Liver Enzyme

A 35-year-old man was referred to our center because of low grade fever, vomiting, yellow sclera, and tenderness in the upper-right quadrant of his abdomen. Laboratory tests showed a white blood cell (WBC) of 7100/μL, a platelet of 184,000/μL, an erythrocyte sedimentation rate (ESR) of 4 mm/h, an alanine aminotransferase (ALT) of 525 U/L, an aspartate aminotransferase AST of 142 U/L, a total bilirubin level of 4.23 mg/dL, and a direct bilirubin level of 3.16 mg/ dL. Viral hepatitis markers, immunoglobuline M antibody to cytomegalovirus (anti-CMV IgM), Ebstein-Barr virus (EBV) IgM, and immunologic markers of autoimmune hepatitis were negative. The patient was diagnosed with acute hepatitis. Alkaline phosphatase was in the normal range throughout the course of the disease. Because of the patient’s occupation as a butcher and his history of eating semi-cooked sheep testes, serologic tests of brucellosis were conducted; the tests came out positive. We were concerned about the hepatotoxi...

Ximelagatran, the first oral agent in the new class of direct thrombin inhibitors, was withdrawn from the market due to a potential risk of severe liver injury. Increased rates of liver enzyme elevations had been observed during clinical trials of chronic use. Despite intensive preclinical investigations the cellular mechanisms behind the observed hepatic effects remain unknown. The aim of this study was to investigate whether ximelagatran has an effect on the plasma membrane fluidity and the membrane lipid composition which may be important for the cell integrity. After 1h exposure of primary human hepatocytes with 10 or 100μM ximelagatran, a significant elevation of membrane fluidity was observed. This elevation was maintained at 24h, but diminished at 48h exposure. As changed membrane lipid composition could influence membrane fluidities, changes in membrane lipid profiles were also studied. After 1h exposure, the phosphatidylcholine/phosphatidylethanolamine molar ratio decreased...

OBJECTIVES: This study aimed to determine the prevalence of the metabolic syndrome, abnormalities of liver enzymes and sonographic fatty liver, as well as the inter-related associations in normal weight, overweight and obese children and adolescents. METHODS: This cross-sectional study was conducted among a sample of 1107 students (56.1% girls), aged 6-18 years in Isfahan, Iran. In addition to physical examination,

A cross-section analytical study was conducted to evaluate the risk of pesticide exposure to those applying the Class II pesticides 2,4-D and paraquat in the paddy-growing areas of Kerian, Perak, Malaysia. It investigated the influence of weather on exposure as well as documented health problems commonly related to pesticide exposure. Potential inhalation and dermal exposure for 140 paddy farmers (handlers of pesticides) were assessed. Results showed that while temperature and humidity affected exposure, windspeed had the strongest impact on pesticide exposure via inhalation. However, the degree of exposure to both herbicides via inhalation was below the permissible exposure limits set by United States National Institute of Occupational Safety and Health (NIOSH). Dermal Exposure Assessment Method (DREAM) readings showed that dermal exposure with manual spraying ranged from moderate to high. With motorized sprayers, however, the level of dermal exposure ranged from low to moderate. Dermal exposure was significantly negatively correlated with the usage of protective clothing. Various types of deleterious health effects were detected among users of manual knapsack sprayers. Long-term spraying activities were positively correlated with increasing levels of the gamma-glutamyl transpeptidase (GGT) liver enzyme. The type of spraying equipment, usage of proper protective clothing and adherence to correct spraying practices were found to be the most important factors influencing the degree of pesticide exposure among those applying pesticides.

