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    High ferritin concentration in acute liver failure: the top of the iceberg?
    Liver Int 2017 Sep 23. Epub 2017 Sep 23.
    Division of Hepatology, Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
    I read with great interest the study performed by Anastasiou and colleagues. They performed an excellent retrospective study, with an expressive number of patients with acute liver failure(ALF). They investigated if serum ferritin and transferrin could predict outcome in ALF. Read More

    Peak hyperammonemia and atypical acute liver failure: the eruption of an urea cycle disorder during hyperemesis gravidarum.
    J Hepatol 2017 Sep 19. Epub 2017 Sep 19.
    Brain Liver Pitié-Salpêtrière (BLIPS) study group, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM UMR_S 938, CDR Saint-Antoine Maladies métaboliques, biliaires et fibro-inflammatoire du foie, & Institut de Cardiométabolisme et Nutrition, ICAN, Paris, France; UF de Soins Intensifs d'Hépato-gastroentérologie, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Assistance Publique - Hôpitaux de Paris, Paris, France. Electronic address:
    Background: Inborn urea cycle deficiencies are under-recognized metabolic causes of hyperammonaemia in adults.

    Methods: A 28-year-old primigravida, 7-week pregnant woman affected by hyperemesis gravidarum developed acute liver injury and then acute liver failure (ALF) in less than 48 hours.

    Results: Because the patient developed atypical features, especially mildly elevated serum transaminases contrasting with very high blood ammonia levels (281 μmol/l), concomitant with normal serum creatinine, an inborn error of metabolism was suspected. Read More

    Case report: An HIV+ patient presenting with pancytopenia, hepatic failure, and coagulopathy; a rare small cell liver carcinoma with diffuse splenic and bone marrow metastasis diagnosed at autopsy.
    Exp Mol Pathol 2017 Sep 18. Epub 2017 Sep 18.
    Department of Pathology, Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, United States.
    A 34-year old male with a giant condyloma acuminatum of the anus secondary to HIV infection presented to the emergency department with a persistent nose bleed lasting 2-3days, acute anemia, thrombocytopenia, and coagulopathy. The patient also had significant hepatosplenomegaly and elevated liver enzymes which were a new finding since the patient's last hospitalization 1-2month prior to the current admission. A bone marrow biopsy showed diffuse infiltration by carcinoma with neuroendocrine features. Read More

    Liver transplantation for NASH cirrhosis is not performed at the expense of major post-operative morbidity.
    Dig Liver Dis 2017 Aug 12. Epub 2017 Aug 12.
    Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Background: Non-alcoholic steatohepatitis (NASH) is an emerging indication for liver transplantation (LT) and coexists with multiple comorbidities. Obese and cirrhotic patients experience more perioperative complications. Limited data exist about short-term complications after LT for NASH cirrhosis. Read More

    Severe Drug-Induced Liver Injury as an Adverse Drug Event of Antibiotics: A Case Report and Review of the Literature.
    Chemotherapy 2017 Sep 22;62(6):367-373. Epub 2017 Sep 22.
    Department of Oncology and Hematology, Paracelsus Medical University, Nürnberg,, Germany.
    Drug-induced liver injury is one of the main reasons for acute liver failure. We report the case of a young patient who experienced a drug-induced liver injury resulting in life-threatening acute liver failure after treatment with different antibiotics (amoxicillin, ciprofloxacin, cefazolin, clindamycin) and acetaminophen, or a combination of these drugs. Moreover, we provide an overview of the hepatotoxic potential of these drugs. Read More

    Hepatic Complications of Anorexia Nervosa.
    Dig Dis Sci 2017 Sep 20. Epub 2017 Sep 20.
    Department of Medicine, University of Colorado, School of Medicine, 12631 E 17th Ave B178, Aurora, CO, 80045, USA.
    Anorexia nervosa (AN) has the highest mortality rate of all psychiatric illnesses due to the widespread organ dysfunction caused by the underlying severe malnutrition. Starvation causes hepatocyte injury and death leading to a rise in aminotransferases. Malnutrition-induced hepatitis is common among individuals with AN especially as body mass index decreases. Read More

    Extracorporeal membrane oxygenation support for refractory septic shock in liver transplantation recipients.
    Ann Surg Treat Res 2017 Sep 30;93(3):152-158. Epub 2017 Aug 30.
    Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    Purpose: This study was designed to assess the outcome of the extracorporeal membrane oxygenation (ECMO) in liver transplantation (LT) recipients with refractory septic shock and predict the prognosis of those cases.

