1,112 results match your criteria Clinics in Liver Disease [Journal]


Alcohol and Alcoholic Liver Disease.

Clin Liver Dis 2019 Feb;23(1):xiii-xiv

Medicine and Surgery, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.10.001DOI Listing
February 2019
2 Reads

Nutrition in Alcoholic Liver Disease: An Update.

Clin Liver Dis 2019 Feb;23(1):99-114

Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX 77030, USA; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.

Malnutrition is a change in body composition owing to disordered nutrition associated with a decrease in function and poor clinical outcomes. Malnutrition can result from overnutrition, undernutrition and inflammatory activity. Patients with alcoholic liver disease are at increased risk for malnutrition. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183008
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.09.012DOI Listing
February 2019
11 Reads

Acute Alcoholic Hepatitis.

Authors:
Gene Y Im

Clin Liver Dis 2019 Feb 26;23(1):81-98. Epub 2018 Oct 26.

Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, Recanati-Miller Transplantation Institute, One Gustave Levy Place, Box 1104, New York, NY 10029, USA. Electronic address:

Alcoholic hepatitis is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by prolonged heavy alcohol use. Treatment is mostly supportive. The short-term prognosis of acute alcoholic hepatitis depends on liver recovery, and ranges widely from rapid improvement to grim multiorgan failure despite treatment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.005DOI Listing
February 2019
11 Reads

Pathogenesis of Alcoholic Liver Disease: An Update.

Clin Liver Dis 2019 Feb;23(1):71-80

Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, 6620 Main Street, Suite 1450, Houston, TX 77030, USA. Electronic address:

Apart from the classic knowledge that ethanol mediates its hepatotoxicity through its metabolism to acetaldehyde, a well-known hepatotoxic molecule, recent research has elucidated several key mechanisms that potentiate ethanol's damage to the liver parenchyma, such as generation of free radicals, activation of Kupffer cells, and alterations to the human bacterial and fungal microbiome. Genetic studies have suggested the role of PNPLA3 and TM6SF2 gene mutations in the progression of alcoholic liver disease. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.006DOI Listing
February 2019
4 Reads

Alcohol Use Disorders in Alcoholic Liver Disease.

Clin Liver Dis 2019 Feb;23(1):55-69

Department of Psychiatry, Michigan Medicine, 1500 East Medical Center Drive, SPC 5118, Ann Arbor, MI 48109, USA.

Alcohol use disorder (AUD) is common in alcoholic liver disease (ALD) and intrinsic to its pathophysiology. Optimal treatment requires a multidisciplinary team approach and a working alliance between patients and providers. Diagnosing AUD involves a combination of thorough history taking, physical examination, screening questionnaires, and alcohol biomarkers. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183008
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.09.004DOI Listing
February 2019
11 Reads

Adolescent Alcoholic Liver Disease.

Clin Liver Dis 2019 Feb 26;23(1):51-54. Epub 2018 Oct 26.

Department of Pediatrics, Texas Children's Hospital, 6701 Fannin Street, Houston, TX 77030, USA. Electronic address:

Alcohol use is common during adolescence. Adolescent alcohol use is a global problem. The risk of alcohol dependence increases based on genetic and psychosocial factors. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.003DOI Listing
February 2019
2 Reads

Epidemiology of Alcohol Consumption and Societal Burden of Alcoholism and Alcoholic Liver Disease.

Clin Liver Dis 2019 Feb;23(1):39-50

Division of Gastroenterology and Hepatology, Porphyria Center, University of Alabama at Birmingham, 1720 2nd Avenue South, BDB 380, Birmingham, AL 35294, USA. Electronic address:

Alcohol abuse is a major determinant of public health outcomes. Worldwide data from 2016 indicate that alcohol is the seventh leading risk factor in terms of disability-adjusted life years, an increase of more than 25% from 1990 to 2016. Understanding the epidemiology of alcoholic liver disease, including the regional variations in consumption and public policy, is an area of active research. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183008
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.09.011DOI Listing
February 2019
10 Reads

Alcohol and the Law.

