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Biomedical subjects

S Sherlock

Publications and source records attributed to S Sherlock.

At least 307 records · Page 17Linked to original sources
PubMed1975

Incidence and clinical significance of e antigen and antibody in acute and chronic liver disease.

"e" is a serum antigen associated with type-B hepatitis. It is found only in hepatitis B surface antigen (HBsAg) positive sera, but is antigenically distinct from HBsAg. e antigen was not detected in the serum of any of 99 cases of acute type-B hepatitis who recovered normally. Its antibody, anti-e, was found in 14 (14%). The antibody usually appeared before clearance of HBsAg and before appearance of HBsAb. Serum e was not detected in any of 29 symptom-free carriers of HBsAg, but 21 (73%) showed anti-e. Serum e was found in chronic active hepatitis (44%) and chronic persistent hepatitis (31%). The antibody, however, was detected in only 2 of 79 patients with chronic active hepatitis but in 7 (44%) of chronic persistent hepatitis. Serum e was not found in 5 patients with primary liver-cell carcinoma or 5 with inactive HBsAg-positive cirrhosis. The antibody was, however, found in all 5 of those with inactive cirrhosis and in 4 of the 5 with primary cancer. These results suggest that the presence of e antigen is associated with active and usually continuing liver disease. Anti-e, however, is associated with inactive liver disease and asymptomatic carriage of HBsAg, and its presence must be regarded as a valuable sign in predicting those who will escape progressive chronic liver disease.

Acute Disease↗
PubMed1975

Urinary and serum octopamine in patients with portal-systemic encephalopathy.

Urinary excretion and serum concentrations of octopamine were studied in seventeen controls, thirty-three patients with portal-systemic encephalopathy, and thirteen patients with liver disease without encephalopathy. No differences were detected between control subjects and patients without encephalopathy. Urinary excretion and serum concentrations of octopamine were significantly higher in patients with encephalopathy compared with those without encephalopathy. The presence and grade of portal-systemic encephalopathy seemed to correlate more closely with the serum-octopamine concentrations than with urinary octopamine excretion. It is postulated that octopamine may be involved in the pathogenesis of portal-systemic encephalopathy.

Adolescent↗
PubMed1975

Casual blood-ethanol estimations in patients with chronic liver disease.

Patients attending a clinic for diseases of the liver were tested for blood-ethanol by a gas chromatographic technique sensitive to about 5 mg/dl (1 mmol/1). Of 172 patients (51 men, 121 women) 36% gave a history of heavy drinking (greater than 80 g ethanol/day; equivalent to 8 fl oz of whisky or 1 litre of wine) and 13% had ethanol in the bloodstream at values of 8-400 mg/dl. 42 patients (24%) had the liver-biopsy changes of alcoholic liver disease, and 17 of these had ethanol in the blood at one time or another. Nearly half (22/49) of all patients admitting heavy drinking also had detectable blood-ethanol. In all cases but 1 where blood-ethanol was found, a drinking history was admitted on first attendance, and alcoholic liver disease was nearly always found on subsequent biopsy. Blood-ethanol and admission of drinking were most constantly found in association with alcoholic steatosis and hepatitis. Both features were less commonly present in cases of alcoholic cirrhosis. Only 1 patient of 22 with "cryptogenic" cirrhosis on biopsy was found to have both ethanol in the blood and an alcoholic history, although 5 had an alcoholic history alone. The value of serial blood-ethanol estimations in the treatment of alcoholics and the detection of relapses is demonstrated. The findings confirm the relatively low frequency of alcoholism as a contributor to cirrhosis in the United Kingdom. Alcohol does not seem a major cause of cryptogenic cirrhosis. Casual blood-ethanol estimation is a useful and objective adjunct to techniques of investigating diseases of the liver.

Alcohol Drinking↗
PubMed1975

Antibodies to Escherichia coli in chronic liver diseases.

Patients with chronic active hepatitis or alcoholic cirrhosis have serum antibodies to many more serotypes of Escherichia coli than do patients with primary biliary cirrhosis or cryptogenic cirrhosis, or normal controls. They also have antibodies against more serotypes than cirrhotic patients with a portacaval shunt. These observations suggest that factors other than shunting of blood away from the liver are responsible for the increased range of antibodies. These factors are discussed. There was no correlation between the number of serotypes to which antibodies were present and the serum immunoglobulin concentration. In three patients, each with chronic active hepatitis, the antibodies were predominantly of the IgM class, while the elevation of globulin in general was mainly due to increased IgG and IgA levels. Antibodies to Escherichia coli, therefore, probably contribute only a small part of the increased globulin levels found in patients with chronic liver disease.