    Methods: From February 2005 to October 2012, ECMO was used in 8 cases of refractory septic shock. Laboratory values including lactate and total bilirubin level just before starting ECMO were obtained and sepsis-related organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH) II score and simplified acute physiology score (SAPS) 3 were calculated. Read More

    Liver transplantation in the treatment of severe iatrogenic liver injuries.
    World J Hepatol 2017 Aug;9(24):1022-1029
    Division of General Surgery and Abdominal Transplantation, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
    The place of liver transplantation in the treatment of severe iatrogenic liver injuries has not yet been widely discussed in the literature. Bile duct injuries during cholecystectomy represent the leading cause of liver transplantation in this setting, while other indications after abdominal surgery are less common. Urgent liver transplantation for the treatment of severe iatrogenic liver injury may-represent a surgical challenge requiring technically difficult and time consuming procedures. Read More

    Neutrophil-to-Lymphocyte Ratio Predicts Death in Acute-on-Chronic Liver Failure Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study.
    Shock 2017 Sep 19. Epub 2017 Sep 19.
    *Department of critical care medicine, Cliniques universitaires Saint Luc, Université catholique de Louvain (UCL), Brussels, Belgium †Department of Anesthesiology and Perioperative Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussel, Belgium.
    The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). Read More

    Pediatric liver failure: we came, we saw, but have we conquered?
    F1000Res 2017 22;6:1540. Epub 2017 Aug 22.
    Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of California, San Francisco, Box 0136, San Francisco, CA, 94143, USA.
    Although there have been advances made in the diagnosis and management of pediatric acute liver failure, there is still no consensus regarding the definition or standardized evaluation, and an inability to predict outcomes, specifically irreversible brain injury, in many patients exists. Much of the research surrounding pediatric acute liver failure in the last several years has centered on the development of predictive scoring systems to enhance diagnosis and treatment decisions. In this article, we will discuss our current understanding of liver failure and updated management strategies in children with acute liver failure. Read More

    Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure.
    Gut 2017 Sep 19. Epub 2017 Sep 19.
    State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
    Objective: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients.

    Design: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria. Read More

    Optimizing hepatic venous outflow reconstruction for hepatic vein stenosis with indwelling stent in living donor liver retransplantation.
    Pediatr Transplant 2017 Sep 18. Epub 2017 Sep 18.
    Organ Transplantation Center, National Center for Child Health and Development, Setagaya, Tokyo, Japan.
    The patient was a boy of 7 years and 5 months of age, who underwent LDLT for acute liver failure at 10 months of age. HV stent placement was performed 8 months after LDLT because of intractable HV stenosis. At 7 years of age, his liver function deteriorated due to chronic rejection. Read More

    Extracorporeal Membrane Oxygenation Can Save Lives in Children With Heart or Lung Failure After Liver Transplantation.
    Artif Organs 2017 Sep;41(9):862-865
    Pediatric Intensive Care Unit, Hôpital Universitaire Necker-Enfants Malades, Paris, Île-de-France, France.
    The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Read More

    Use of Nonvascularized Abdominal Rectus Fascia After Liver, Small Bowel, and Multiorgan Transplantation: Long-Term Follow-up of a Single-Center Series.
    Transplant Proc 2017 Oct;49(8):1810-1814
    Intestinal Failure, Rehabilitation and Transplant Unit, Hepatology, Hepato-Pancreato-Biliary Surgery and Liver Transplant Unit, Multiorgan Transplant Institute, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina. Electronic address:
    Background: The abdominal wall may be severely compromised in the vast majority of intestinal and multiorgan transplant candidates, and sometimes as a consequence of complex liver transplantation. Multiple options have been described to overcome this problem, varying from component separation to the extreme need of performing an abdominal wall transplantation. The aim of the present paper is to report the largest and longest-term results of patients that received an abdominal rectus fascia (ARF) after liver, intestinal, or multiorgan transplantation at a single transplant center. Read More

