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Biomedical subjects

D Larrey

Publications and source records attributed to D Larrey.

At least 73 records · Page 4Linked to original sources
PubMed1995

Failure of ursodeoxycholic acid to prevent acute cellular rejection after liver transplantation.

BACKGROUND/AIMS: Acute rejection is still a major problem after liver transplantation. Ursodeoxycholic acid has beneficial effects in cholestasis by reducing the expression of major histocompatibility complex antigens. METHODS: We have performed a double-blind randomised study comparing ursodeoxycholic acid with placebo for the prevention of acute cellular rejection after liver transplantation. Twenty-six patients received ursodeoxycholic acid 600 mg per day and 24 patients received placebo for 2 months. RESULTS: Neither rejection incidence nor rejection severity was significantly different in the two groups (p > 0.90). CONCLUSIONS: We conclude that adjuvant ursodeoxycholic acid administration does not prevent rejection after liver transplantation.

Acute Disease↗
PubMed1995

[Drug-induced hepatitis: epidemiologic, clinical, diagnostic and physiopathologic aspects in 1995].

Drug-induced hepatotoxicity is a major cause of iatrogenic diseases. More than 900 compounds, including herbal medicines are involved and can reproduce the full spectrum of liver injuries. Acute hepatitis are the most frequently observed. Three types are described: acute hepatocellular hepatitis which are frequently similar to viral hepatitis, and can lead to fulminant liver failure and death within a few days, or, more insidiously, to cirrhosis; acute cholestatic hepatitis, which exhibits a better prognosis, may be misleading by mimicking biliary obstruction; mixed-pattern hepatitis, which associates features of hepatocellular and cholestatic hepatitis. Acute hepatitis generally exhibits no specific patterns. Then, the diagnosis is difficult and relies upon the elimination of other causes and a compatible or a suggestive time-relationship between drug ingestion and the onset of hepatitis as well as between drug withdrawal and recovery. Sometimes, drug hepatotoxicity is suggested by the association of hepatitis to hypersensitivity manifestations (hypereosinophilia), to some histopathological features (eosinophilic infiltration, microvesicular steatosis, giant hepatocytes) or, more uncommonly, to specific autoantibodies (anti-mitochondrial type 6, anti-LKM2, anti-LM antibodies). Cross hepatotoxicity may occur between drugs having related chemical structures.

Acute Disease↗
PubMed1995

Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil.

PURPOSE: To assess computed tomography (CT) with iodized oil for depiction of small hepatocellular carcinoma (HCC) before liver transplantation. MATERIALS AND METHODS: Thirty-five consecutive cirrhotic patients underwent CT with iodized oil to determine the presence, number, size, and location of possible nodules. All patients underwent liver transplantation within 4 months after CT. Explanted livers were cut in 8-mm slices that corresponded to axial CT scan planes. Comparison between CT staging and pathologic findings was made. RESULTS: Pathologic studies showed 17 HCC nodules (diameter, 0.9-4.0 cm) in nine of the 35 livers. CT depicted nine of these 17 nodules. Lesion-by-lesion analysis revealed a sensitivity of 53%; CT falsely depicted three additional nodules not confirmed with pathologic findings. Patient-by-patient analysis revealed an 89% sensitivity and an 88% specificity. CONCLUSION: CT with iodized oil, when assessed lesion by lesion, has a low sensitivity. These results must be considered when liver resection is proposed for HCC.

Carcinoma, Hepatocellular↗
PubMed1995

Cross hepatotoxicity between tricyclic antidepressants and phenothiazines.

OBJECTIVE: To describe a case of cross hepatotoxicity between tricyclic antidepressants and phenothiazines. PATIENT: A woman who developed three episodes of drug-induced hepatitis within 3 years as a result of successive treatment with two tricyclic antidepressants, trimipramine and desipramine, and one neuroleptic derivative, cyamemazine. INTERVENTIONS: The drugs were withdrawn after the patient experienced liver dysfunction, although bromazepam was later administered with no side effects. RESULTS: After three episodes of drug-induced hepatitis the patient's serum aspartate aminotransferase and alanine aminotransferase levels returned to normal when the tricyclic antidepressants and cyamemazine were withdrawn. CONCLUSIONS: Trimipramine, desipramine and cyamemazine are related by their chemical structures which include a tricyclic ring. This suggests that this chemical moiety might be involved in the hepatotoxicity of tricyclic antidepressants and phenothiazine derivatives.

Aged↗
PubMed1995

Effect of anti-ulcer drugs on DNA synthesis in adult normal human hepatocytes in culture.