Clin Liver Dis 2019 Feb;23(1):25-38

Section of Gastroenterology, Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.

In the intersection of alcohol ingestion with the law, medical ethics, and public safety, physicians are often unsure about how to proceed. Physicians' primary focus should be on patient education with an ethical and legal duty to warn the patient of the adverse effects of alcohol. Warning third parties of potential harm related to alcohol-related impairment may involve a breach of patient confidentiality; therefore it should only be undertaken after careful analysis suggests that the risk for significant harm exceeds the burden that results to the patient from warning others. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183007
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.09.002DOI Listing
February 2019
11 Reads

Will Studies in Nonalcoholic Steatohepatitis Help Manage Alcoholic Steatohepatitis?

Clin Liver Dis 2019 Feb;23(1):157-165

Gastroenterology Section, VA Long Beach Healthcare System, 5901 East Seventh Street - 11G, Long Beach, CA 90822, USA. Electronic address:

Hepatic steatosis and steatohepatitis have several etiologies; the most common are alcoholic steatohepatitis (ASH) and obesity/metabolic syndrome-induced steatohepatitis, also known as nonalcoholic steatohepatitis (NASH). Although the etiology of these 2 conditions is different, they share pathways to disease progression and severity. They also have differences in physiologic pathways, and shared and divergent mechanisms can be therapeutic targets. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183008
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.09.008DOI Listing
February 2019
10 Reads

Chronic Neurologic Effects of Alcohol.

Clin Liver Dis 2019 Feb;23(1):141-155

Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 7200 Cambridge Street, 9th Floor, MS:BCM609, Houston, TX 77030, USA. Electronic address:

Chronic alcohol use induces silent changes in the structure and function of the central and peripheral nervous systems that eventually result in irreversible, debilitating repercussions. Once identified, nutritional supplementation and cessation measures are critical in preventing further neurologic damage. The proposed mechanisms of neuronal injury in chronic alcohol abuse include direct toxic effects of alcohol and indirect effects, including those resulting from hepatic dysfunction, nutritional deficiencies, and neuroinflammation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.010DOI Listing
February 2019
2 Reads

Liver Transplantation for Alcoholic Liver Disease: An Update.

Clin Liver Dis 2019 Feb;23(1):127-139

6620 Main Street, Suite 1425, Houston, TX 77030, USA.

Alcoholic liver disease is a serious and increasing contributor to the global liver disease burden. Extensive selection criteria, including a minimum abstinence period, has previously been used to secure good outcomes but new research questions the effectiveness of abstinence periods and has recommended changes in integrated alcohol use treatment to effectively prevent relapse. Patients have unique health concerns, including posttransplantation risks of malignancy and metabolic complications, but overall very good long-term outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.007DOI Listing
February 2019
8 Reads

Alcohol-Associated Cirrhosis.

Authors:
Michael R Lucey

Clin Liver Dis 2019 Feb;23(1):115-126

Division of Gastroenterology and Hepatology, University of Wisconsin-Madison School of Medicine and Public Health, 1685 Highland Avenue Suite 4000, Madison, WI 53705-2281, USA. Electronic address:

Alcohol-associated cirrhosis (AC) contributes up to 50% of the overall cirrhosis burden in the United States. AC is typically a comorbid condition in association with alcohol-use disorder. AC is often coexistent with other conditions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.013DOI Listing
February 2019
15 Reads

Histopathology of Alcohol-Related Liver Diseases.

Clin Liver Dis 2019 Feb;23(1):11-23

Department of Pathology, The Department of Veteran Affairs New York Harbor Healthcare System, 800 Poly Place, Brooklyn, NY 11209, USA.