    Malignant transformation of oral leukoplakia in a patient with dyskeratosis congenita.
    Oral Surg Oral Med Oral Pathol Oral Radiol 2017 Aug 12. Epub 2017 Aug 12.
    Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Dyskeratosis congenita (DC) is a rare, inherited, bone marrow failure syndrome caused by premature telomere shortening. The classic mucocutaneous triad of clinical features comprises reticulated skin pigmentation, nail dysplasia, and oral leukoplakia. Multiple somatic features, including bone marrow failure, pulmonary fibrosis, and liver disease, are also common. Read More

    Therapeutic plasma exchange in the treatment of complicated Plasmodium falciparum malaria: A case report.
    J Clin Apher 2017 Sep 18. Epub 2017 Sep 18.
    Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
    Severe falciparum malaria is associated with multiple organ dysfunction and a high rate of fatal outcome. Malaria is a world-wide disease in tropical areas through the bites of vector mosquitoes. Parasitic protozoans introduced by the mosquito's saliva to the blood travel to the liver then mature and reproduce. Read More

    Validation of Prognostic Scores to Predict Short-term Mortality in Patients with Acute-on-Chronic Liver Failure.
    J Gastroenterol Hepatol 2017 Sep 16. Epub 2017 Sep 16.
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
    Background And Aim: The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration.

    Methods: ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria. The diagnostic performances for short-term mortality were compared by the area under the receiver operating characteristics (AUROC) curve. Read More

    Early colectomy in steroid-refractory acute severe ulcerative colitis improves operative outcome.
    Int J Colorectal Dis 2017 Sep 17. Epub 2017 Sep 17.
    Department of Gastrointestinal Surgery & Liver Transplantation, All India Institute of Medical Sciences, Room 1005, 1st floor Academic Block, New Delhi, 110029, India.
    Purpose: Up to a third of patients with acute severe ulcerative colitis (ASUC) fail to respond to intensive steroid therapy and eventually require a salvage colectomy. We have previously reported that the mortality of emergency colectomy can be decreased by offering it within the first week of intensive medical therapy. We implemented this policy and report the results of our experience. Read More

    A Case of Hepatorenal Syndrome and Abdominal Compartment Syndrome with High Renal Congestion.
    Am J Case Rep 2017 Sep 18;18:1000-1004. Epub 2017 Sep 18.
    Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
    BACKGROUND Hepatorenal syndrome (HRS) is a reversible renal impairment that occurs in patients with acute liver failure and advanced liver cirrhosis. HRS is due to a renal vasoconstriction that results from extreme vasodilatation. It is therefore a functional disorder, not associated with structural kidney damage. Read More

    Increased Level of Interleukin 6 Associates With Increased 90-day and 1-year Mortality in Patients With End-stage Liver Disease.
    Clin Gastroenterol Hepatol 2017 Sep 14. Epub 2017 Sep 14.
    Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Germany. Electronic address:
    Background & Aims: Organ allocation for liver transplantation is based on prognosis, using the model for end-stage liver disease (MELD) or MELD-Na score. These scores do not consider systemic inflammation and septic complications. Blood level of C-reactive protein (CRP), in addition to the MELD score, associates with mortality in patients with end-stage liver disease, whereas levels of interleukin 6 (IL6) have not been systematically studied. Read More

    [Autoimmune hepatitis: Immunological diagnosis].
    Presse Med 2017 Sep 14. Epub 2017 Sep 14.
    CHU Mohammed VI, laboratoire d'immunologie, Marrakech, Maroc; CHU Mohammed VI, centre de recherche clinique, Marrakech, Maroc; Université Cadi Ayyad, faculté de médecine, laboratoire de recherche PCIM, Marrakech, Maroc.
    Autoimmune hepatopathies (AIHT) including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune cholangitis (AIC), represent an impressive entities in clinical practice. Their pathogenesis is not perfectly elucidated. Several factors are involved in the initiation of hepatic autoimmune and inflammatory phenomena such as genetic predisposition, molecular mimicry and/or abnormalities of T-regulatory lymphocytes. Read More

