm-muscle circumference, the nutritional status was also assessed using the levels of pre-albumin(pre-ALB), retinol-binding protein(RBP) and non-protein respiratory quotient(NPRQ) measured with an indirect calorimeter.RESULTS: A general assessment for the nutritional status with physical examinations did not show a significant difference between HCV-related cirrhosis and alcoholic cirrhosis. However, the levels of pre-ALB and RBP in alcoholic compensated cirrhotic patients were significantly higher than those in HCV-related compensated cirrhotic patients. In addition, the frequency of having a normal nutritional status(NPRQ ≥ 0.85 and ALB value > 3.5 g/d L) in alcoholic compensated cirrhotic patients was significantly higher than that in HCV-related compensated cirrhotic patients.CONCLUSION: According to our small scale study, alcoholic compensated cirrhotic patients can develop severe portal hypertension even with a relatively well-maintained liver function and nutritional status compared with HCV-related cirrhosis. 展开更多
关键词 alcoholic liver cirrhosis HEPATITIS C VIRUS Rapid-
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Pleomorphic hepatocellular carcinoma following consumption of hypericum perforatum in alcoholic cirrhosis
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作者 Evangeli S Lampri Elli Ioachim +3 位作者 Haralampos Harissis Eufemia Balasi Antigoni Mitselou Vasiliki Malamou-Mitsi 《World Journal of Gastroenterology》 SCIE CAS 2014年第8期2113-2116,共4页
Hepatocellular carcinoma (HCC) often develops in patients with underlying liver disease, yet HCC with syncytial giant cells (SGCs) is extremely rare. Herein, we report a 55-year-old man with a 6-year history of alcoho... Hepatocellular carcinoma (HCC) often develops in patients with underlying liver disease, yet HCC with syncytial giant cells (SGCs) is extremely rare. Herein, we report a 55-year-old man with a 6-year history of alcoholic cirrhosis who during his regular checkup presented with marked elevation of alpha-fetoprotein. Clinical examination and imaging analyses revealed a tumor-like lesion in segment 4 of the liver, which was removed by limited wedge resection. Histological analysis by hematoxylin and eosin staining indicated pleomorphic and atypical nodules, with some SGCs, embedded within the boundaries of the neoplastic lesion. The adjacent liver parenchyma showed microvesicular steatosis, pericellular fibrosis, and moderate hemosiderin accumulation (grade 2, as determined by Prussian blue iron stain) in hepatocytes and Kupffer cells but no copper accumulation (as determined by orcein stain). Immunohistochemical analysis showed hepatocyte antigen-positive staining for the neoplastic cells and SGCs. The diagnosis was made for cirrhosis-related HCC with SGCs. The previous reports of pleomorphic HCC have featured osteoclast-like (i.e., mesenchymal type) giant cells, making this case of epithelial type giant cells very rare. The patient&#x02019;s 6-month history of hypericum perforatum/St John&#x02019;s wort self-medication may have prompted the cirrhosis or HCC progression or the unusual SGC manifestation. 展开更多
关键词 Hepatocellular carcinoma Giant cell carcinoma Hypericum perforatum St John’ s wort Syncytial giant cell Pleomorphic liver tumor alcoholic cirrhosis
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Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018:Rates and healthcare burden associated with readmissions
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作者 Asim Kichloo Zain El-Amir +7 位作者 Dushyant Singh Dahiya Farah Wani Jagmeet Singh Dhanshree Solanki Ehizogie Edigin Precious Eseaton Asad Mehboob Hafeez Shaka 《World Journal of Hepatology》 2021年第12期2128-2136,共9页
