Presentation
This book presents the facts as they are known today and, in areas where all the facts are not established, presents the well-founded opinions of those considered to be authorities. [books.google.de]
We present a patient with toxemia of pregnancy and the HELLP syndrome [hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP)] resulting in massive hepatic necrosis. [ncbi.nlm.nih.gov]
Pregnancy with hepatitis E infection was not identified in the present study. Clinically 13 of these cases had hyperacute presentation and rest of them presented with acute form. [diagnosticpathology.biomedcentral.com]
Entire Body System
- Fever
A 33-year-old previously healthy man had a 2-week history of fever, malaise, night FULL TEXT [annals.org]
Yellow fever still occurs in people travelling to tropical regions without proper vaccination or rarely as a small outbreak due to vaccine adverse effect. [demosmedical.com]
After his most recent discharge, he had been home for 5 days, and for 3 days had no fever, but had had fever and sweating for 2 days. He had been taking prednisone, 10 mg three times a day. [nap.edu]
See in single cell hepatocellular necrosis. examples of damage to each zone Zone 1 - phosphorus Zone 2 - yellow fever Zone 3 - CCL4, ischemia Describe hepatic secondary intention secondary intention is scar formation Kupffer cells are acivated in the [quizlet.com]
Infectious Disorders Viral hepatitis Miliary tuberculosis Malaria Staphylococcal bacteremia 2 0 to TSS Salmonellosis typhoid fever Candida Parasitic & helminthic infection 78. [slideshare.net]
- Anemia
However, 24 hours after the surgery, the patient began experiencing marked worsening of her right upper quadrant abdominal pain and was subsequently noted to have developed new thrombocytopenia (53,000/μL), anemia (hemoglobin 7.5 g/dL), low haptoglobin [acgcasereports.gi.org]
Sickle cell anemia. Hereditary sideroblastic anemia. Selected acquired causes: [49] Myelodysplastic syndromes Myelofibrosis Aplastic anemia, intractable. Microscopic See hereditary hemochromatosis. [librepathology.org]
Hepatic Disease Associated with Pregnancy Pre-eclampsia Hypertension, proteinuria, dependent pitting edema in the third trimester HELLP syndrome hemolytic anemia with schistocytes, elevated liver enzymes, low platelet (due to DIC) Morphology: fibrin [slideshare.net]
[…] solubility considerations) Lithogenic bile: Disturbance in the equilibrium between beta-glucoronidase and its inhibitor (glucaric acid) lead to increased free bilirubin (insoluble pigment) in bile factors predisposing to pigmented stone formation Hemolytic anemia [quizlet.com]
For the pre- ceding 6 months, she had been ill with fever, anemia, edema, joint pains, muscle tenderness, paresthesias, and muscle spasms. [nap.edu]
- Chills
[…] cholangitis (acute vs. chronic) Acute: gangrenous, empyema Chronic: repeated, indolent, low-grade inflammation and fibrosis; calculi present in 85% of cases Can have acute superimposed on chronic Primary sclerosing cholangitis Clinical presentation: chills [quizlet.com]
Physical Examination: He appeared to be chronically ill, was slightly jaundiced, and was having a shaking chill. He had a maculopapular rash over his face. [nap.edu]
Hematological
- Easy Bruising
This was manifested by the loss of hair and easy bruising, poor healing, and bleed- ing from minor wounds, which she had allegedly had for 20 years. She had been on Diamox and Diuril. Physical Examination: She was obese, pale, and not jaundiced. [nap.edu]
Gastrointestinal
- Abdominal Pain
Case Report A healthy, 30-year-old woman at 32 weeks gestation presented to the emergency department with sudden-onset headache and abdominal pain. [acgcasereports.gi.org]
However, on the seventh day, she complained of progressive abdominal pain, and showed hypotension and tachycardia. [casereports.in]
On the 4th day he developed first right chest pain and then generalized abdominal pain with abdominal tenderness and rebound tender- ness. [nap.edu]
Abdominal pain. Hepatomegaly. Etiology: ~50% have a myeloproliferative disease. [29] May be due to mass effect from a tumour. Clinical DDx: Hepatic veno-occlusive disease. Microscopic Features: [30] Sinusoidal dilation in zone III (congestion). [librepathology.org]