    [Acute-on-chronic liver failure].
    Ugeskr Laeger 2017 Sep;179(38)
    Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute decompensation of liver cirrhosis, organ failure and high short-term mortality (20-80% at one month). The main precipitants are infections and excessive alcohol intake, and the mechanistic features include a high level of systemic inflammation, macrophage activation and liver injury. The severity of ACLF is graded according to the number and extent of organ failures. Read More

    Long-term T3 and T4 treatment as an alternative to aerobic exercise training in improving cardiac function post-myocardial infarction.
    Biomed Pharmacother 2017 Sep 11;95:965-973. Epub 2017 Sep 11.
    Laboratório de Fisiologia Cardiovascular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address:
    Here we aimed to compare the beneficial effects of T3 and T4 hormone treatment to those provided by aerobic exercise training in Wistar rats post-myocardial infarction (MI). Rats in one group were SHAM-operated and in the other group were subjected to MI surgery. One week after surgery, the MI group animals either received T3 and T4 hormones by gavage or underwent a low intensity aerobic exercise training protocol on a treadmill, and both treatments lasted until 10 weeks after MI. Read More

    Leptolide Improves Insulin Resistance in Diet-Induced Obese Mice.
    Mar Drugs 2017 Sep 15;15(9). Epub 2017 Sep 15.
    Instituto de Biología y Genética Molecular, University of Valladolid-CSIC, Valladolid 47005, Spain.
    Type 2 diabetes (T2DM) is a complex disease linked to pancreatic beta-cell failure and insulin resistance. Current antidiabetic treatment regimens for T2DM include insulin sensitizers and insulin secretagogues. We have previously demonstrated that leptolide, a member of the furanocembranolides family, promotes pancreatic beta-cell proliferation in mice. Read More

    Autoimmune acute liver failure and seronegative autoimmune liver disease in children: Are they different from classical disease?
    Eur J Gastroenterol Hepatol 2017 Sep 13. Epub 2017 Sep 13.
    Departments of aPediatric Gastroenterology bPathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
    Objectives: Presentation as autoimmune acute liver failure (AI-ALF) and seronegative autoimmune liver disease (SN-AILD) represents two uncommon variants of AILD. We compared the clinical profile and outcome of AI-ALF with autoimmune-non-acute liver failure (AI-non-ALF) and also SN-AILD with seropositive autoimmune liver disease (SP-AILD).

    Materials And Methods: Children managed as AI-ALF and AI-non-ALF including SN-AILD and SP-AILD were enrolled and compared. Read More

    Tacrolimus Aggravated Tube Feeding Syndrome with Acute Renal Failure in a Pediatric Liver Transplant Recipient.
    Case Rep Transplant 2017 20;2017:7345680. Epub 2017 Aug 20.
    KUNO University Children's Hospital, Regensburg, Germany.
    Acute renal failure can be caused by calcineurin inhibitors (CNIs), due to arteriolopathy and altered tubular function. Within this context, we present the case of a 14-month-old liver transplant recipient who suffered an acute polyuric renal failure during a short episode of hypercaloric feeding. In our case, CNI-induced distal RTA led to nephrocalcinosis and therefore to secondary nephrogenic diabetes insipidus. Read More

    Acute Liver Failure in a Patient Travelling From Asia: The Other Face of the Coin of Infectious Disease.
    Gastroenterology Res 2017 Aug 31;10(4):268-270. Epub 2017 Aug 31.
    Liver Unit in Kings College Hospital, London, UK.
    We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). Read More

