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Phase angle associates with severity and mortality in acute-on-chronic liver failure.

BACKGROUND: Acute-on-chronic liver failure is characterized by acute hepatic decompensation and high short-term mortality, thereby necessitating prompt prognostic assessment. Although phase angle (PhA) has been established as a biomarker in chronic diseases, its prognostic significance in ACLF remains unclear. METHODS: In this study, we evaluated PhA in 78 ACLF patients and compared the results with those of two control groups: 45 patients with chronic hepatitis B infection but normal liver function, and 51 patients with abnormal liver function who did not meet the ACLF criteria. Upon hospita…

A novel SLC44A gene variant in a patient with neonatal cholestasis and liver failure.

UNLABELLED: SLC44A1 gene variants (MIM # 618868) are associated with a choline transporter deficiency with a rare autosomal recessive genetic disorder characterized by neurodegeneration, childhood-onset with ataxia, tremor, optic atrophy, and cognitive decline. Variants in the SLC44A1 gene are considered to be responsible for the syndrome. We reported a four-month-old baby with neonatal cholestasis and liver failure, but neurological development and examination were normal. During the patient's initial physical examination, height, weight, and head circumference were < -2 SDS. He was alert, wi…

Wernicke encephalopathy in a patient with drug-induced liver failure: a case report.

INTRODUCTION: Wernicke encephalopathy is a metabolic disease mainly associated with vitamin B1 deficiency, which is common in chronic alcoholism. Non-alcoholic Wernicke encephalopathy is difficult for early diagnosis. CASE PRESENTATION: One case involved a 62-year-old man who was admitted to hospital with drug-induced liver failure. He presented lower extremity weakness and progressive worsening of consciousness disturbance post-admission and was eventually identified as Wernicke encephalopathy by magnetic resonance imaging scan and deficiency in vitamin B1. The classic symmetric hyperintense…

Typhoid Fever as a Cause of Liver Failure in the United States: A Case Report.

Background: Typhoid fever is a multisystemic illness caused by Salmonella typhi and Salmonella paratyphi, transmitted fecal orally through contaminated water and food. It is a rare diagnosis in the US, with most cases reported in returning travelers. Hepatitis and cholestasis are rare sequelae of salmonella infection. However, acute liver failure (ALF) is exceptionally uncommon. We report a case of typhoid fever in a returning traveler to the US progressing to ALF. Case Presentation: A 48-year-old man presented with high-grade fever, abdominal pain, vomiting, acholic stools, dark urine, and ye…

Correlation of the FIB-4 Liver Biomarker Score with the Severity of Heart Failure.

Background and Objectives: Heart failure is associated with high morbidity and mortality and linked with several pre-existing health conditions and risk factors. Early detection and prompt management in heart failure improves patient outcomes. Liver involvement is associated with heart failure disease progression, and hence liver biomarkers and liver fibrosis may have a prognostic impact. Several blood test based markers and scoring systems estimate liver fibrosis and hence can be useful prognostic tools. Materials and Methods: We retrospectively analyzed a series of 303 patients with decompen

Unmasking the Unusual: Cryptococcal Pericarditis in a Patient with Liver Failure - a Rare Occurrence.

BACKGROUND Cryptococcosis is an invasive fungal infection caused by Cryptococcus species complex. C. neoformans is one of the pathogenic species within the genus. C. neoformans infections often present as an opportunistic infection in severely immunocompromised individuals. Infection of the pericardium in the setting of liver failure is uncommon. We present a case of cryptococcal pericarditis in a patient with liver failure. CASE REPORT A 47-year-old man with a past medical history of psoriatic arthritis, and alcohol use disorder presented to the emergency department with a 2-week history of p…

[The research of liver failure in Banna miniature pigs caused by amanita exitialis].

Objective: To explore the characteristics of Banna miniature pig liver failure induced by amanita exitialis. Methods: From September to October 2020, a reverse high performance liquid chromatography (RP-HPLC) method was used to determine the toxin content of amanita exitialis solution, and 2.0 mg/kg amanita exitialis solution (α-amanitins+β-amanitins) was administered orally to Banna miniature pigs. Toxic symptoms, blood biochemical indexes and histopathological changes of liver, heart and kidney were observed at each time point. Results: All Banna miniature pigs died within 76 h of exposure, …

Acute on Chronic Liver Failure in Patients with Alcohol-Associated Hepatitis: A Review.