This study reports the clinical, clinicopathological and ultrasonographic findings from dogs with chronic pancreatitis (CP). Fourteen dogs with clinical signs consistent with CP and histological confirmation of the disease were evaluated. Abdominal ultrasound and clinical pathology results were recorded. Sensitivities of pancreatic enzymes for diagnosis of CP were calculated with two different cut-off values. The mean age of affected dogs was 9.1 years. Spaniels were the most common breed with CP, representing seven of the 14 dogs in this study. CP was histologically severe in nine cases. Most dogs showed chronic low-grade gastrointestinal signs and abdominal pain. Five dogs had exocrine pancreatic insufficiency and five dogs had diabetes mellitus. The sensitivity of elevated trypsin-like immunoreactivity for CP was 17 per cent. The sensitivities of canine pancreatic lipase immunoreactivity, lipase and amylase for CP were 44 to 67 per cent or 14 to 28 per cent depending on the cut-o...

Hemolytic uremic syndrome (HUS) includes a heterogeneous group of hemolytic disorders. Among the identified causes of HUS are infections, particularly infections with Shiga toxin-producing ESCHERICHIA COLI (STEC), complement disorders, and disorders interfering with the degradation of von Willebrand factor (VWF). Other causes for atypical HUS include the cobalamin metabolism; pregnancy/hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP); drugs; and other disorders (e.g., systemic diseases appearing as HUS, such as systemic lupus erythematosus and rejection after transplantation). The group not related to STEC is often also called atypical HUS. Most of the occurrences of infectious HUS have only one episode. Recurrent episodes (recurrent HUS) have strong relationships to diseases of the complement system. In these two subgroups the prognosis is poor, with severe renal insufficiency, together with the need for renal replacement therapy. Severe arterial hypertension is common. Treatment options are limited. To better define this group of patients, the European Society for Pediatric Nephrology supported an initiative to develop a European HUS registry. In this registry, 167 patients were acquired; 73 were female (43.8%). The year of onset of the disease ranged from 1974 to 2005. The prevalence of atypical HUS/recurrent HUS can be calculated as 3.3 per million child population (< 18 years). Underlying disorders included factor H, factor I, MCP-1, pneumococci, and von Willebrand factor disturbances. In 33 patients at least one renal transplantation was performed (total, 55 kidneys); 18% were successful and 73% demonstrated recurrence or thrombosis. Treatment options were plasma substitution or plasmapheresis. Despite continued efforts, transplantation is not recommended at present for these patients. Living-related transplantation should be abandoned. New therapeutic strategies are urgently needed.

1. A trial was conducted to examine the effects of dietary vitamin E content, age and sex on haematological indices and liver enzymes of Japanese quails. A total of 800 1-d-old quail chicks were assigned at random into 4 equal groups and fed on starter and layer diets containing 0, 1, 5 or 10 times the NRC recommended supplements of vitamin E. No selenium was added to the basal deficient diets; the other diets were supplied with 0.2 mg selenium/kg diet. 2. The investigation covered the age span of 3 to 12 weeks in female and male birds. Blood samples were collected at 3-week intervals and tested for haematological indices (erythrocyte count; leucocyte count; susceptibility of erythrocytes to haemolysis; haemoglobin concentration (Hb); packed cell volume (PCV); and mean corpuscular volume (MCV)) and liver enzymes (aspartate transaminase, AST, and glutathione peroxidase, GSH-Px). 3. The significant differences between the 4 dietary treatments indicated that as the levels of selenium and/or vitamin E increased, the percentage of erythrocytes haemolysed and AST activity decreased, whereas Hb and GSH-Px concentrations increased. 4. Differences between age groups showed that older quails had higher erythrocyte susceptibility to haemolysis, higher AST levels and but lower erythrocyte count and PCV. 5. Females had lower erythrocyte haemolysis and higher Hb concentrations than males. 6. The interaction between dietary groups and age groups revealed that the differences between age groups were reduced as the level of selenium and/or vitamin E increased, leading to similar group means over the age period of study. 7. In conclusion, NRC recommended supplements of vitamin E (12 and 25 mg/kg diet) were not adequate. Doses equal to, at least, 5 times that recommended were advised to improve GSH-Px (index of antioxidant status) and Hb concentrations.

