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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Liver function tests (LFTs): Active disease is associated with a slight increase in alkaline phosphatase and transaminase. CRP (an acute phase reactant) can be used to monitor disease activity.
Acute Fatty Liver of Pregnancy
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Janaka de Silva, Sanjeewa Padumadasa
It is important that reference values that are specific to the trimester of pregnancy are used when interpreting laboratory results. The majority of liver function tests remain within the non-pregnant range during pregnancy, except for alkaline phosphatase and alpha-fetoprotein which increase due to their production by the placenta and albumin which decreases due to haemodilution. Although hypoglycemia and derangements of the liver and renal function tests may be found in AFLP, these may not be always visible. Aspartate and Alanine Transaminase (AST/ALT) levels are often elevated, but these may not reflect the severity of the condition. The neutrophil leukocytosis, which is commonly observed during pregnancy, is usually more distinct in AFLP. As coagulopathy is usually present in AFLP, a coagulation screen should be performed. Serum ammonia is useful if encephalopathy is suspected.
Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Associated with truncal obesity and development of diabetes, fatty liver infiltration is a common cause of abnormal liver test results. Usually, the transaminase levels are elevated, but with an AST:ALT ratio <1 and a normal MCV. Fatty liver disease may progress to cirrhosis and rarely, liver failure.
Plantamajoside alleviates acute sepsis-induced organ dysfunction through inhibiting the TRAF6/NF-κB axis
Published in Pharmaceutical Biology, 2023
Daili Feng, Ruying Guo, Wei Liao, Jiancheng Li, Song Cao
PMS is important component of Chinese herb Plantago asiatica, which has a wide range of curative function in multifold illnesses (Zan et al. 2019; Yu et al. 2022). The important evidence demonstrated that PMS mitigated lipopolysaccharide (LPS)-mediated pulmonary injury via inhibiting the NF-κB/MAPK axis (Wu H et al. 2016). Moreover, PMS exhibited the anti-fibrosis effect in liver through restraining the activation of hepatic stellate cells (Wang Y and Yan 2019). MPO and BLAF proteins are important indexes to evaluate the degree of lung tissue injury (Wang S et al. 2020). ALT and AST are transaminase reflecting the situation of liver injury, which are mainly indicators to detect liver function in clinic (Yip et al. 2021). CK is an important energy regulating enzyme directly related to intracellular energy transport, muscle contraction and ATP regeneration (Lima et al. 2021). The greatest value of CK and CK-MB in clinical application is the diagnosis of myocardial infarction (Wei et al. 2021). In this research, we explored the effect of PMS in sepsis-mediated organ damage through examining the above-mentioned indicators. The results indicated that PMS eased lung, liver and heart damage in the sepsis mouse model via prohibiting correlated factors.
Gastrodin ameliorates Concanavalin A-induced acute hepatitis via the IL6/JAK2/STAT3 pathway
Published in Immunopharmacology and Immunotoxicology, 2022
Yingqun Zhou, Jiaojiao Chen, Zhilu Yao, Xuezhen Gu
Based on the above, we investigated whether gastrodin could exert an anti-inflammatory effect in ConA-induced autoimmune hepatitis and explored its possible mechanisms. As described before, if the liver suffered an acute or chronic injury, the level of transaminases was elevated. Consistently, we found that the level of serum ALT and AST was increased in the ConA group, while significantly decreased with increasing dosage of gastrodin (50 and 100 mg/kg). Moreover, hepatocyte cytokines that participated in the development of hepatitis, were strongly increased in the ConA group while obviously decreased in the gastrodin pretreatment group. Histologically, gastrodin pretreatment significantly decreased the infiltration of inflammatory cells and reduced the degree of hepatocyte necrosis, which is consistent with the previously obtained biochemical results. Also, gastrodin pretreatment greatly decreased the genes level of adhesion molecules like Icam1, Ccl5, and Cxcl2.
Genetic variants associated with ALT elevation from therapeutic acetaminophen
Published in Clinical Toxicology, 2022
Andrew A. Monte, Ian Arriaga Mackenzie, Jack Pattee, Sasha Kaiser, Emileigh Willems, Barry Rumack, Kate M. Reynolds, Richard C. Dart, Kennon J. Heard
Demographic risk factors have not adequately explained the risk of DILI; female sex was associated with the condition in a US-based cohort [2], while male sex predominated in a Spanish cohort [3]. A UK cohort suggested that sex was a modifying effect dependent upon the drug that caused the injury [2]. DILI is characterized by the microscopic patterns it imparts; hepatocellular, cholestatic, or mixed. While most DILI is categorized as predominantly one microscopic subtype, some drugs may yield different patterns in different patients. Thus, the pathophysiology of the injury may vary among patients. In addition to these clinical and demographic factors, genetic differences between patients may predispose some patients to elevated transaminases when challenged with some medications. In fact, genetic variants have been associated with the development of hepatotoxicity for such drugs as fluvoxamine [4], isoniazid [5], and may explain some of these differences between patients that develop DILI. Genetic variation may also explain different hepatic injury outcomes following acetaminophen overdose.