Acute on chronic liver failure (ACLF) is a unique disease process associated with significant short-term mortality wherein patients with either chronic liver disease or cirrhosis suffer rapid decompensation in hepatic function accompanied by extrahepatic organ failures. Alcohol-associated hepatitis (AH) is a common precipitant of ACLF and has been shown to uniquely affect the pathophysiology of systemic and hepatic immune responses in patients with ACLF. Treatment of AH-associated ACLF includes supportive measures as well as treatment directed at AH; however, AH-directed therapies unfortunatel…

Mechanism and Effect of HNF4α Decrease in a Rat Model of Cirrhosis and Liver Failure.

BACKGROUND & AIMS: HNF4α, a master regulator of liver development and the mature hepatocyte phenotype, is down-regulated in chronic and infl … ption factor (TF) binding and chromatin modification. Studies compared decompensated cirrhosis with liver failure after 26 weeks of treatment with earlier compensated cirrhosis and with additional rat models of chronic fibrosis. Finally, to resolve cell-specific responses and intercellular signaling, we compared transcriptomes of liver, nonparenchymal, and infl …

Выяснение атеологии острой неисправности печени имеет решающее значение для позитивного воздействия на исход.

Регулирование детей с острой печени сопряжено с трудностями. В этом ретроспективном исследовании педиатрические пациенты, диагностированные у ALF в нашем центре за последние 26 лет, были разделены на две группы (G1 = диагностирован в период с 1997 по 2009 год; G2 = в период с 2010 по 2022 год) по сравнению с тем, различаются ли они в отношении аэтологии, необходимости трансплантации печени (LT) и результатов. В общей сложности 90 детям (средний возраст - 4,6 года, диапазон - 1,2-10,4 года; М/Ф = 43/47 года) был диагностирован АФО, аутоиммунный гепатит (АГИ) - 16 (18 процентов), передозировка п

Совпадение в аннотации оригинала
Management of children with acute liver failure is challenging. In this retrospective study, paediatric patients diagnosed with ALF at our centre, in the last 26 years, were divided into two groups (G1 = diagnosed from 1997 to 2009; G2 = from 2010 to 2022) and compared to see whether they differed with regard to aetiologies, need for liver transplantation (L…

Outbreak of indeterminate acute liver failure in children with adenoviraemia - Not a new disease.

BACKGROUND & AIMS: In the year 2022, an outbreak of indeterminate acute hepatitis and indeterminate paediatric acute liver failure (ID-PALF) in association with adenoviraemia in immunocompetent children was reported in the UK. We postulate that this association is not a new disease in immunocompetent children. METHODS: Children with acute hepatitis during the outbreak who were referred to King's College Hospital, London for advice and management were included in the study. Data on the frequency of ID-PALF in 2022, as well as transplantation rates and the association with adenovirus infection,…

A case of focal nodular hyperplasia with hepatic failure treated with liver transplantation.

Focal nodular hyperplasia (FNH) is a benign nodular lesion, but because of its feature of portal tract vessel abnormality, it may induce por … r lesion was an FNH-like lesion. She experienced several instances of variceal rupture and suffered liver failure, receiving liver transplantation. The excised liver showed a centrally scarred area in the nodule, indicating that the diagnosis was FNH. We herein report this case as a rare case of FNH that progressed to liver failure.

Spectrum of Neuroimaging Abnormalities in Brain in Patients of Acute-on-Chronic Liver Failure.

BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality. There is a paucity of data about the spectrum of neuroimaging abnormalities in the brain in ACLF patients. The present study was aimed to study the prevalence of cerebral edema and other parenchymal changes in MR imaging of the brain in patients with ACLF. METHODS: In this prospective observational study, MR imaging was done in patients with ACLF (n = 41), and findings were compared with age and sex-matched patients with acute decompensation (AD) (n = 13) and those with cirrhosis but witho…

Impact of compensated cirrhosis on survival in patients with acute-on-chronic liver failure.

BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is considered a main prognostic event in patients with chronic liver disease (CLD). We analyzed the 28-day and 90-day mortality in ACLF patients with or without underlying cirrhosis enrolled in the ACLF Research Consortium (AARC) database. METHODS: A total of 1,621 patients were prospectively enrolled and 637 (39.3%) of these patients had cirrhosis. Baseline characteristics, complications and mortality were compared between patients with and without cirrhosis. RESULTS: Alcohol consumption was more common in cirrhosis than non-cirrhos…

The hypotaurine-taurine pathway as an antioxidative mechanism in patients with acute liver failure.

The liver has been thought to protect against oxidative stress through mechanisms involving reduced glutathione (GSH) that consumes high-energy phosphor-nucleotides on its synthesis. However, hepatoprotective mechanisms in acute liver failure (ALF) where the phosphor-nucleotides are decreased in remain to be solved. Liver tissues were collected from patients with ALF and liver cirrhosis (LC) and living donors (HD) who had undergone liver transplantation. Tissues were used for metabolomic analyses to determine metabolites belonging to the central carbon metabolism, and to determine sulfur-conta…

Role of ammonia in predicting the outcome of patients with acute-on-chronic liver failure.

BACKGROUND: High venous ammonia (VA) values have been proven to be a part of the mechanism of hepatic encephalopathy in patients with liver cirrhosis (LC) as well as acute hepatitis. Moreover, VA has been associated with poor prognosis and high mortality in these clinical settings. However, the role of ammonia in acute-on-chronic liver failure (ACLF) has not yet been clearly established. AIM: To assess the role of VA in predicting the outcome of cirrhotic patients with ACLF in a tertiary care center. METHODS: We performed a retrospective observational study including consecutive patients wit…

Intravenous Lipid Emulsions in the Prevention and Treatment of Liver Disease in Intestinal Failure.

The development of intestinal failure-associated liver disease (IFALD) in pediatric and adult patients on parenteral nutrition is usually multifactorial in nature due to nutritional and non-nutritional causes. The role of lipid therapy as a contributing cause is well-established with the pathophysiological pathways now better understood. The review focuses on risk factors for IFALD development, biological effects of lipids, lipid emulsions and the mechanisms of lipid toxicity observed in laboratory animals followed by a synopsis of clinical studies in pediatric and adult patients. The introduc

Evaluation of Fibrosis in Intestinal Failure-Associated Liver Disease in the Sustain Registry.

BACKGROUND: Intestinal failure-associated liver disease (IFALD) is one of the leading complications in type III intestinal failure (IF). Early recognition of liver-fibrosis development in IFALD is crucial to the development of strategies aimed at reducing the risk of complications secondary to IFALD. Our aim was to identify patients with advanced fibrosis using a noninvasive index and to study the risk factors for fibrosis development in the Sustain registry. METHODS: Using the Sustain registry, patients requiring >3 months of parenteral nutrition (PN) support were identified. The presence or

Thyroid Storm Presenting as Acute Liver Failure in a Patient with Graves' Disease.

Although mild elevations in liver enzymes are relatively common in thyrotoxicosis, acute liver failure (ALF) is an infrequent occurrence. Despite the emergence of liver transplantation as a viable treatment for ALF, survival rates continue to remain unsatisfactory, coupled with higher rates of postoperative complications and re-transplantation in this group. We present the disease course, management, and outcome of a patient with Graves' disease who presented with ALF secondary to thyroid storm. Thyrotoxicosis should always be included in the differential diagnosis of ALF, as timely diagnosis …

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series.

Acute liver failure (ALF) is a life-threatening disease associated with multi-organ failure and increased mortality. Severe inflammation is now considered the main pathophysiological mechanism for organ dysfunction, thus rebalancing pro- and anti- inflammatory cytokines may improve liver function and outcome. The aim of this study was to assess the clinical effects of a haemoadsorption column on biochemical parameters in patients with ALF. We prospectively included 28 patients with ALF who were treated with three consecutive sessions of continuous venovenous haemofiltration in combination with…