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Lung Matters
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Since chemotherapy does not specifically target cancer cells, many healthy cells are killed in the process of treatment, particularly fast-growing cells such as the hair follicles, gut, mouth and blood. The most common side effects include low red and white blood cell counts, loss in appetite, nausea, vomiting, diarrhea, hair loss and mouth sores, among many others (Alder, 2017). It is clear that many options are available to patients; however, their success is limited and comes at a price of often severe side effects. The liver is the primary site of metabolism for many of these drugs. All of the mentioned therapies can cause damage to the liver known as hepatotoxicity. The clinical presentations of hepatotoxicity can vary from asymptomatic to an increase of liver chemistries and evident cholestatic hepatitis. This damage can progress to fibrosis and cirrhosis, malignant transformation, veno-occlusive disease/sinusoidal obstruction and even fulminant hepatic failure (Grigorian and Brien, 2014).
Hepatic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Ghassan M. Hammoud, Jamal A. Ibdah
Hepatitis E virus (HEV) is a positive-stranded RNA virus that belongs to the Hepeviridae family. The virus is transmitted via the fecal–oral route, commonly by contaminated water supplies. Vertical transmission of hepatitis E virus ranged between 33% and 50% (33,34). The virus is endemic in the Middle East, India, Southeast Asia, Central Asia, Central America, and South America. Hepatitis E is an acute disease that does not progresses to chronicity, although reports of chronic HEV have been described in liver transplant recipients (35,36). The clinical presentation is basically the same as that for HAV. HEV infection is known to cause severe hepatitis, fulminant liver failure, preterm labor, and increased mortality in pregnant women especially in their third trimester with reported maternal mortality rates as high as 20% to 31.1% (4,37). The incubation period is 3–8 weekes, with a mean of 40 days. Cholestatic hepatitis is common. Acute hepatitis E infection is diagnosed by detection of IgM anti-HEV or a rising titer of IgG anti-HEV. The treatment is supportive therapy. A proved effective vaccine against HEV is currently not available. There is no current evidence that HEV infection is transmitted in breast milk.
Dermatophytosis
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Mahmoud A. Ghannoum, Iman Salem, Nancy Isham
Terbinafine has been associated with diarrhea, pruritus, dyspepsia, rash, taste disturbance, urticaria, abdominal pain, headache, visual disturbance, and neutropenia. Rare cases of cholestatic hepatitis and fulminant hepatic failure have been reported [52–54]. Terbinafine should be avoided in patients with renal impairment or hepatic cirrhosis, as terbinafine clearance is reduced by 50%. In addition, terbinafine levels are potentiated by cimetidine and antagonized by rifampin. Cyclosporine levels should be monitored if taken concurrently with terbinafine [1,4,51].
Molecular mechanisms of hepatotoxicity induced by compounds occurring in Evodiae Fructus
Published in Drug Metabolism Reviews, 2023
Caiqin Yan, Ting Peng, Tingting Zhang, Yuan Wang, Na Li, Kai Wang, Xijuan Jiang
5-Methoxypsoralen (5-MOP) (Table 1) serves as a good example. 5-MOP is a linear furocoumarin, also known as bergapten, which could be easily obtained from numerous plant sources. Since the psoralen ultraviolet A (PUVA) radiation was developed in the 1970s to treat psoriasis, hitherto multiple case reports and studies have established that psoralen and its derivatives are hepatotoxic in combination with UVA light exposure (Bjellerup et al. 1979; Pariser and Wyles 1980). During the clinical application in the past decades, 5-MOP intake was always correlated with a high incidence of cholestatic liver injury. After 40 times of treatments with 5-MOP and photochemotherapy over three months, a 55-year-old woman was reported to develop cholestatic hepatitis as indicated by increased level of bilirubin (Stephens and Cooper 1999). In addition, results of histological examination showed that 5-MOP treatment caused distinct hypertrophy of centrolobular hepatocytes in mice (Diawara et al. 2000).
Utilization of HCV viremic donors in kidney transplantation: a chance or a threat?
Published in Renal Failure, 2022
Paulina Czarnecka, Kinga Czarnecka, Olga Tronina, Teresa Baczkowska, Magdalena Durlik
The breakthrough in transplantation that occurred after the publication of the THINKER and EXPANDER study results encouraged other researchers to attempt replicating these results in ‘real-life’ studies. Kapila et al. presented the largest such study, which included 64 KTRs. Treatment with GLE/PIB or sofosbuvir/ledipasvir lasted 12 weeks and was initiated 72 days after transplantation. Three recipients did not develop viremia, even though the donors had low, but detectable viremia lower than 142 IU/mL. All but one patient achieved SVR. One patient did not respond to treatment because of resistance to NS5A inhibitors and was retreated with sofosbuvir/velpatasvir/voxilaprevir [46]. Fibrosing cholestatic hepatitis was observed in two patients; eleven and fourteen weeks after transplant. Both were successfully treated with DAAs.
Clinical Features, Autoantibodies, and Outcome of Neonatal Lupus Erythematosus
Published in Fetal and Pediatric Pathology, 2022
Age at onset of cutaneous lesions ranged from birth to 20 days. Eleven infants (36.7%) had cutaneous lesions. Of these 11 infants, 10 presented with characteristic annular erythema, three presented with papulosquamous rashes. The most frequent lesions were isolated to the face and scalp, with all cases (100%). The trunk and extremities were also commonly affected, with six cases (54.5%) and five cases (45.5%), respectively. Petechiae and ecchymoses induced by thrombocytopenia were not considered cutaneous lesions. All four infants with CHB were detected by routine examination during gestation on account of maternal connective tissue diseases. One patient (3.3%) showed a second-degree AV block and three patients (10.0%) showed a third-degree AV block. Among the nine patients with transaminase elevations, one child had cholestatic hepatitis. Seizures occurred on one patient who suffered grade one intraventricular hemorrhage while hospitalized.