Hepatocellular Carcinoma Clinical features: upper abdominal pain or fullness malaise, fatigue, weight loss hepatomegaly with irregularity or nodularity Laboratory: increased tumor markers – serum AFP and serum CEA not conclusive false (+) in non-neoplastic [slideshare.net]
- Right Upper Quadrant Tenderness
There was no mass or tenderness in the right upper quadrant. [nap.edu]
- Melena
Massive melena due to acute gastric ulcers (six) and petechiae. 3. Hemorrhagic ascites, 300 cc. 4. Acute erosive esophagitis. 5. Aspiration of gastric contents. 6. Right pleural effusion, 300 cc. 7. Examination of brain not permitted. [nap.edu]
Liver, Gall & Pancreas
- Jaundice
History of alcohol Preop. hepatic dis. and/or Jaundice Jaundice before death Case Anes. prac. [nap.edu]
(mg/dL) Defect Age at onset of jaundice 64. [slideshare.net]
782.4 gravis (see also Necrosis, liver) 570 malignant (see also Necrosis, liver) 570 pernicious (see also Necrosis, liver) 570 Inflammation, inflamed, inflammatory (with exudation) Jaundice (yellow) 782.4 malignant (see also Necrosis, liver) 570 Necrosis [icd9data.com]
Incidence- 1%, jaundice within the first 4 weeks; repeated ingestion causes jaundice in 40% of cases. [quizlet.com]
Hyperacute encephalopathy within 7 days of onset of jaundice very high risk of cerebral oedema Acute jaundice to encephalopathy: 8-28 days high risk of cerebral oedema Subacute jaundice to encepalopathy: 5-26 weeks low risk of cerebral oedema Aetiology [aic.cuhk.edu.hk]
- Fetor Hepaticus
hepaticus - characteristic body odor that is variously described as "musty" or "sweet and sour" Palmar erythema (a reflection of local vasodilatation) and spider angiomas of the skin - Impaired estrogen metabolism and consequent hyperestrogenemia Functional [quizlet.com]
Hepatic Failure Clinical Features: Jaundice Hypoalbuminemia peripheral edema Hyperammonemia cerebral dysfunction Fetor hepaticus “musty” or “sweet & sour” body odor due to mercaptan formation by action of GI bacteria on methionine (sulfur-containing [slideshare.net]
Skin
Urogenital
- Dark Urine
She developed jaundice with dark urine and a tempera- ture of 103 F. The jaundice became deeper and in the last 3 days of life she was oliguric and the last day hypotensive. [nap.edu]
Workup
Serum
- Lymphocytosis
Abstract Cytomegalovirus Mononucleosis is an acute febrile illness characterized by atypical lymphocytosis (1). The clinical picture strikingly resembles infectious mononucleosis with generalized malaise and splenomegaly. [annals.org]
Lymphocytosis into the ducts was not seen. D. Ballooned hepatocytes and dilated canaliculi were seen. E. Pigment was present, but mostly in Kupffer cells, not hepatocytes or as bile plugs. F. [librepathology.org]
[…] in order of significance: (1) lipofuscin pigmentation in Kupffer's cells, (2) lobular polymorphonuclear cytosis, (3) acidophilic bodies in necrotic areas, (4) degree of inflammation in portal triads, (5) lobular lymphocytes is, and (6) portal triad lymphocytosis [nap.edu]
- Hypoglycemia
Hypoglycemia occurs in many patients with ALF and is often due to depletion of hepatic glycogen stores and impaired gluconeogenesis. [en.wikipedia.org]
- Hyperglobulinemia
Criteria for Diagnosis: liver biopsy or at least three of the following: Hyperglobulinemia, esp. with hypoalbuminemia Low protein ( 32. Bridging fibrous septae Nodules 34. [slideshare.net]
- Hyperglobulinemia
Criteria for Diagnosis: liver biopsy or at least three of the following: Hyperglobulinemia, esp. with hypoalbuminemia Low protein ( 32. Bridging fibrous septae Nodules 34. [slideshare.net]
- Hypertriglyceridemia
Enhanced cellular uptake of remnant high-density lipoprotein particles: a mechanism for high-density lipoprotein lowering in insulin resistance and hypertriglyceridemia. Circ Res. 2008;103:159-66. [187] Zou C, Shao J. [deutsche-apotheker-zeitung.de]
Other Pathologies
- Hepatic Necrosis
Numerology Chaldean Numerology The numerical value of massive hepatic necrosis in Chaldean Numerology is: 7 Pythagorean Numerology The numerical value of massive hepatic necrosis in Pythagorean Numerology is: 9 Images & Illustrations of massive hepatic [definitions.net]
Hepatic necrosis after ethanol ablation for hepatocellular carcinoma (HCC), although rare, is well known and described, particularly in patients with chronic liver disease. [ncbi.nlm.nih.gov]
