Search results for "LIVER BIOPSY"
showing 10 items of 152 documents
Primary Biliary Cholangitis management: controversies, perspectives, and daily practice implications from an expert panel
2020
Primary biliary cholangitis (PBC) is a rare progressive immune-mediated liver disease that, if not adequately treated, may culminate in end-stage disease and need for transplantation. According to current guidelines, PBC is diagnosed in the presence of antimitochondrial antibodies (AMA) or specific antinuclear antibodies, and of a cholestatic biochemical profile, while biopsy is recommended only in selected cases. All patients receive ursodeoxycholic acid (UDCA) in first line; the only registered second-line therapy is obeticholic acid (OCA) for UDCA-inadequate responders. Despite the recent advances in understanding PBC pathogenesis and developing new treatments, many grey areas remain. Si…
Optimizing diagnostic approach to drug-induced liver injury
2018
Drug-induced liver injury (DILI) is often a trial even to expert clinicians, because sometimes diagnosis is not easy to be made. Guidelines of the American College of Gastroenterology (ACG) yielded in 2014, help to better understand the problem. The diagnosis of DILI is made through a detailed evaluation of clinical, serological, radiological and histological aspects. Biochemical data include liver function tests that allow to assess the pattern of damage, such as hepatocellular, cholestatic and mixed liver injury; serological data include testing for major and possibly minor hepatotropic viruses, non-organ specific autoantibodies. Clinical scenario might include jaundice, nausea, vomiting …
Biochemical biomarkers of NAFLD/NASH
2020
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the Western world and the global epidemics of obesity and type 2 diabetes have led to a dramatic increase of its prevalence and incidence. Among NAFLD patients, those with nonalcoholic steatohepatitis (NASH) have a double risk of fibrosis progression, that is the main driver toward the evolution in cirrhosis and its complications, including hepatocellular carcinoma and hepatic decompensation. Furthermore, patients with NAFLD are also at risk for cardiovascular diseases and extrahepatic malignancies, that represent the first and the second cause of death, respectively. The availability of non-invasi…
PWE-139 Further Validation of Terminal Peptide of Procollagen Iii (PIIINP) for the Detection and Assessment of Nonalcoholic Steatohepatitis in Patien…
2013
Introduction PIIINP has recently been shown to discriminate between simple steatosis (SS) and NASH both in patients without advanced fibrosis and in patients with all degrees of fibrosis 1 . In this study we validated PIIINP as a biomarker of NASH in a cohort of patients with biopsy proven NAFLD and evaluated its performance at the proposed diagnostic thresholds. Methods 71 patients with NAFLD and no evidence of other liver disease were included in this study. Liver biopsies were performed on all patients and analysed by a expert liver histopathologist. All liver biopsies were of suitable size for analysis (> 12mm and > 5 portal tracts) and classified in a dichotomous manner into those with…
Non-invasive Diagnostic Approach to NASH: Biological Markers
2020
Non-alcoholic fatty liver disease (NAFLD) prevalence and incidence are dramatically increasing in parallel with the epidemics of both obesity and type 2 diabetes, accounting for the most growing cause of chronic liver disease, of hepatocellular carcinoma and of end-stage liver disease leading to liver transplantation. Natural history studies clearly demonstrated that among NAFLD population, those with non-alcoholic steatohepatitis (NASH) have a double risk of fibrosis progression, and that the severity of liver fibrosis is the main driver of hepatic and extrahepatic prognosis. Consistently, the availability of non-invasive markers to be used in NAFLD patients represents a relevant medical n…
Ein gestieltes D�nndarmsegment zum zirkul�ren Ersatz des extrahepatischen Gallengangs bei erhaltener papill�rer Passage
1991
The effect of a small bowel segment as a extrahepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy showed that the grafts had healed without any sign of irritation. Histologically the structure of the graft remained undisturbed. There w…
Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced live…
2019
Background: Recent two studies reported that intravoxel incoherent motion (IVIM) analysis can separate healthy livers and viral hepatitis B (VHB) induced liver fibrosis. However, in these two studies the starting b-value for bi-exponential decay analysis was b =10 and b =15 s/mm 2 respectively. The current study has two primary aims. The first is to further confirm the diagnostic value of IVIM in detecting liver fibrosis. The second is to test whether by sampling very low b-value densely, then b =0 s/mm 2 image could be included to improve IVIM’s diagnostic performance. Methods: This was a prospective study with data acquired at the Third Xiangya Hospital of Central South University, Changs…
Rare <i>Atg7</i>&nbsp;Genetic Variants Predispose to Severe Fatty Liver Disease
2021
Background&Aims: Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease and has a strong heritable component. The aim of this study was to identify new genes involved in NAFLD pathogenesis. Methods: We examined rare variants captured by whole-exome sequencing in individuals with severe fibrosis or hepatocellular carcinoma due to NAFLD (severe NAFLD, n=301) after variant prioritization. We replicated the results in the UK Biobank and the Liver biopsy cohort (n=2268). Results: We observed an enrichment of the p.P426L variant (rs143545741 C>T; OR=7.2, 2.3-17.3; p C; MAF=0.060 vs. 0.035; OR=1.7, 1.2-2.5; p=0.003). In the UK Biobank cohort, the p.V471A variant wa…
Mechanisms inactivating the gene for E-cadherin in sporadic gastric carcinomas
2006
Nonalcoholic fatty liver disease (NAFLD) is the most common cause for elevated liver enzymes in the developed nations. Beyond prevention programs which are of particular interest because of the increasing number of overweight children, treatment should be focussed on the most important risk factors, obesity and insulin resistance. As a consequence of elucidating the pathomechanisms of NAFLD, the number of potential therapeutic options increased. However, many studies investigating the therapeutic effect show shortcomings in at least one of the following points: lack of a serial liver biopsy, short term of treatment and limited number of included patients. The second generation insulin sensi…
Drug-induced hepatitis: a rare complication of oral anticoagulants.
1994
Hepatotoxicity is a rare complication of coumarin anticoagulants. We present the case of a 56-year-old woman who developed a viral-hepatitis-like picture 8 months after mitral valve replacement and oral anticoagulation. Phenprocoumon-induced hepatitis was diagnosed after positive reexposure and improvement following withdrawal of the drug. There appeared to be cross-reactivity to warfarin since this drug led to a similar increase in alkaline phosphatase and gamma-glutamyl transferase after a few days of administration. Liver biopsy showed an acute viral-hepatitis-like picture. Anticoagulation was changed to a subcutaneous low molecular weight heparin and low-dose aspirin. Because of the wid…