    Administration of Albumin Solution Increases Serum Levels of Albumin in Patients with Chronic Liver Failure in a Single-arm Feasibility Trial.
    Clin Gastroenterol Hepatol 2017 Sep 12. Epub 2017 Sep 12.
    Background & Aims: Infections are life threatening to patients with acute decompensation and acute-on-chronic liver failure (AD/ACLF). Patients with AD/ACLF have prostaglandin E2-mediated immune suppression, which can be reversed by administration of albumin; infusion of 20% human albumin solution (HAS) might improve outcomes of infections. We performed a feasibility study to determine optimal trial design, assess safety, and validate laboratory assessments of immune function to inform design of a phase 3 trial. Read More

    Exertional Heat Illness Resulting in Acute Liver Failure and Liver Transplantation.
    J Spec Oper Med 2017 ;17(3):15-17
    Heat illness remains a large medical burden for militaries around the world. Mitigating the incidence as well as the complications of heat illness must remain on the forefront of operational planning when operating in hot environments. We report the case of a 27-year-old male U. Read More

    Characteristics of infection and its impact on short-term outcome in patients with acute-on-chronic liver failure.
    Medicine (Baltimore) 2017 Sep;96(37):e8057
    aDepartment of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang bDepartment of Hepatology, Tianjin Third Central Hospital, Tianjin Institute of Hepatobiliary Disease, Tianjin Key laboratory of Artificial Cell, Tianjin, China.
    Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Read More

    Dengue Hemorrhagic Fever: ARare Cause of Acute Liver Failure.
    J Coll Physicians Surg Pak 2017 Aug;27(8):511-513
    Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
    Acute liver failure (ALF) is an acute medical emergency which carries high mortality without liver transplantation. Various hepatotropic viruses, drug induced liver injury, auto immune hepatitis, and metabolic liver diseases are the commonly implicated etiologic agents. Liver involvement in dengue hemorrhagic fever (DHF) is quite common, but acute liver failure is its rare complication. Read More

    DADLE improves hepatic ischemia/reperfusion injury in mice via activation of the Nrf2/HO‑1 pathway.
    Mol Med Rep 2017 Aug 29. Epub 2017 Aug 29.
    Department of Hepatobiliary Surgery and Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, P.R. China.
    Hepatic ischemia/reperfusion (I/R) injury is a common pathophysiological process that occurs following liver surgery, which is associated with oxidative stress, and can cause acute liver injury and lead to liver failure. Recently, the development of drugs for the prevention of hepatic I/R injury has garnered interest in the field of liver protection research. Previous studies have demonstrated that [D‑Ala2, D‑Leu5]‑Enkephalin (DADLE) exerts protective effects against hepatic I/R injury. Read More

    [Acute alcoholic hepatitis.]
    Recenti Prog Med 2017 Sep;108(9):366-373
    World Health Organization Collaborating Centre for Research and Health Promotion on Alcohol and Alcohol-related Health Problems - SOD di Alcologia e Centro Alcologico Regionale Toscano, Azienda Ospedaliero-Universitaria Careggi, Firenze.
    Chronic alcohol related liver disease is characterized by a cascade of events defined as follows: steatosis, steatohepatitis/steatofibrosi, cirrhosis and hepatocellular carcinoma. On one of these histologic patterns may overlap acute alcoholic hepatitis (AAE) (mild, moderate, severe). Severe AAE can cause a severe clinical picture: jaundice with a duration of less than three months, jaundice in the first decompensation event, serum bilirubin higher than 5 mg/dL, ratio AST/ALT >2:1, AST less than 500 IU/L ALT <300 IU/L, neutrophil leukocytosis and increased GGT. Read More

    Cryopreservation of Hepatocyte Microbeads for Clinical Transplantation.
    Cell Transplant 2017 Aug;26(8):1341-1354
    1 Dhawan Lab at Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, London, United Kingdom.
    Intraperitoneal transplantation of hepatocyte microbeads is an attractive option for the management of acute liver failure. Encapsulation of hepatocytes in alginate microbeads supports their function and prevents immune attack of the cells. Establishment of banked cryopreserved hepatocyte microbeads is important for emergency use. Read More