Excessive alcohol consumption can lead to a spectrum of liver histopathology, including steatosis, steatohepatitis, foamy degeneration, fatty liver with cholestasis, and cirrhosis. Although variability in sampling and pathologist interpretation are of some concern, liver biopsy remains the gold standard for distinguishing between steatohepatitis and noninflammatory histologic patterns of injury that can also cause the clinical syndrome of alcohol-related hepatitis. Liver biopsy is not routinely recommended to ascertain a diagnosis of alcohol-related liver disease in patients with an uncertain alcohol history, because the histologic features of alcohol-related liver diseases can be found in other diseases, including nonalcoholic steatohepatitis and drug-induced liver injury. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.001DOI Listing
February 2019
2 Reads

Introduction: Alcohol and Alcoholism.

Clin Liver Dis 2019 Feb;23(1):1-10

Division of Abdominal Transplantation, Baylor College of Medicine, 6620 Main Street, Suite 1450, Houston, TX 77030, USA. Electronic address:

This article discusses alcohol use throughout history. The discovery and cultivation of wine and beer and distillation of spirits are explored. The article spans prehistory, Egypt, Ancient Greece, Ancient Rome, Europe, and the Americas; and the religions Judaism, Christianity, and Islam. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.09.009DOI Listing
February 2019
2 Reads

Advances in Pediatric Hepatology.

Authors:
Philip Rosenthal

Clin Liver Dis 2018 Nov;22(4):xi

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of California, San Francisco, 550 16th Street, Mailcode 0136, San Francisco, CA 94143, USA. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.08.001DOI Listing
November 2018
1 Read

Liver Transplantation in Children.

Clin Liver Dis 2018 Nov 22;22(4):807-821. Epub 2018 Aug 22.

Pediatric Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Houston, TX 77030, USA. Electronic address:

Liver transplantation (LT) for children has excellent short- and long-term patient and graft survival. LT is a lifesaving procedure in children with acute or chronic liver disease, hepatic tumors, and a few genetic metabolic diseases in which it can significantly improve quality of life. In this article, the authors discuss the unique aspects of pediatric LT, including the indications, patient selection and evaluation, allocation, transplant surgery and organ selection, posttransplant care, prognosis, adherence, and transition of care. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.004DOI Listing
November 2018
12 Reads

Acute Liver Failure: An Update.

Clin Liver Dis 2018 Nov 22;22(4):773-805. Epub 2018 Aug 22.

Department of Pediatric Gastroenterology and Hepatology, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

Pediatric acute liver failure (PALF) is a dynamic, life-threatening condition of disparate etiology. Management of PALF is dependent on intensive collaborative clinical care and support. Proper recognition and treatment of common complications of liver failure are critical to optimizing outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.009DOI Listing
November 2018
13 Reads

Pediatric Liver Tumors.

Clin Liver Dis 2018 Nov 24;22(4):753-772. Epub 2018 Aug 24.

Department of Pediatrics, Johns Hopkins School of Medicine, 600 North Wolfe Street, CMSC 2-117, Baltimore, MD 21287, USA. Electronic address:

Although liver tumors are rare in the pediatric population, they are common in the setting of children with specific risk factors requiring increased awareness and, in some instances, screening. The evaluation of a liver mass in children is largely driven by the age at diagnosis, the presence of any medical comorbidities, and initial testing with alpha fetoprotein and imaging. Specific guidelines for the management of different tumors have been implemented in recent years such that a multidisciplinary approach is ideal and care should be provided by centers with experience in their management. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.008DOI Listing
November 2018
1 Read

Cirrhosis and Portal Hypertension in the Pediatric Population.

Clin Liver Dis 2018 Nov 22;22(4):735-752. Epub 2018 Aug 22.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box #65, Chicago, IL 60611, USA. Electronic address:

Cirrhosis is a complex process in which the architecture of the liver is replaced by structurally abnormal nodules due to cirrhosis. Cirrhosis frequently leads to the development of portal hypertension. In children, portal hypertension may be caused by a wide range of etiologies, including extrahepatic portal vein obstruction, biliary atresia, alpha 1 antitrypsin deficiency, and autoimmune hepatitis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.007DOI Listing
November 2018
12 Reads

Nonalcoholic Liver Disease in Children and Adolescents.

