China
Africa
Explore chapters and articles related to this topic
Liver disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
It is usually discovered incidentally by the finding of elevated transaminases on routine investigation, when no other underlying cause is found. In NAFLD as compared to alcoholic liver disease, the AST may be normal with an AST/ALT ratio of <0.8. Definitive diagnosis requires a liver biopsy, but this is rarely indicated in pregnancy.
Systemic illnesses (diabetes mellitus, sarcoidosis, alcoholism, and porphyrias)
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Stephanie Kielb, Laurie Bachrach, Nancy Rios
Unfortunately, identification of alcohol abuse is often difficult because it involves elements of denial and lack of rationalization. Often, information from relatives and surveys can be of help. Biological confirmation via laboratory and physical examinations may also help expose the problem. Several abnormalities are seen in laboratory analysis such as, elevated aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), carbohydrate-deficient transferrin (CDT), and erythrocyte mean corpuscular volume (MCV). A high AST/ALT ratio, elevated GGT and CDT are virtually 80% specific for the diagnosis.54 Clinical symptoms can develop acutely within days or progress increasingly over weeks. During the early stage of nutritional deficiency patients experience fatigue, muscle cramping, and irritability. If nutritional deficiency is prolonged for an extended period, signs of neuropathy begin to appear. First, patients experience distal sensory loss accompanied with weakness in both hands and feet, followed by cramping and aching particularly of the lower extremities associated with mild sensory loss and dysesthesias.
Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Investigations are not specific and blood tests may be normal. Blood tests are often normal and rarely differentiate between relatively benign fatty liver and steatohepatitis.In addition to a Fibroscan (see below), there are several non-invasive ways of assessing the degree of fibrosis: The enhanced liver fibrosis (ELF) score which is derived from measurement of hyaluronic acid, amino-terminal propeptide of type III procollagen (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP-1) is a measure of fibrosis and a score <10.51 means the patient is unlikely to have severe fibrosis.The NAFLD fibrosis score (available at www.nafldscore.com) which is derived from six variables (age, body mass index, blood glucose, platelet count, albumin, and AST : ALT ratio). An intermediate or high score (> –1.455), suggests advanced liver fibrosis.The Fibrosis (FIB) 4 score (available at www.gihep.com/calculators/hepatology/fibrosis-4-score/) includes age, AST, ALT, and platelet count. A score of >2.67 suggests advanced liver fibrosis.Fibroscan: This may show an increased CAP score (showing fatty infiltration). Elasticity measures fibrosis.Liver biopsy: This shows fatty infiltration of the liver with ballooning of the cells and nuclei, and fibrosis in steatohepatitis and cirrhosis. In NASH, there is liver cell necrosis, a heavy neutrophil infiltrate, steatosis, Mallory's hyaline and perivenular fibrosis. These features may be superimposed on cirrhosis.
Diagnostic and prognostic value of the AST/ALT ratio in patients with sepsis and septic shock
Published in Scandinavian Journal of Gastroenterology, 2023
Tobias Schupp, Kathrin Weidner, Jonas Rusnak, Schanas Jawhar, Jan Forner, Floriana Dulatahu, Lea Marie Brück, Ursula Hoffmann, Thomas Bertsch, Christel Weiß, Ibrahim Akin, Michael Behnes
From a total of 361 consecutive patients with sepsis or septic shock, 72 patients without evidence of AST or ALT were excluded. The final study cohort comprised 289 patients, 55% presented with sepsis and 45% with septic shock on day 1. The median AST/ALT ratio on day 1 was 1.8 (IQR 1.1 − 2.5). As seen in Table 1, patients were median-aged at 69 years and most patients were males (63%). When stratified for patients presenting with sepsis or septic shock (Table 1, middle and right panel), especially the rates of coronary artery disease (37 vs. 34%; p = 0.617), congestive heart failure (23 vs. 20%; p = 0.503) and atrial fibrillation (30 vs. 30%; p= 0.920) were equally distributed, whereas patients with septic shock revealed higher rates of LVEF < 35% (20 vs. 11%; p = 0.001), alongside with higher rates of cardiopulmonary resuscitation (19 vs. 6%; p = 0.001).
The association between non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis with blood selenium level based on the NHANES 2017-2018
Published in Annals of Medicine, 2022
Jie Liu, Liao Tan, Zhaoya Liu, Ruizheng Shi
Liver stiffness and CAP (a novel physical parameter related to liver steatosis) were detected by VCTE using FibroScan model 502 V2 Touch (Echosens, North America) with a medium (M) or extra-large (XL) wand (probe) in the NHANES Mobile Examination Centre (MEC). The activity of AST and ALT were measured using the kinetic rate method on the Roche Cobas 6000 (c501 module) analyser. FLI was ranged from 0 to 100 using the followed formula: (e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (ggt) + 0.053*waist circumference − 15.745)/(1 + e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (ggt) + 0.053*waist circumference − 15.745) * 100. FIB-4 was calculated by followed formula: age (years) × AST [U/L]/(platelets [109/L] × (ALT [U/L])1/2). BARD was ranged from 0 to 4 defined by BMI, AST/ALT ratio and history of diabetes. BMI ≥28 kg/m2 was given 1 point. AST/ALT ratio ≥0.8 was given 2 points. The history of diabetes was given 1 point. There were three conditions to definition NAFLD: (1) liver steatosis (CAP ≥246 DB/m) [31]; (2) AST >37 U/L or ALT >40 U/L in males and AST or ALT >31 U/L in females [32]; (3) FLI ≥60 [21]. There were three conditions to identified advanced liver fibrosis: (1) VCTE ≥8.8 E/kpa (liver stiffness F3 and F4) [33]; (2) FIB-4 > 3.25[25]; 3) BARD ≥2[34].
The combination of N-acetylcysteine and cyclosporin A reduces acetaminophen-induced hepatotoxicity in mice
Published in Ultrastructural Pathology, 2021
Nalan Kaya Tektemur, Elif Erdem Güzel, Mehmet Gül, Ahmet Tektemur, Sena Özcan Yıldırım, Merve Kavak Balgetir, Gonca Ozan Kocamüftüoğlu, Tuba Yalçın, İbrahim Enver Ozan
AST, an enzyme produced by the liver, is a biochemical marker used to detect liver damage and diagnose many liver diseases. The ALT level, also called serum glutamic pyruvic transaminase (SGPT), is above normal in the blood, a strong indicator of liver damage. AST/ALT ratio is used especially in the evaluation of liver damage. In the APAP-induced hepatotoxicity model, AST-ALT tests are very important for the evaluation of liver damage and the effectiveness of treatments.33 There are many studies in the literature that there is an increase in serum AST and ALT levels after the administration of toxic dose APAP.34,35 Based on this, we think that the serious increase in serum AST and ALT levels in mice treated with APAP is directly related to hepatotoxicity. Excessive NAPQI formation after APAP overdose causes depletion of hepatic GSH. There are many reports of decreased liver GSH levels in APAP-induced hepatotoxicity studies.36,37 In accordance with the literature, in this study, a decrease in liver GSH level was detected in the APAP group.