    Liver involvement in urea cycle disorders: a review of the literature.
    J Inherit Metab Dis 2017 Sep 12. Epub 2017 Sep 12.
    CHRU de Tours, service médecine interne, Tours, France.
    Urea cycle disorders (UCDs) are inborn errors of metabolism of the nitrogen detoxification pathway and encompass six principal enzymatic deficiencies. The aging of UCD patients leads to a better knowledge of the long-term natural history of the condition and to the reporting of previously unnoticed manifestations. Despite historical evidence of liver involvement in UCDs, little attention has been paid to this organ until recently. Read More

    Liver transplantation in critically ill patients: Preoperative predictive factors of post-transplant mortality to avoid futility.
    Clin Transplant 2017 Sep 12. Epub 2017 Sep 12.
    Service de réanimation médicale, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, France.
    Liver transplant (LT) is often the only life-saving therapeutic option for patients with acute liver failure (ALF) (i.e. without prior liver disease) and for acute-on-chronic liver failure (ACLF). Read More

    Decreased activity of plasma ADAMTS13 are related to enhanced cytokinemia and endotoxemia in patients with acute liver failure.
    Biomed Rep 2017 Sep 19;7(3):277-285. Epub 2017 Jul 19.
    Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan.
    Deficient ADAM metalloproteinase with thrombospondin type-1 motif, member 13 (ADAMTS13) activity (ADAMTS13:AC) results in the accumulation of unusually large von Willebrand factor multimers (UL-VWFM) and causes microcirculatory disturbances and multiple organ failure, while endotoxins trigger the activation of a coagulation cascade. The objective of the present study was to explore the role of ADAMTS13 in endotoxemia in patients with acute liver failure (ALF). Plasma concentrations of endotoxin and cytokines, including interleukin (IL)-6 and IL-8, and activity of the plasma ADAMTS13 inhibitor were determined, along with ADAMTS13:AC, the VWF antigen (VWF:Ag) and UL-VWFM, in 27 patients with acute hepatitis (AH), 11 patients with ALF, and 10 healthy controls. Read More

    Extracorporeal membrane oxygenation (ECMO) as salvage treatment for pulmonary Echinococcus granulosus infection with acute cyst rupture.
    Int J Infect Dis 2017 Sep 8. Epub 2017 Sep 8.
    Department of Medicine V - Pneumology, Allergology and Critical Care Medicine, ECLS Center Saar, Saarland University, Homburg/Saar, Germany.
    Extracorporeal membrane oxygenation (ECMO) has been successfully used for the treatment of patients with respiratory failure due to severe infections. Though rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs and other organs. Read More

    Clinical patterns associated with the concurrent detection of anti-HBs and HBV DNA.
    J Med Virol 2017 Sep 11. Epub 2017 Sep 11.
    Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Germany.
    Background: Simultaneous detection of anti-HBs and HBV DNA is a rare serological combination and has been described in acute (AHB) and chronic HBV infection (CHB).

    Objectives: To scrutinize viral and clinical patterns associated with concurrent detection of anti-HBs and HBV DNA.

    Study Design: Simultaneous detection of anti-HBs and HBV DNA was observed in 64/1444 (4. Read More

    Liver Failure as the Presentation of Ornithine Transcarbamylase Deficiency in a 13-Month-Old Female.
    JIMD Rep 2017 Sep 9. Epub 2017 Sep 9.
    Division of Genetics and Genomics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
    Ornithine transcarbamylase deficiency (OTCD) is an X-linked urea cycle disorder with variable expressivity in heterozygous females. While liver function testing is often abnormal in patients with OTCD, liver failure is uncommon on presentation. A 13-month-old female with no significant past medical history presented with irritability, right arm weakness, and decreased appetite. Read More

    Prostacyclin mimetics afford protection against lipopolysaccharide/d-galactosamine-induced acute liver injury in mice.
    Toxicol Appl Pharmacol 2017 Sep 5;334:55-65. Epub 2017 Sep 5.
    Department of Molecular and Medical Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan. Electronic address:
    Prostacyclin (PGI2) serves as a protective, anti-inflammatory mediator and PGI2 mimetics may be useful as a hepatoprotective agent. We examined whether two PGI2 mimetics, ONO-1301 and beraprost, are beneficial in acute liver injury and attempted to delineate the possible mechanism underlying the hepatoprotective effect. Acute liver injury was induced by lipopolysaccharide/d-galactosamine (LPS/GalN) in mice. Read More