BACKGROUND Alcoholic liver cirrhosis(ALC)is a chronic liver disease with varying disease severity.Readmissions of ALC are associated with poor outcomes.AIM To identify and assess trends of readmissions for ALC over an... BACKGROUND Alcoholic liver cirrhosis(ALC)is a chronic liver disease with varying disease severity.Readmissions of ALC are associated with poor outcomes.AIM To identify and assess trends of readmissions for ALC over an eight-year period.METHODS This retrospective interrupted trend study analysed 30-d readmissions of ALC in the United States from 2010 to 2018 using the National Readmissions Database.Hospitalization for ALC was the reason for index admission obtained using the International Classification of Diseases codes(571.2 and K70.3X).Biodemographic characteristics and hospitalization trends were highlighted over time.A multivariate regression analysis model was used to calculate the trend for riskadjusted odds of 30-d all-cause ALC readmissions,ALC specific readmission rate,ALC readmission proportion,inpatient mortality,mean length of stay(LOS)and mean total hospital cost(THC)following adjustments for age,gender,grouped Charlson Comorbidity Index,insurance,mean household income,and hospital characteristics.RESULTS There was a trend towards increasing total 30-d readmissions of ALC from 7660 in 2010 to 15085 in 2018(P<0.001).Patients readmitted for ALC were noted to have an increasing comorbidity burden over time.We noted a rise in the risk-adjusted 30-d all-cause readmission of ALC from 24.9%in 2010 to 29.9%in 2018(P<0.001).ALC-specific readmission rate increased from 6.3%in 2010 to 8.4%in 2018(P<0.001)while ALC readmission proportion increased from 31.4%in 2010 to 36.3%in 2018(P<0.001).Inpatient mortality for 30-d readmissions of ALC declined from 10.5%in 2010 to 8.2%in 2018(P=0.0079).However,there was a trend towards increasing LOS from 5.6 d in 2010 to 6.3 d in 2018(P<0.001)and increasing THC from 13790 dollars in 2010 to 17150 dollars in 2018(P<0.001).The total days of hospital stay attributable to 30-d readmissions of ALC increased by 119.2%while the total attributable hospital costs increased by 149%by the end of 2018.CONCLUSION There was an increase in the 30-d readmission rate and comorbidity burden for ALC;however,inpatient mortality declined.Additionally,there was a trend towards increasing LOS and THC for these readmissions. 展开更多
关键词 alcoholic liver cirrhosis READMISSIONS EPIDEMIOLOGY TRENDS MORTALITY
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Randomized controlled trial of Qing Gan Huo Xue Prescription in the treatment of alcoholic liver cirrhosis
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作者 Jie-Lu Pan Lian-Jun Xing +2 位作者 Ji Zhang Xiao Yu Hai-Yan Zhang 《Journal of Hainan Medical University》 2022年第8期17-22,共6页
Objective:To evaluate the efficacy of Qing Gan Huo Xue Prescription(QGHXP)in the treatment of patients with alcoholic liver cirrhosis(ALC)of damp and heat stasis syndrome.Methods:A total of 69 patients with ALC were r... Objective:To evaluate the efficacy of Qing Gan Huo Xue Prescription(QGHXP)in the treatment of patients with alcoholic liver cirrhosis(ALC)of damp and heat stasis syndrome.Methods:A total of 69 patients with ALC were randomly divided into TCM group(n=35)and control group(n=34).The TCM group was given QGHXP 1 pack TID orally.Control group received polyene phosphatidylcholine capsule 456 mg TID for 24 weeks.The observation measurements are symptom efficacy rate,serum level of liver enzyme,and non-invasive liver cirrhosis evaluation,including liver stiffness measurement(LSM)examininged by FibroTouch,APRI score,FIB-4 index and Maddrey discriminant function.Results:The symptom efficacy rate of the experimental group and the control group was 85.70%and 61.80%(P=0.024).Liver enzyme levels(serum ALP,γ-GT,AST and ALT)of TCM group were lower than those of control group(P<0.05).LSM of TCM group was reduced after treatment,and was significant lower than control group(14.19±1.49)vs.(15.06±1.24)(P<0.05).The APRI scores,FIB-4 index and Maddrey discriminant functions of TCM group were lower than those of control group(P<0.05).Conclusion:QGHXP is an effective alternative for the treatment of damp and heat stasis syndrome of ALC in improving liver function and clinical symptoms. 展开更多
关键词 alcoholic liver cirrhosis Qing Gan Huo Xue Prescription (QGHXP) Traditional Chinese medicine TREATMENT
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