Liver enzyme alteration: a guide for clinicians
TL;DR: In this review, a schematic approach is used that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, and abnormal enzymatic activity within the 2 subgroups are reviewed.
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Abstract: ISOLATED ALTERATIONS OF BIOCHEMICAL MARKERS OF LIVER DAMAGE in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.
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ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries
TL;DR: The evaluation of hepatocellular injury includes testing for viral hepatitis A, B, and C, assessment for nonalcoholic fatty liver disease and alcoholic liver disease, screening for hereditary hemochromatosis, autoimmune hepatitis, Wilson’s disease, and alpha-1 antitrypsin deficiency.
926
Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association
Connie B. Newman,David Preiss,Jonathan A. Tobert,Terry A. Jacobson,Robert L. Page,Larry B. Goldstein,Clifford Chin,Lisa R. Tannock,Michael Miller,Geetha Raghuveer,P. Barton Duell,Eliot A. Brinton,Amy Pollak,Lynne T. Braun,Francine K. Welty,Vascular Biology +15 more
TL;DR: In patients for whom statin treatment is recommended by current guidelines, the benefits greatly outweigh the risks, and the difference in the incidence of muscle symptoms without significantly raised creatinine kinase in statin-treated compared with placebo-treated participants is <1%, suggesting that muscle symptoms are usually not caused by pharmacological effects of the statin.
594
Targeting of Antithrombin in Hemophilia A or B with RNAi Therapy
K. John Pasi,Savita Rangarajan,Pencho Georgiev,Tim Mant,Michael Desmond Creagh,Toshko Lissitchkov,David H. Bevan,Steve Austin,Charles R. M. Hay,Inga Hegemann,Rashid S. Kazmi,Pratima Chowdary,Liana Gercheva-Kyuchukova,Vasily Mamonov,Margarita Timofeeva,Chang-Heok Soh,Pushkal Garg,Akshay Vaishnaw,Akin Akinc,Benny Sørensen,Margaret V. Ragni +20 more
TL;DR: Once‐monthly subcutaneous administration of fitusiran resulted in dose‐dependent lowering of the antithrombin level and increased thrombin generation in participants with hemophilia A or B who did not have inhibitory alloantibodies.
333
Host Response to Translocated Microbial Products Predicts Outcomes of Patients With HBV or HCV Infection
Netanya G. Sandler,Christopher Koh,Annelys Roque,Jason L. Eccleston,Rebecca B. Siegel,Mary DeMino,David E. Kleiner,Steven G. Deeks,T. Jake Liang,Theo Heller,Daniel C. Douek +10 more
TL;DR: LPS-induced local and systemic inflammation is associated with cirrhosis and predicts progression to end-stage liver disease in patients with HBV or HCV infection.
313
Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure
Maria Nikolaou,Maria Nikolaou,Maria Nikolaou,John Parissis,M. Birhan Yilmaz,Marie-France Seronde,Marie-France Seronde,Matti Kivikko,Matti Kivikko,Said Laribi,Said Laribi,Catherine Paugam-Burtz,Danlin Cai,Pasi Pohjanjousi,Pierre-François Laterre,Nicolas Deye,Pentti Põder,Alain Cohen-Solal,Alain Cohen-Solal,Alexandre Mebazaa,Alexandre Mebazaa +20 more
TL;DR: Abnormal LFTs were present in about a half of patients presenting with ADHF treated with inotropes and were associated with specific clinical, biological, and prognostic features, including a short-term overmortality with increased transaminases but not with biological signs of cholestasis, in ADHF patients.
295
References
MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study.
Federica Botta,Edoardo G. Giannini,Paola Romagnoli,Alberto Fasoli,Federica Malfatti,Bruno Chiarbonello,Emanuela Testa,Domenico Risso,G Colla,Roberto Testa +9 more
TL;DR: In a European series of cirrhotic patients the MELD score is an excellent predictor of both short and medium term survival, and performs at least as well as the Child-Pugh score.
Plasma clearance of intravenously injected aspartate aminotransferase isozymes: evidence for preferential uptake by sinusoidal liver cells.
TL;DR: The tissue distribution of the radioactivity following intravenous administration of 125I‐labeled isozymes revealed that the liver is a major organ involved in plasma clearance of these isoz enzymes, supported by the significant retardation in plasma clearing of m‐AAT in hepatectomized as well as CCI4‐intoxicated rats.
Global prevalence of putative haemochromatosis mutations.
TL;DR: The distribution of the C282Y mutation coincides with that of populations in which haemochromatosis has been reported and is consistent with the theory of a north European origin for the mutation.
Fulminant hepatic failure as the initial presentation of acute autoimmune hepatitis.
William R. Kessler,Oscar W. Cummings,George J. Eckert,Naga Chalasani,Lawrence Lumeng,Paul Y. Kwo +5 more
TL;DR: Patients with an acute presentation of autoimmune hepatitis differed from patients with a classical presentation clinically, biochemically, and histologically and the pattern of zone 3 necrosis may be a specific finding in those with acute autoimmune hepatitis.