Background Metabolic syndrome (MetS) is frequently characterized by elevated liver enzymes, including gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT). Our objective was to evaluate the range of prevalence of MetS in apparently healthy individuals whose liver enzyme concentrations were all within-normal-range. Methods We have performed a cross sectional analysis on participants of the Tel-Aviv medical center inflammation survey (TAMCIS) recruited between the years 2003-2009. Analyzed were a cohort of 6,561 men and 3,389 women. Results The prevalence of MetS increased significantly from the first quintile to the fifth for both GGT and ALT, all the five quintiles being in the normal range. Logistic regression analysis for the presence of MetS showed crude odds ratios of 2.7 and 2.4 between the first and fourth quintiles and 3.6 and 3.2 for the fifth quintile in men and women respectively for ALT. For GGT the respective odds being 3.6 and 3.2 for the fourth quintile ...

Human cytomegalovirus (HCMV) is the most common cause of severe morbidity and mortality in immune- compromised individuals. This study was conducted to determine the incidence of HCMV infection in HCV patients who either spontaneously cleared the virus or progressed to chronic HCV infection. The study included a total of eighty four cases (48 females and 36 males) that were referred to blood banks for blood donation with an age range of 18-64 years (mean age 37.62 ± 10.03 years). Hepatitis C virus RNA and HCMV DNA were detected in sera by RT-nested PCR and nested PCR respectively in all subjects. Immunoglobulin G levels for HCV and HCMV were determined. Besides, IgM antibodies for HCMV infection were also determined in subjects' sera. Fifty three out of 84 cases (63%) were positive for HCV-RNA while 31 (37%) cases had negative HCV RNA. Forty six (87%) and 13 (25%) cases out of 53 HCV RNA positive patients were positive for HCMV IgG and IgM antibodies respectively. While 20 of 5...

Experimental evidence is presented that demonstrates the impact of selenium on the effects of a variety of anticancer treatments, including chemotherapy and radiation. Selenium-dependent glutathione peroxidase can detoxify organic peroxides resulting from some of these treatments. Selenium deficiency has also been associated with significant changes in liver enzymes that activate some drugs and contribute to detoxification. Some forms of free selenium have cytotoxicity against a variety of tumor cell lines, both murine and human. Experimental data suggest that catalytic oxidation of cellular glutathione and reduction of molecular oxygen are part of the mechanism of this antitumor activity. This provides provocative possibilities for the inclusion of selenium into cancer therapy regimens.

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The hepatic disposition of two glycosidase inhibitors was studied in the isolated perfused rat liver and after subcellular fractionation. The mannosidase inhibitor 1-deoxymannojirimycin (dMM) and the glucosidase inhibitor N-methyl-1-deoxynojirimycin (MedNM) exhibited minimal binding to albumin and reached liver concentrations that approximately equaled their medium concentrations, after 30 min (MedNM) or 90 min (dMM). Within 2 hr 0.5% of the dose of MedNM and 2.9% of dMM were excreted in bile. No metabolites were found for MedNM, whereas minor (bio)degradation was inferred for dMM. After subcellular fractionation, dMM and MedNM were found predominantly in the cytosolic fraction. Compared to the other particulate fractions, MedNM was elevated in the microsomal fraction, and both compounds were slightly enriched in the lysosomal fraction. We conclude that dMM and MedNM will likely inhibit liver enzymes when sufficiently high plasma levels are reached.

Celalettin ÜSTÜN,1 Muhit ÖZCAN,1 Günhan GÜRMAN,1 Mehtap ÇAKIR,1 Selim EREKUL,2 Gülen AKYOL,4 Mutlu ARAT,1 Harika ÇELEBI,1 Ramazan IDLMAN,3 Osman ILHAN,1 Taner DEMIRER,1 Meral BEKSAÇ,1 Haluk KOÇ1 ... 1Department of Hematology, 2Department ...