Clin Liver Dis 2018 Nov 22;22(4):723-733. Epub 2018 Aug 22.

Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of California, San Francisco, 550 16th Street, 5th Floor, Mail Code 0136, San Francisco, CA 94143, USA.

Pediatric nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. The spectrum of NAFLD ranges from steatosis to nonalcoholic steatohepatitis (NASH) to fibrosis. Obesity rates in children continue to rise and, as a result, NAFLD in children is becoming more prevalent. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183006
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.07.001DOI Listing
November 2018
11 Reads

Hepatitis B and C.

Clin Liver Dis 2018 Nov 22;22(4):703-722. Epub 2018 Aug 22.

Division of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin, Suite 1010, Houston, TX 77030, USA. Electronic address:

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major global public health and economic burden, with an estimated 257 million and 71 million people, respectively, having chronic infection worldwide. The natural history of HBV and HCV in children depends on age at time of infection, mode of acquisition, ethnicity, and genotype. Most children infected perinatally or vertically remain asymptomatic but are at uniquely higher risk of developing chronic viral hepatitis, progressing to liver cirrhosis and hepatocellular carcinoma (HCC), hence classifying HBV and HCV as oncoviruses. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.002DOI Listing
November 2018
9 Reads

Autoimmune Hepatitis, Sclerosing Cholangitis, and Autoimmune Sclerosing Cholangitis or Overlap Syndrome.

Clin Liver Dis 2018 Nov;22(4):689-702

Division of Gastroenterology, Hepatology and Nutrition, Golisano Children's Hospital, University of Rochester Medical Center, 601 Elmwood Avenue, Box 667, Rochester, NY 14642, USA; Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Florida, PO Box 100296, Gainesville, FL 32610, USA.

Autoimmune hepatitis (AIH) is characterized by elevated serum aminotransferases, immunoglobulin G, autoantibodies, and interface hepatitis, in the absence of a known diagnosis. Presentation is varied. Therapy is with immunosuppression. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183005
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.06.005DOI Listing
November 2018
13 Reads

Inborn Errors of Bile Acid Metabolism.

Clin Liver Dis 2018 Nov 22;22(4):671-687. Epub 2018 Aug 22.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 240 Sabin Way, Cincinnati, OH 45229, USA; Division of Pathology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 240 Sabin Way, Cincinnati, OH 45229, USA.

Inborn errors of bile acid metabolism are rare causes of neonatal cholestasis and liver disease in older children and adults. The diagnosis should be considered in the context of hyperbilirubinemia with normal serum bile acids and made by urinary liquid secondary ionization mass spectrometry or DNA testing. Cholic acid is an effective treatment of most single-enzyme defects and patients with Zellweger spectrum disorder with liver disease. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183005
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.06.006DOI Listing
November 2018
13 Reads

Progressive Familial Intrahepatic Cholestasis.

Clin Liver Dis 2018 Nov 3;22(4):657-669. Epub 2018 Aug 3.

Institute of Liver Studies, King's College London, King's College Hospital, Denmark Hill, London SE5 9RS, UK.

Genetic cholestasis has been dissected through genetic investigation. The major PFIC genes are now described. ATP8B1 encodes FIC1, ABCB11 encodes BSEP, ABCB4 encodes MDR3, TJP2 encodes TJP2, NR1H4 encodes FXR, and MYO5B encodes MYO5B. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183005
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.06.003DOI Listing
November 2018
4 Reads
3.660 Impact Factor

Alpha-1-Antitrypsin Deficiency Liver Disease.

Clin Liver Dis 2018 Nov 22;22(4):643-655. Epub 2018 Aug 22.

Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Saint Louis University School of Medicine, 1465 South Grand Boulevard, St Louis, MO 63104, USA; Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, 1465 South Grand Boulevard, St Louis, MO 63104, USA. Electronic address:

In homozygous ZZ alpha-1-antitrypsin (AAT) deficiency, the liver synthesizes large quantities of AAT mutant Z, which folds improperly during biogenesis and is retained within the hepatocytes and directed into intracellular proteolysis pathways. These intracellular polymers trigger an injury cascade, which can lead to liver injury. This is highly variable and not all patients develop liver disease. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.06.010DOI Listing
November 2018
2 Reads

Alagille Syndrome.

Clin Liver Dis 2018 Nov 22;22(4):625-641. Epub 2018 Aug 22.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address:

Alagille syndrome is a complex multisystem autosomal dominant disorder with a wide variability in penetrance of clinical features. A majority of patients have pathogenic mutations in either the JAG1 gene, encoding a Notch pathway ligand, or the receptor NOTCH2. No genotype-phenotype correlations have been found in any organ system. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183005
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.06.001DOI Listing
November 2018
7 Reads

Primary Biliary Cholangitis: A New Era.

Clin Liver Dis 2018 08 31;22(3):xiii-xiv. Epub 2018 Mar 31.

Division of Hepatology, University of Miami Miller School of Medicine, 1500 Northwest 12th Avenue, Suite 1101, Miami, FL 33136, USA. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.012DOI Listing
August 2018
1 Read

Current Status of Liver Transplantation for Primary Biliary Cholangitis.

Clin Liver Dis 2018 08;22(3):613-624

Division of Gastroenterology and Hepatology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. Electronic address:

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease diagnosed with elevated alkaline phosphatase in the presence of antimitochondrial antibody. With the introduction and widespread use of ursodeoxycholic acid the proportion of PBC patients undergoing liver transplant (LT) has decreased. However, up to 40% of patients are ursodeoxycholic acid nonresponders and require second-line treatment or progress to end-stage liver disease requiring LT. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.011DOI Listing
August 2018
2 Reads

Overlap Syndrome of Autoimmune Hepatitis and Primary Biliary Cholangitis.

Clin Liver Dis 2018 08;22(3):603-611

Department of Digestive Diseases, Yale University, New Haven, CT, USA. Electronic address:

Overlap syndrome of autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) is typically defined as concomitant or serial presentation with clinical features of both of these 2 distinct diseases. The Paris criteria and variations of the International Autoimmune Hepatitis group scoring systems for the diagnosis of AIH have been used to diagnose overlap syndrome. If left untreated, patients with overlap syndrome will have higher rates of portal hypertension, gastrointestinal bleeding, ascites, death, and need for liver transplant. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183003
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.03.010DOI Listing
August 2018
3 Reads

Antimitochondrial Antibody-Negative Primary Biliary Cholangitis: Is It Really the Same Disease?

Clin Liver Dis 2018 08;22(3):589-601

Division of Gastroenterology and Hepatology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA; Office of the Provost, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA. Electronic address:

Antimitochondrial antibody (AMA)-negative primary biliary cholangitis (PBC) is a term reserved for patients with clinical and histopathological findings consistent with PBC but without positive AMA. There does not seem to be a natural progression from AMA negativity to positivity. Antinuclear and antismooth muscle antibodies are frequently found in the absence of histologic autoimmune hepatitis features. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.009DOI Listing
August 2018
3 Reads

Liver Biopsy in Primary Biliary Cholangitis: Indications and Interpretation.

Clin Liver Dis 2018 08;22(3):579-588

Division of Liver Pathology Research, Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA. Electronic address:

Primary biliary cholangitis is a disease characterized by immune-mediated bile duct destruction, followed by inflammation, scarring, and the development of chronic cholestasis and a slow progression to cirrhosis over the course of years. Liver biopsy has traditionally been used in conjunction with clinical evaluation and serologic autoantibody testing to establish the diagnosis, but it is no longer required in typical cases with positive antimitochondrial antibodies. Biopsy remains essential, however, in antimitochondrial antibody-negative patients or suspected overlap syndrome with autoimmune hepatitis, and if an adequate biopsy is performed precise staging is possible for assessment of prognosis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.008DOI Listing
August 2018
2 Reads

Natural History of Primary Biliary Cholangitis in the Ursodeoxycholic Acid Era: Role of Scoring Systems.