Adolescent↗
PubMed1975

Jaundice due to carbimazole.

On three occasions, a 63 year old housewife with hyperthyroidism developed a reaction which included fever, pruritus, malaise, and, on one occasion, jaundice one to 17 days after taking carbimazole. Challenge with carbimazole was followed within 12 hours by abdominal pain, pruritus, and increased serum transaminase levels. Light microscopy of a liver biopsy showed increase of portal zone cellularity over the control and the electron microscopy revealed fine structural changes compatible with drug-related liver injury.

Aspartate Aminotransferases↗
PubMed1975

Influence of azathioprine on hepatic reserve in chronic active liver disease.

The kinetics of hepatic indocyanine green (ICG) uptake have been analysed in 14 patients with chronic active liver disease. The removal of incremental, submaximal ICG doses were compatible with Michaelis-Menten kinetics in approximately 80% of studies in patients allowing the calculation of the maximal rate of removal (Rmax) and the Michaelis constant (Km). Neither of these variables correlated with other laboratory indices of liver function. Although determinations of Rmax before and after a two-weeks trial of azathioprine therapy were not significantly different, in two patients Rmax was markedly reduced by treatment. It is concluded that azathioprine over the short term does not improve the liver's reserve for ICG removal; in fact, in isolated cases this drug may be detrimental.

Adolescent↗
PubMed1975

The Budd-Chiari syndrome: correlation between hepatic scintigraphy and the clinical, radiological, and pathological findings in nineteen cases of hepatic venous outflow obstruction.

From 1965 to 1972, 19 patients with the Budd-Chiari syndrome were investigated. An underlying diagnosis was made in 10 cases, polycythemia rubra vera being the commonest etiology. Percutaneous liver biopsy confirmed the diagnosis in 18 patients, and in 14 the site of hepatic vein obstruction was defined or its presence suggested by hepatic venography. Hepatic scintiscanning showed predominant central localization of radiocolloid in 7 patients. In another 8 patients this appearance was present in association with other less specific features. These findings were correlated with inferior vena cavography in 13 patients in whom a characteristic narrowing and distortion of the vein throughout its intrahepatic course was noted. In 3 other patients, the vein was found to be occluded. Autopsy evidence in 6 patients suggests that the central concentration of radiocolloid on scintiscanning and the narrowing and distortion of the inferior vena cava were due to disproportionate enlargement of the caudate lobe. Additional studies indicated that the separate venous drainage of the caudate lobe may be preserved when the main hepatic veins are occluded and that hypertrophy of the caudate lobe occurs because of its relatively more efficient perfusion. Demonstration of the enlarged caudate lobe by scintiscanning and inferior vena cavography provides valuable diagnostic support for the Budd-Chiari syndrome.

Adult↗
PubMed1975

Serum ferritin in patients with iron overload and with acute and chronic liver diseases.

An immunoradiometric assay was used to determine serum ferritin in patients with iron overload disorders and in patients with liver disease. In patients with iron overload, serum ferritin was closely correlated in an exponential manner with quantitative measurements of storage iron; however, a different relationship applied when storage iron levels were within normal range, suggesting that circulating ferritin is in equilibrium with two functionally distinct tissue ferritin pools. High ferritin levels were common in patients both with acute and chronic liver disease, normal values being virtually confined to women and to subjects with a history of recent hemorrhage. In liver disease generally, serum ferritin varied both with the serum transaminase level and with liver iron concentration, but correlated well with neither factor separately. There was no correlation with the serum iron or total iron-binding capacity. An extremely close correlation was found between serum ferritin and an empirical index derived from the product of the serum transaminase times liver iron concentration, implying that the circulating level depended on both the degree of hepatocellular injury and liver iron store. There was a close linear correlation between the serum ferritin-transaminase ratio and liver iron concentration in all disorders studied, and this index may prove to be the most useful value for diagnostic purposes.

Acetaminophen↗
PubMed1975

Jaundice due to erythromycin estolate.

A 43-year-old male developed abdominal pain and jaundice after the administration of erythromycin estolate. The diagnosis was strongly suspected on clinical grounds, but ultimate confirmation depends upon the demonstration of biochemical and morphological alterations after challenge with the drug.

Abdomen↗