The aim of this work was to investigate the effect of four H2 receptor antagonist, cimetidine, ranitidine, famotidine, nizatidine, and of two proton pump inhibitors, omeprazole and lansoprazole, on the mitotic response of human hepatocytes in primary culture. After plating at subconfluent density, cells were exposed to 0.2 to 20 mumol/L of these drugs for 48 hours, either in the absence or in the presence of epidermal growth factor (EGF). The rate of DNA synthesis was evaluated by [3H]-thymidine incorporation into genomic DNA. Both the basal rate of DNA synthesis and the extent of stimulation by EGF exhibited a wide interindividual variability, and were not correlated with the viability of freshly prepared cells. In contrast, the effects of anti-ulcer drugs on the rate of DNA synthesis were clearly reproducible from one culture to another. H2 receptor antagonists had no significant effect (P > .2) over the entire range of concentration tested, whereas omeprazole and lansoprazole significantly inhibited the rate of DNA synthesis by 60% to 90% at 30 mumol/L (P = .016). This effect was concentration dependent between 2 and 20 mumol/L. Neither of the drugs tested was cytotoxic under the conditions used in this work, as assessed by measurements of the do nov protein synthesis. We conclude that, in contrast to H2 receptor antagonists, omeprazole and lansoprazole are able to interfere with the replicative synthesis of DNA in human hepatocytes in culture, at suprapharmacological concentrations. Whether or not this effect is clinically significant remains to be established.

Anti-Ulcer Agents↗
PubMed1995

Lethal acute graft-versus-host disease in a liver transplant recipient: relations with cell migration and chimerism.

We report herein the case of a patient who developed fatal acute graft-versus host disease (GvHD) after liver transplantation (LT). GvHD occurred 18 days after LT and was characterized by skin epidermolysis, diarrhea and leucopenia. Skin biopsy showed epidermal dyskeratosis with epithelial necrosis, a lesion consistent with GvHD. Despite immunosuppressive therapy, the patient died within 24 days. In our observation, GvHD occurred although five HLA compatibilities were identified between the donor and the recipient, an apparently favorable and uncommon situation. This case further supports the qualification that LT may be complicated by GvHD and strongly suggests that minor rather than major histocompatibility antigens are the main target of allogenic interactions of GvHD. The involvement of chimerism in GvHD is controversial and requires further investigation.

Cell Movement↗
PubMed1995

[Familial transmission of hepatitis C virus].

OBJECTIVES: The intrafamilial transmission of hepatitis C virus infection was assessed in the family members of patients with chronic hepatitis C. METHODS: The presence of serum anti-hepatitis C virus (HCV) antibodies and epidemiological features were studied in 193 relatives (104 heterosexual partners, 89 children) of 113 patients with chronic hepatitis C. The presence of serum anti-HCV antibodies was detected by an ELISA 2 test and confirmed by a RIBA 2 test. In all patients, liver injury was ascertained by biopsy (31 cirrhosis, 82 chronic active hepatitis). RESULTS: Eleven of 104 (10.6%) regular heterosexual partners were positive for anti-HCV antibodies. In 8 of these, risk factors were detected (drug addiction: n = 6, blood transfusion: n = 1, occupational exposure: n = 1). Only 3 of 96 (3.2%) regular heterosexual partners without percutaneous risk factors were positive for HCV. Among couples with heterosexual partners negative for anti-HCV antibodies, the mean duration of the sexual relationship was 12 years. Serum anti-HCV antibodies were present in 1 of 89 (1.1%) children without history of blood transfusion or drug addiction. None of the 35 children born after supposed maternal contamination were positive for serum anti-HCV antibodies. CONCLUSIONS: We conclude that the prevalence of serum anti-HCV antibodies, assessed with second generation tests, in sexual partners of patients with chronic hepatitis C, is lower than previously reported with first generation anti-HCV tests but higher than in the general population (3.2% vs approximately equal to 1%). Serum anti-HCV antibodies were very rarely detected in children from patients with chronic hepatitis C.

Adult↗
PubMed1995

[Lichen planus and hepatitis C virus. Apropos of 5 new cases].

Lichen planus is an immunologically mediated skin or mucous disease, which has recently been described in some patients with hepatitis C virus-related liver disease. We report 5 new cases of the association of hepatitis C with lichen planus, to be added to the 15 cases published in the literature. The sex ratio (female/male) was of 1.2. Lichen planus occurred more frequently in chronic active hepatitis (2/3 of cases) than in cirrhosis (1/3 of cases). Lichen planus manifestations were only mucous (30%), only cutaneous (40%) or both (30%). Mucous lesions were mainly observed in patients with cirrhosis (3/4 of cases). The onset of skin and hepatic manifestations was variable, with liver disease as the most frequent revealing symptom (60%). The influence of interferon remains unclear. However, it seemed to trigger more than to relieve lichen planus.

Adrenal Cortex Hormones↗
PubMed1995

[Liver cirrhosis and granulomatous hepatitis after prolonged ingestion of lysine acetylsalicylate].

We report the case of a 75-year-old woman who was hospitalized for serum aminotransferase elevation. She had taken 1 g/d of salicylate therapy (Aspegic 1000) for 5 years, clorazepate for 10 years, naftidrofuryl for 8 months and quinapril for 3 months. Liver histology showed cirrhosis and granulomatous hepatitis. Discontinuation of salicylate therapy resulted in normalization of liver tests, although other drug administration was pursued. This observation suggests that salicylate therapy can induce cirrhosis.

Aged↗