Clin Liver Dis 2018 08;22(3):563-578

Division of Gastroenterology and Hepatology, Stanford University, Alway Building, Room M211, 300 Pasteur Drive, Stanford, CA 94305, USA. Electronic address:

Primary biliary cholangitis (PBC) is a chronic disease that progresses to end-stage liver disease. Ursodeoxycholic acid (UDCA), the standard treatment for PBC for several decades, is associated with improved survival without liver transplantation. Approximately 40% of patients do not respond to UDCA. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.007DOI Listing
August 2018
2 Reads

Individualizing Care: Management Beyond Medical Therapy.

Clin Liver Dis 2018 08;22(3):545-561

Division of Gastroenterology and Hepatology, Department of Medicine and Surgery, University of Milan Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy; Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK. Electronic address:

The evolving research landscape, with advances in the omics technologies, availability of large-scale patient cohorts, and forthcoming availability of novel drugs in primary biliary cholangitis (PBC), is creating a unique opportunity for developing a precision medicine (PM) program. PM has potential to change the paradigm of management. Diagnostic work-up of PBC patients may include information on genetic variants and molecular signature to define a particular subtype of disease and provide an estimate of treatment response and survival. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183003
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.03.006DOI Listing
August 2018
3 Reads

Chronic Complications of Cholestasis: Evaluation and Management.

Authors:
David N Assis

Clin Liver Dis 2018 08 28;22(3):533-544. Epub 2018 May 28.

Department of Medicine, Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06510, USA. Electronic address:

Patients with primary biliary cholangitis (PBC) are at risk for various harmful consequences of chronic cholestasis. These include fat-soluble vitamin deficiency, even in the setting of macronutrient sufficiency, as well as metabolic bone disease, including osteoporosis with fractures. Hyperlipidemia is often present and less commonly associated with risk of cardiovascular event; however, the long-term effect of new emerging therapies for PBC remains to be determined. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.014DOI Listing
August 2018
2 Reads

Understanding and Treating Pruritus in Primary Biliary Cholangitis.

Clin Liver Dis 2018 08 17;22(3):517-532. Epub 2018 May 17.

Division of Hepatology, Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, FL, USA.

Pruritus is a common symptom with primary biliary cholangitis. Research has focused on refining understanding of the neurohumoral pathways involved in transduction of pruritus from peripheral cutaneous receptors to the central nervous system, and identifying modulating drugs. Current treatments have variable efficacy and safety. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.005DOI Listing
August 2018
1 Read

Work in Progress: Drugs in Development.

Clin Liver Dis 2018 08 17;22(3):501-515. Epub 2018 May 17.

National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK. Electronic address:

Primary biliary cholangitis is an archetypal autoimmune disease that causes cholestasis, fibrosis, and liver failure. Ursodeoxycholic acid and obeticholic acid are approved for its treatment. Not all patients respond, some are intolerant, many have ongoing symptoms, and new therapies are required. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10893261183002
Publisher Site
http://dx.doi.org/10.1016/j.cld.2018.03.004DOI Listing
August 2018
4 Reads

Current Treatment Options for Primary Biliary Cholangitis.

Clin Liver Dis 2018 08 19;22(3):481-500. Epub 2018 May 19.

Division of Gastroenterology and Hepatology, UC Davis School of Medicine, 4150 V Street, PSSB 3500, Sacramento, CA 95817, USA. Electronic address:

Primary biliary cholangitis is a progressive, autoimmune disease of the interlobular bile ducts, leading to secondary damage of hepatocytes that may progress to cirrhosis and liver failure. Until recently, the only approved treatment was ursodeoxycholic acid. However, 40% of patients do not have an adequate response. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.003DOI Listing
August 2018
3 Reads
3.660 Impact Factor

Role of Bile Acids and the Biliary HCO Umbrella in the Pathogenesis of Primary Biliary Cholangitis.