A case of acquired skin fragility syndrome associated with hepatic disease in a 9-year-old, spayed female, domestic shorthair cat is described. The cat was admitted to the veterinary hospital of the University of São Paulo (Brazil) with a 6-week history of vomiting, inappetence and weight loss. Remarkable signs were weakness, lethargy and profound jaundice that had been present for 10 days according to the owner. On completion of the physical examination, when the cat was gently manipulated for blood collection the thoracic limb and interscapular skin tore. Liver enzymes and bilirubin levels were all above the normal range. On histological examination of skin and liver, Masson's trichrome stain showed collagen fibre alteration and major hepatocyte abnormalities. Findings were consistent with feline skin fragility syndrome associated with cholangiohepatitis and hepatic lipidosis.

Objective: Clozapine-induced hepatotoxicity is not infrequent and usually transient. It mostly causes asymptomatic elevation of liver transaminases. “Elevation in liver enzymes to what extent should preclude further treatment?” or “Is only a dose-reduction sufficient?” are questions yet to be answered. The present article uses a case report to discuss the treatment alternatives when liver enzymes reach three times the upper normal limits during the clozapine therapy. Methods: In the following case report, the authors describe a 27-year-old male patient diagnosed with schizophrenia, resistant to different atypical and typical antipsychotics. Based on the pathological findings of our patient and a review of the literature, the author summarizes the reasons for the liver enzymes increase and treatment alternatives during clozapine treatment. Results: Substantial improvement was achieved with clozapine therapy. Increase in liver enzymes at the beginning of the clozapine treatment was su...

The (-) enantiomer of cis-5-fluoro-1l-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine [(-)-FTC)], a substituted oxathiolane compound with anti-hepatitis B virus activity in vitro, was assessed for its efficacy in woodchucks with naturally acquired woodchuck hepatitis virus (WHV) infection. Pharmacokinetics and in vitro anabolism were also determined. (-)-FTC was anabolized to the 5'-triphosphate in a dose-related fashion, reaching a maximum concentration at about 24 h in cultured woodchuck hepatocytes. Following administration of a dose of 10 mg/kg of body weight intraperitoneally (i.p.), the clearance of (-)-FTC from plasma was monoexponential, the terminal half-life was 3.76 +/- 1.4 h, and the systemic clearance was 0.12 +/- 0.06 liters/h/kg. The antiviral efficacy of (-)-FTC in the woodchuck model was assessed by quantitation of serum WHV DNA levels and by WHV particle-associated DNA polymerase activity at two dosages, 30 and 20 mg/kg given i.p. twice daily (b.i.d.), respecti...

Patients with diabetes mellitus (DM), experience significant morbidity and mortality from microvascular retinopathy, nephropathy and neuropathy. Hyperglycemia can induce diabetic complications through multiple pathways. Activation of protein kinase C (PKC) by hyperglycemia is one of the pathways which causes diabetic complications. Effect of nifedipine (a calcium channel blocker), and polymyxine B sulphate (a Protein kinase C inhibitor) was studied in adult male Sprague-dawley rats, who was made diabetic with streptozotocin. PKC activity was determined in tissues and serum enzymes and metabolite level was measured in all controls, diabetic and drug treated animals. The results showed that, levels of the, urea (two-fold), creatinine (60%), triglyceride (two-fold) and liver alanine transaminase (ALT) activity (two-fold), were significantly increased in diabetic group. In nifedipine, treated diabetic group, although urea and creatinine level was increased, but liver enzymes were not si...