Treatment
Recognition of the potentially severe consequences is important because early treatment with sulfhydryl compounds may prevent serious liver injury. [ncbi.nlm.nih.gov]
Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.de]
Prognosis
Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.de]
Without transplantation up to 80% die in specialist units approx 30% survive spur cells in peripheral blood indicate poor prognosis presence of jaundice for at least 1 wk prior to onset of encephalopathy associated with poor prognosis Following transplantation [aic.cuhk.edu.hk]
Current data indicate a poor prognosis if: An arterial pH 50 nmol/L) on or after day two following overdose (found in ~70% of cases with a poor prognosis). [patient.info]
The 1993 classification defines hyperacute as within 1 week, acute as 8–28 days, and subacute as 4–12 weeks. [1] It reflects the fact that the pace of disease evolution strongly influences prognosis. [en.wikipedia.org]
Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989 Aug;97(2):439-45. PubMed PMID: 2490426. Shah AD, Wood DM, Dargan PI. Understanding lactic acidosis in paracetamol (acetaminophen) poisoning. [lifeinthefastlane.com]
Etiology
Etiologic Factors In a total number of 224 cases, etiology could be determined in 49 cases, including 8 pregnant females with HBsAg positivity. [diagnosticpathology.biomedcentral.com]
Although the etiology is difficult to prove, the clinical picture and time sequence indicated that the offending agent was: drug in 8; serum hepatitis in 11; infectious hepatitis in 11; and halothane in 3. [link.springer.com]
General Etiology: Echinococcus. Microscopic Features: Laminated wall +/- calcification. [14] Organisms -- see Echinococcus. Images Liver cyst wall - intermed. mag. (WC) Liver cyst wall - high mag. [librepathology.org]
Epidemiology
Epidemiology Frequency United States Cardiac cirrhosis rarely occurs in the United States. Its true prevalence is difficult to estimate, since the disease typically remains subclinical and undiagnosed. [emedicine.medscape.com]
Effect of dietary fiber and protein intake on blood pressure: a review of epidemiologic evidence. Clin Exp Hypertens. 1999;21:785-96. [77] Heaney RP, Layman DK. Amount and type of protein influences bone health. [deutsche-apotheker-zeitung.de]
General Epidemiology: Rare. Serology: [20] AMA +ve. Anti-dsDNA +ve. Microscopic See: autoimmune hepatitis and primary biliary cirrhosis. A. B. C. D. AIH/PBC overlap. [librepathology.org]
In addition, a history of hepatic disease was noted, as was any comment regarding epidemiologic factors as- sociated with toxic or viral hepatitis (e.g., occu- pational exposure to jaundiced persons, medica- tions taken before admission, and alcoholism [nap.edu]
Pathophysiology
Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.de]
"Intracranial hypertension in acute liver failure: pathophysiological basis of rational management". Seminars in Liver Disease. 23 (3): 271–82. doi : 10.1055/s-2003-42645. [en.wikipedia.org]
Pathophysiology Decompensated right ventricular or biventricular heart failure causes transmission of elevated right atrial pressure to the liver via the inferior vena cava and hepatic veins. [emedicine.medscape.com]
Ammonia currently thought to be the main pathophysiological agent Other possible aetiological mechanisms include the presence of benzodiazepine agonists (hepatic coma can be reversed temporarily by flumazenil) and altered GABA status Clinical features [aic.cuhk.edu.hk]
Panis Y, McMullan DM, Emond JC: Progressive necrosis after hepatectomy and the pathophysiology of liver failure after massive reduction. Surgery 1997;121:142–149. [karger.com]
Prevention
Recognition of the potentially severe consequences is important because early treatment with sulfhydryl compounds may prevent serious liver injury. [ncbi.nlm.nih.gov]
Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.de]
Prevention with specific hepatitis B immune serum globulin. J. Amer. Med. Ass. 218 (1971) 1655–1970. Google Scholar 9. Lander, J. J., Giles, J. P., Purcell, R. H. and Krugman, S. Viral hepatitis type B (MS-2 strain). [link.springer.com]
Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. [deutsche-apotheker-zeitung.de]