Clin Liver Dis 2018 08 19;22(3):457-479. Epub 2018 May 19.

Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. Electronic address:

The biliary HCO umbrella hypothesis states that human cholangiocytes and hepatocytes create a protective apical alkaline barrier against millimolar concentrations of potentially toxic glycine-conjugated bile salts in bile by secreting HCO into the bile duct lumen. This alkaline barrier may retain biliary bile salts in their polar, deprotonated, and membrane-impermeant state to avoid uncontrolled invasion of apolar toxic bile acids, which initiate apoptosis, autophagy and senescence. In primary biliary cholangitis, defects of the biliary HCO umbrella, leading to impaired biliary HCO secretion have been identified. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.013DOI Listing
August 2018
2 Reads

The Genetics and Epigenetics of Primary Biliary Cholangitis.

Clin Liver Dis 2018 08;22(3):443-455

Division of Rheumatology, Allergy and Clinical Immunology, UC Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis 95616, CA. Electronic address:

Both genetic background and environmental factors contribute to primary biliary cholangitis (PBC). Recent innovative technologies, such as genome-wide association studies, identified a remarkable number of susceptible nonhuman leukocyte antigen genes contributing to the development of PBC; however, they are primarily indicators of active immunologic responses commonly involved in autoimmune reactions. Thus, recent studies have focused on epigenetic mechanisms that would link genetic predisposition and environmental triggering factors. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.002DOI Listing
August 2018
1 Read

Changes in the Epidemiology of Primary Biliary Cholangitis.

Clin Liver Dis 2018 08;22(3):429-441

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan 20090, Italy.

Primary biliary cholangitis (PBC) is considered a model autoimmune disease, characterized by circulating anti-mitochondrial antibodies and a selective autoimmune destruction of intrahepatic cholangiocytes. PBC is heterogeneous in its presentation, symptomatology, disease progression, and response to therapy. The pathogenesis is still largely unknown and epidemiologic studies have facilitated the identification of risk factors and the understanding of disease prevalence, geographic variations, heterogeneity, and differences in sex ratio. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.03.001DOI Listing
August 2018
2 Reads

Acute Liver Failure.

Clin Liver Dis 2018 05;22(2):xiii-xiv

Division of Gastroenterology and Hepatology, Liver Transplantation, Rutgers New Jersey Medical School, University Hospital, 185 South Orange Avenue, MSB H Room 536, Newark, NJ 07101-1709, USA. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.02.001DOI Listing
May 2018
7 Reads

Future Approaches and Therapeutic Modalities for Acute Liver Failure.

Clin Liver Dis 2018 05 9;22(2):419-427. Epub 2018 Feb 9.

Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB H-538, Newark, NJ 07103, USA. Electronic address:

The current gold standard for the management of acute liver failure is liver transplantation. However, because of organ shortages, other modalities of therapy are necessary as a possible bridge. This article discusses the current modalities as well as the future management of acute liver failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.011DOI Listing
May 2018
5 Reads

Liver Transplantation for Acute Liver Failure.

Clin Liver Dis 2018 05;22(2):409-417

Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers New Jersey Medical School, 185 South Orange Avenue, H-532, Newark, NJ 07103, USA.

With the advent of liver transplant for acute liver failure (ALF), survival rate has improved drastically. Liver transplant for ALF accounts for 8% of all transplant cases. The 1-year survival rates are 79% in Europe and 84% in the United States. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.014DOI Listing
May 2018
5 Reads

Management of Acute Liver Failure in the Intensive Care Unit Setting.

Clin Liver Dis 2018 05 23;22(2):403-408. Epub 2018 Feb 23.

Department of Medicine, Emory University School of Medicine, 1365 Clifton Road Northeast, B6100, Atlanta, GA 30322, USA. Electronic address:

This article discusses the intensive care unit management of patients with acute liver failure. It focuses on the clinical presentation, identification, and management of the myriad of complications seen in patients with acute liver failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.013DOI Listing
May 2018
5 Reads

Non-Intensive Care Unit Management of Acute Liver Failure.

