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Hepatitis C
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Rebecca Pierce-Williams, Neil Silverman, Raja Dhanekula, Jonathan M. Fenkel, Danielle Tholey
Any woman who tests positive for anti-HCV antibody should have HCV RNA quantitative evaluation (via PCR) performed. An HCV genotype is also recommended, as treatment is tailored to the genotype and subtype. She should be screened for co-infection with HIV (HIV antibody) and hepatitis A and B (hepatitis B surface antigen), as well as other STIs. Patients with chronic HCV infection are at high risk of liver failure if they are infected with other forms of viral hepatitis. Screening for immunity to hepatitis A (hepatitis A total antibody) and hepatitis B (hepatitis B surface antibody), and vaccinating if non-immune, is also recommended. Blood tests to measure liver function include aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, platelet count and international normalized ratio (INR). Imaging of the liver to evaluate for cirrhosis can be completed with ultrasound during pregnancy, or liver elastography preconception or postpartum. Patients with cirrhosis should receive the pneumococcal vaccination [5]. A hepatology referral is recommended for assessment of disease severity, counseling on risk reduction behaviors, and treatment.
Progabide
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
The only serious adverse effect seen with PGB is hepatotoxicity. Most available AEDs can impair liver function, but this has been of particular concern with PGB. An increase in liver aminotransferase levels has been detected in 9% (32,33) to 15.3% (personal communication) of patients and aminotransferase elevation has been associated with clinical hepatitis in 0.64% of patients. However, it would appear that clinical hepatitis can be forecast: aminotransferase levels rise progressively for several weeks. After PGB withdrawal, the levels return to normal. Clinical manifestations, when present, disappear if PGB is discontinued soon enough. No hepatic fatalities were observed during the pilot studies and controlled trials because of regular monitoring of patients. Three fatal cases of hepatitis occurred in loosely monitored patients, but none have been observed in France in the postmarketing phase because of intensive scrutiny of liver function tests. In most patients, the increase in aminotransferase levels is transient and it is not necessary to discontinue PGB (27,12). The occurrence of abnormal liver function tests is usually limited to the first 6 months of treatment. However, monthly or bimonthly monitoring of liver function is mandatory throughout treatment, and the drug should be stopped if transaminase levels exceed three times the upper limit of normal.
Carnitine palmitoyl transferase II deficiency, lethal neonatal
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Hepatomegaly is also characteristic [1, 2, 4], and liver size may increase progressively. Aminotransferase levels may be elevated. Hepatic calcifications have been seen on ultrasound [12]. Histologic examination has revealed lipid vacuoles in hepatocytes [4, 6].
Cumulative effects of manganese nanoparticle and radiofrequency radiation in male Wistar rats
Published in Drug and Chemical Toxicology, 2022
Sonali Pardhiya, Usha Singh Gaharwar, Rohit Gautam, Eepsita Priyadarshini, Jay Prakash Nirala, Paulraj Rajamani
Increased production and use of MNPs in different industries and healthcare etc., may enhance the risk to occupationally exposed personnel and the environment. A lower dose of MNPs administered orally did not elicit any toxic response (Singh et al.2013). The bioavailability of intraperitoneally administered substances is more than the oral route of administration (Nemes et al. 2000). Higher bioavailability will yield a better understanding of the combined effect of RFR and MNP. In addition, humans are also exposed to RFR emits from the cell phone, base transceiver station (BTS), and other electronic gadgets. Previous studies showed that rats exposed to 30–45 days of RFR exposure have affected liver, kidney, and reproductive parameters, hence the exposure period was kept for 45 days (Adebayo et al.2019, Gautam et al. 2019). The present study was conducted to evaluate the effects of MNP and RFR individually and in combination with Wistar rats. Serum aminotransferases have become the most frequently used and standard marker for hepatotoxicity. The enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) catalyze the transfer of amino acids, aspartate and alanine respectively to the keto group of ketoglutaric acid. In addition, ALT is generally present in the liver and AST in a wide variety of issues like the heart, skeletal muscle, kidney, brain, and liver (Rosen and Keefe 2000, Friedman et al.2003). ALP is yet another enzyme that is produced mainly in the liver, but some of it is also produced in bones, intestines, pancreas, and kidneys.
Dexamethasone increases renal free fatty acids and xanthine oxidase activity in female rats: could there be any gestational impact?
Published in Drug and Chemical Toxicology, 2022
Olufunto O. Badmus, Isaiah W. Sabinari, Lawrence A. Olatunji
The current study also revealed that DEX exposure during gestation or not led to increased renal AST, ALP, and GGT. Elevated serum aminotransferase levels (ALT, AST, ALP, and GGT) have been reported in patients with CKD (Sette and Almeida Lopes 2014). Furthermore, elevated levels of aminotransferases can signal organ damage (Thriveni et al. 2009). In the present study, DEX exposure in both pregnant and non-pregnant rats elicited increased renal aminotransferases. During normal pregnancy, ALT and AST are not elevated compared to non-pregnancy, however, these can become elevated in some different conditions during pregnancy especially oxidative stress (Zhou et al. 2015). In the present study, elevated ALT and AST caused by DEX treatment were further aggravated in pregnant rats. The kidney has the highest levels of GGT amongst tissues and it catalyzes the degradation of GSH in the kidney. Hence, when renal GGT is elevated, it degrades virtually all luminal GSH in the kidney (Lash 2005) thereby impairing renal function since the kidney depends on an adequate amount of GSH to function normally.
Renal and Hepatic Disease: Cnidoscolus aconitifolius as Diet Therapy Proposal for Prevention and Treatment
Published in Journal of the American College of Nutrition, 2021
Maria Lilibeth Manzanilla Valdez, Maira Rubi Segura Campos
In addition to the guideline of Brunt and Tiniakos (52) shown in Table 2, another way to diagnose LD and specifically NAFLD is with hepatic biomarkers. The alterations in serum aminotransferases can show hepatic injury. Serum aminotransferases are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). ALT is found in the liver parenchyma and AST is found in the liver, heart, skeletal muscle, pancreas, and lung. So, the AST is not as specific as the ALT. The elevation in serum levels usually indicates injury or necrosis in the hepatocytes (38).Alkaline phosphatase (ALP) and gamma-glutamyl-transpeptidase (GGT): GGT is an enzyme found in the hepatocyte and in the biliary epithelium. ALP is found in the liver, bone, intestine and placenta. An elevation of both is a sign of hepatic cholestasis.Bilirubin: it is a product of the degradation of the catabolism of hemoglobin. It is metabolized in the smooth endoplasmic reticulum of the hepatocyte, by glucuronyl-transferase.