Multisystem involvement in chronic liver disease

Golding, Peter L.; Smith, M. G. M.; Williams, Roger

doi:10.1016/0002-9343(73)90258-1

Cited by 202 publications

(29 citation statements)

References 27 publications

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“…Proximal and distal tubular acidosis were also found, even if less frequently than haemodynamic alterations. The incidences of such alterations in AC are similar to those found by other authors, both for RPF and GFR (1,15) and for tubular acidosis (6,10). More over, we found them in many cases with CAH without cirrhosis.…”

Section: Commentsupporting

confidence: 91%

Functional Renal Alterations in Chronic Liver Diseases

Geñtilini¹,

Buzzelli²,

Stefani³

et al. 1980

Digestion

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83 patients with chronic active hepatitis (CAH), 38 of them with cirrhosis, were studied and compared with 10 control subjects suffering from chronic persistent hepatitis (CPH). Tubular acidosis frequently was found in our cases. Renal plasma flow and glomerular filtration rate were significantly decreased in CAH when compared with CPH. Selective renal arteriography showed evident decrease of arterial flow in the outer cortex. Selective renal scan with ^99mTc microspheres of human albumin showed a frequent escape of the tracer from the kidney to the lung. PGE_1· and PGE₂ levels appeared higher in the renal artery than in the vein and were significantly more elevated in 9 cases with cirrhosis vs. 13 controls. These results suggest the frequent functional impairment of the kidney also in the early stages of CAH, with an increase of PGE levels and an opening of intrarenal shunts.

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Section: Commentsupporting

confidence: 91%

Functional Renal Alterations in Chronic Liver Diseases

Geñtilini¹,

Buzzelli²,

Stefani³

et al. 1980

Digestion

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“…Similarly, pulmonary changes in patients with primary biliary cirrhosis [24] have been viewed as another tissue manifestation of the underlying autoimmune process. Nevertheless, impaired diffusion due to documented interstitial fibrosis has been observed only in a few cases of terminal stage chronic liver disease [17]. In our series, morphological evaluation of pulmonary parenchyma by high resolution CT failed to detect interstitial lesions in patients after OLT.…”

Section: Discussioncontrasting

confidence: 60%

“…Structural lesions of the pulmonary interstitium have been discussed in patients with systemic diseases, such as cystic fibrosis, protease inhibitor deficiency, or Sjogren's syndrome [17]. Similarly, pulmonary changes in patients with primary biliary cirrhosis [24] have been viewed as another tissue manifestation of the underlying autoimmune process.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of pulmonary diffusion abnormalities without interstitial changes in long-term survivors of liver transplantation

Ewert¹,

Mutze²,

Schachschal³

et al. 1999

Transplant International

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Abnormalities in lung function are frequent findings in patients with terminal stage chronic liver disease. While spirometric parameters improve early after liver transplantation, a reduction in diffusion capacity has been reported up to 15 months after transplantation. It is unknown to what extent this disturbance in gas exchange occurs among long term survivors after liver transplantation. We assessed lung function in terms of spirometry, and gas exchange as well as pulmonary morphology by high resolution computed tomography (HRCT) in 40 patients 38 months (median, range 20-147 months) after liver transplantation. The prevalence of restrictive or obstructive changes was not different from predicted values. For the whole group of longterm survivors the carbon monoxide transfer coefficient (KCO) was reduced to 71.3 + 12.0 % predicted ( P < 0.05). HRCT revealed interstitial changes in only 2/40 (5.0 %), emphysematous bullae in 2/40 (5.0 %) and pleural thickening in 9/40 (22,s Yo). Diffusion abnormalities are prevalent in the majority of patients after liver transplantation, whereas spirometric abnormalities are absent also in the long term. The high prevalence of impaired gas exchange and the absence of interstitial lesions imply that changes in pulmonary blood vessels are the most likely cause.

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“…A proportion of these T-lymphocytes expressed markers of activation (HLA-DR+ 7.5 (2.1)%); CD25+2-3 (09)%; (1.5)%. This increased T-cell activation was also seen in the sarcoid groups (HLA-DR+ 10.0 (1.9)%; CD25+3-0 (1.1)%; CD7+5*0 (02)%). This was not seen in the primary biliary cirrhosis patients without lymphocytosis and the normal volunteers.…”

mentioning

confidence: 56%

Immunological features of lung lavage cells from patients with primary biliary cirrhosis may reflect those seen in pulmonary sarcoidosis.

Spiteri

Epstein

et al. 1990

Gut

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To investigate the basis of subclinical alveolitis in patients with primary biliary cirrhosis, 10 primary biliary cirrhosis patients were studied by bronchoalveolar lavage. Both bronchoalveolar lavage lymphoid and non-lymphoid cell populations were analysed using immunocytological methods to determine their proportions and phenotypic features in an attempt to gain information as to possible immune mechanisms active in the lung ofthese patients. Six of the 10 patients in our study showed evidence of an alveolitis (raised lymphocyte count: 27-6 (4.3)% of total count) on lavage. The results were compared with control groups of normal volunteers and patients with active pulmonary sarcoidosis. The six primary biliary cirrhosis patients with lymphocytosis had a raised CD4/CD8 T-cell ratio (4.13:1), similar to the sarcoid patients (5.60:1). A proportion of these T-lymphocytes expressed markers of activation (HLA-DR+ 7.5 (2.1)%); CD25+2-3 (09)%; (1.5)%. This increased T-cell activation was also seen in the sarcoid groups (HLA-DR+ 10.0 (1.9)%; CD25+3-0 (1.1)%; CD7+5*0 (02)%). This was not seen in the primary biliary cirrhosis patients without lymphocytosis and the normal volunteers. Within the non-lymphoid cell population, an increase in dendritic (RFD1+) celis was seen in primary biliary cirrhosis patients with lymphocytosis (31.2 (1-9)%) and sarcoid patients (46.3 (5

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Multisystem involvement in chronic liver disease

Cited by 202 publications

References 27 publications

Functional Renal Alterations in Chronic Liver Diseases

Functional Renal Alterations in Chronic Liver Diseases

High prevalence of pulmonary diffusion abnormalities without interstitial changes in long-term survivors of liver transplantation

Immunological features of lung lavage cells from patients with primary biliary cirrhosis may reflect those seen in pulmonary sarcoidosis.

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