Clin Liver Dis 2018 05 9;22(2):389-401. Epub 2018 Feb 9.

Gastroenterology and Hepatology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136, USA.

Acute liver failure (ALF) is an uncommon syndrome with a highly variable and unpredictable clinical course. The initial diagnostic evaluation is typically performed in a non-intensive care unit (ICU) setting, like the emergency department or general hospital ward. Prompt restoration of intravascular volume with intravenous fluids and correction of electrolyte, metabolic, and acid-base disturbances are important initial interventions in the management of ALF and can be safely accomplished in non-ICU settings in many patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.009DOI Listing
May 2018
11 Reads

Prognostic Models in Acute Liver Failure.

Clin Liver Dis 2018 05 8;22(2):375-388. Epub 2018 Feb 8.

Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson University Hospital, Medical Education Building, Room 466, 1 Robert Wood Johnson Place, New Brunswick, NJ 08901, USA.

There is a strong imperative to develop valid and accurate prognostic modeling for acute liver failure (ALF). Despite the numerous clinical models that have been proposed thus far and the use of some such models, that is, King's College Criteria and Model for End-Stage Liver Disease, in clinical practice to aid decision-making, there is a significant need for improvement for determining patients' clinical course, survival, and requirement for liver transplantation. Future prognostic models shall need a stronger statistical foundation and accountability for time and variability in the clinical course of ALF and be applied for pretransplant and posttransplant outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.010DOI Listing
May 2018
4 Reads

The Clinical Spectrum and Manifestations of Acute Liver Failure.

Clin Liver Dis 2018 05;22(2):361-374

Division of Gastroenterology and Hepatology, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.

Acute liver failure (ALF) is a rare life-threatening condition characterized by rapid progression and death. Causes vary according to geographic region, with acetaminophen and drug-induced ALF being the most common causes in the United States. Determining the cause aids in predicting the prognosis and the presentation of manifestations and guides providers to perform cause-specific management. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.012DOI Listing
May 2018
9 Reads

Nonviral or Drug-Induced Etiologies of Acute Liver Failure.

Clin Liver Dis 2018 05;22(2):347-360

Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY 10021, USA. Electronic address:

Acute liver failure (ALF) is a rare but highly fatal condition. The most common causes include drug-induced and viral hepatitis, but other less common etiologies, especially autoimmune hepatitis, Budd-Chiari syndrome, and Wilson disease, need to be considered. Because diagnosis is frequently tied to potential for reversibility of ALF and prognosis, early identification in a timely manner is crucial. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.008DOI Listing
May 2018
8 Reads

Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and Acute Liver Failure.

Clin Liver Dis 2018 05 9;22(2):325-346. Epub 2018 Feb 9.

Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address:

Acetaminophen (APAP) is the leading cause of acute liver failure (ALF), although the worldwide frequency is variable. APAP hepatotoxicity develops either following intentional overdose or unintentional ingestion (therapeutic misadventure) in the background of several factors, such as concomitant use of alcohol and certain medications that facilitate the formation of reactive and toxic metabolites. Spontaneous survival is more common in APAP-induced ALF compared with non-APAP etiologies. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.007DOI Listing
May 2018
3 Reads

Nonacetaminophen Drug-Induced Acute Liver Failure.

Clin Liver Dis 2018 05 7;22(2):301-324. Epub 2018 Feb 7.

Division of Gastroenterology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Room M2408, Washington, DC 20007, USA. Electronic address:

Acute liver failure of all causes is diagnosed in between 2000 and 2500 patients annually in the United States. Drug-induced acute liver failure is the leading cause of acute liver failure, accounting for more than 50% of cases. Nonacetaminophen drug injury represents 11% of all cases in the latest registry from the US Acute Liver Failure Study Group. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cld.2018.01.006DOI Listing
May 2018
5 Reads