Aim: To compare the efficacy, safety, and pharmacokinetics of oral and intramuscular (i.m.) phenyramidol in patients with low back pain. Materials and methods: Consecutive patients with low back pain were recruited and randomized (5:3) to treatment with either 800 mg oral or i.m. phenyramidol. Pain was assessed by visual analogue scale every 30 min for 2 h. Blood samples were drawn at baseline and every 15 min for 2 h. A 5-point verbal global evaluation scale was performed by both patients and physicians. In addition, the need for rescue analgesics after 2 h was noted. After the acute phase, patients were re-randomized (5:3) to receive either a placebo tablet or a 400 mg phenyramidol tablet 3 times a day for 7 days. Efficacy of the long term treatment was measured by the evaluation of both patients and physicians (with a 5-point verbal global evaluation scale) and by the daily amount of naproxen sodium consumed as the rescue analgesic drug. Results: Seventy-two patients (45F/27M) ha...

rESUMo objetivo: Relatar experiência com a execução da técnica de Menghini auxiliada por ultrassom na avaliação da disfunção de enxertos hepáticos. Métodos: A técnica de Menghini utiliza uma agulha de sucção, por via percutânea, permitindo uma punção rápida (em menos de um segundo), o que pode contribuir para diminuir a incidência de complicações. resultados: Foram estudadas 87 biópsias realizadas com uma agulha de sucção 16 gauge em um período de um ano e três meses. Utilizou-se a ultrassonografia para avaliação da presença de líquido ou coleções peri-hepáticas, disfunções biliares e vasculares antes do procedimento, para marcação de um local seguro de punção e, finalmente, para controle pós-biópsia. A principal indicação de biópsia foi elevação de enzimas hepáticas. Em 81 casos foi colhido um fragmento e foram obtidas amostras satisfatórias em 85 procedimentos (97,7%). Complicações menores ocorreram em seis pacientes (6,9%): cinco com dor local e um com reação vagal. Houve uma com...

Everolimus displays antiproliferative effects on cancer cells, yields antiangiogenic activity in established tumours, and shows synergistic activity with paclitaxel in preclinical models. This study assessed the safety and the pharmacokinetic interactions of everolimus and paclitaxel in patients with advanced malignancies. Everolimus was dose escalated from 15 to 30 mg and administered with paclitaxel 80 mg m(-2) on days 1, 8, and 15 every 28 days. Safety was assessed weekly, and dose-limiting toxicity (DLT) was evaluated in cycle 1. A total of 16 patients (median age 54.5 years, range 33-69) were entered; 11 had prior taxane therapy for breast (n=5), ovarian (n=3), and vaginal cancer (n=1) or angiosarcoma (n=2). Grade 3 neutropenia in six patients met the criteria for DLT in two patients receiving everolimus 30 mg weekly. Other drug-related grade 3 toxicities were leucopenia, anaemia, thrombocytopenia, stomatitis, asthenia, and increased liver enzymes. Tumour stabilisation reported...

The acronym RACAND means the association of Raynaud's phenomenon, anticentromere antibodies and digital necrosis without digital sclerosis. It is a rare syndrome recently individualised. The association with primary biliary cirrhosis has never been previously reported, and leads to discuss its nosology. A 57-year-old woman with a history of Raynaud's phenomenon, presented with recurrent episodes of fingers and toes necrosis. Clinical

Human cytomegalovirus (HCMV) is the most common cause of severe morbidity and mortality in immune- compromised individuals. This study was conducted to determine the incidence of HCMV infection in HCV patients who either spontaneously cleared the virus or progressed to chronic HCV infection. The study included a total of eighty four cases (48 females and 36 males) that were referred to blood banks for blood donation with an age range of 18-64 years (mean age 37.62 ± 10.03 years). Hepatitis C virus RNA and HCMV DNA were detected in sera by RT-nested PCR and nested PCR respectively in all subjects. Immunoglobulin G levels for HCV and HCMV were determined. Besides, IgM antibodies for HCMV infection were also determined in subjects' sera. Fifty three out of 84 cases (63%) were positive for HCV-RNA while 31 (37%) cases had negative HCV RNA. Forty six (87%) and 13 (25%) cases out of 53 HCV RNA positive patients were positive for HCMV IgG and IgM antibodies respectively. While 20 of 53...