    Hepatitis B virus-related mortality in rheumatoid arthritis patients undergoing long-term low-dose glucocorticoid treatment: A population-based study.
    J Formos Med Assoc 2017 Sep 4. Epub 2017 Sep 4.
    Department of Nursing, College of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan. Electronic address:
    Background/purpose: Glucocorticoids (GC) are commonly used in rheumatoid arthritis (RA) patients which bears a risk of hepatitis B virus (HBV) reactivation. The purpose of this study was to investigate the risk of HBV-related mortality under long-term low-dose GCs in Taiwanese RA patients.

    Methods: We retrospectively analyzed 45,423 RA patients using National Health Insurance Research Database from January 1999 to December 2011. Read More

    Hepatic NK cell-mediated hypersensitivity to ConA-induced liver injury in mouse liver expressing hepatitis C virus polyprotein.
    Oncotarget 2017 Aug 4;8(32):52178-52192. Epub 2016 Aug 4.
    Beijing Institute of Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies, Beijing, China.
    The role of hepatic NK cells in the pathogenesis of HCV-associated hepatic failure is incompletely understood. In this study, we investigated the effect of HCV on ConA-induced immunological hepatic injury and the influence of HCV on hepatic NK cell activation in the liver after ConA administration. An immunocompetent HCV mouse model that encodes the entire viral polyprotein in a liver-specific manner based on hydrodynamic injection and φC31o integrase was used to study the role of hepatic NK cells. Read More

    Predictors of acute kidney injury after paraquat intoxication.
    Oncotarget 2017 Aug 18;8(31):51345-51354. Epub 2017 May 18.
    Department of Nephrology and Poison Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.
    Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. Read More

    Clinical Usefulness of Measuring Red Blood Cell Distribution Width in Patients with Hepatitis B Virus-Related Acute-On-Chronic Liver Failure.
    Clin Lab 2017 Sep;63(9):1403-1410
    Background: The red blood cell distribution width (RDW) is increased in chronic liver disease, but its clinical significance in hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is still unclear. The aim of the present study was to investigate the clinical significance of RDW in HBV-ACLF patients.

    Methods: The medical records of HBV-ACLF patients who were admitted to The Second Affiliated Hospital of Anhui Medical University between April 2012 and December 2015 were retrospectively reviewed. Read More

    Postauthorization safety study of the DPP-4 inhibitor saxagliptin: a large-scale multinational family of cohort studies of five outcomes.
    BMJ Open Diabetes Res Care 2017 31;5(1):e000400. Epub 2017 Jul 31.
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
    Objective: To evaluate the risk of serious adverse events among patients with type 2 diabetes mellitus initiating saxagliptin compared with oral antidiabetic drugs (OADs) in classes other than dipeptidyl peptidase-4 (DPP-4) inhibitors.

    Research Design And Methods: Cohort studies using 2009-2014 data from two UK medical record data sources (Clinical Practice Research Datalink, The Health Improvement Network) and two USA claims-based data sources (HealthCore Integrated Research Database, Medicare). All eligible adult patients newly prescribed saxagliptin (n=110 740) and random samples of up to 10 matched initiators of non-DPP-4 inhibitor OADs within each data source were selected (n=913 384). Read More

    Metabolomics Analysis of Urine Samples from Children after Acetaminophen Overdose.
    Metabolites 2017 Sep 6;7(3). Epub 2017 Sep 6.
    Division of Systems Biology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR 72079, USA.
    Acetaminophen (APAP), a commonly used over-the-counter analgesic, accounts for approximately fifty percent of the cases of acute liver failure (ALF) in the United States due to overdose, with over half of those unintentional. Current clinical approaches for assessing APAP overdose rely on identifying the precise time of overdose and quantitating acetaminophen alanine aminotransferase (ALT) levels in peripheral blood. Novel specific and sensitive biomarkers may provide additional information regarding patient status post overdose. Read More

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