Edit concept Question Editor Create issue ticket

Massive Hepatic Necrosis

Atrophy Acute Yellow Liver


Presentation

  • 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]
  • Massive liver necrosis in the newborn is a rare occurrence, but whenever present hemochromatosis should be considered in the differential diagnosis.[ncbi.nlm.nih.gov]
  • The present report describes a rare case of massive hepatic necrosis with partial gastric, splenic, and pancreatic infarctions after local treatment of liver HCC with ethanol ablation and discusses the reasons for this complication.[ncbi.nlm.nih.gov]
  • We present data that suggest that the circulating liver progenitor could have a lymphoblastoid morphological appearance. Similar cells are seen among the cellular infiltrate of MHN.[ncbi.nlm.nih.gov]
  • We present here a case of fatal massive hepatic necrosis in a patient with cytomegalovirus mononucleosis. A 33-year-old previously healthy man had a 2-week history of fever, malaise, night FULL TEXT[annals.org]
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]
  • Her condition was uneventful except for low grade fever and mild liver dysfunction on the sixth day. However, on the seventh day, she complained of progressive abdominal pain, and showed hypotension and tachycardia.[casereports.in]
  • Zone 2 (mid-zonal), although rare, is seen in yellow fever . Zone 3 (centrilobular) occurs with ischemic injury, toxic effects, carbon tetrachloride exposure, or chloroform ingestion.[en.wikipedia.org]
Pertussis
  • […] delivery, and in the neonatal period Stay on the cutting edge of your field with new and improved chapters including: obstetric factors associated with infections of the fetus and newborn infant; human milk; borella infections; tuberculosis; bordetella pertussis[books.google.de]
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]
  • 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]
Jaundice
  • Cook GC, Sherlock S: Jaundice and its relation to therapeutic agents. Lancet 1:175, 1965 CrossRef Google Scholar Copyright information Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1971 Authors and Affiliations Charles M.[link.springer.com]
  • ) 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]
  • Infectious mononucleosis typically occurs in adolescents or young adults and presents with fevers, fatigue, malaise, sore throat, jaundice, and lymphadenopathy. Most CMV infections are clinically silent.[demosmedical.com]
  • Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease (such as jaundice ), and indicates that the liver has sustained severe damage (loss of function of 80–90% of liver cells).[en.wikipedia.org]
  • […] since OD and start NAC empirically) Stage 1 (0-24hrs) asymptomatic or GI upset only Stage 2 (24-48 hrs) resolution or nausea and vomiting RUQ pain and tenderness progressive elevation of transaminases, bilirubin, PT Stage 3 (48-96 hrs) hepatic failure (jaundice[lifeinthefastlane.com]
Ulcer
  • We report a case of a 15-yr-old boy with ulcerative colitis who developed a generalized hypersensitivity reaction with a serum sickness-like syndrome and severe hepatotoxicity while taking sulfasalazine, perphenazine, and amitriptyline.[ncbi.nlm.nih.gov]
Stupor
  • Ritt DJ, Whelon G, Werner D: Acute hepatic necrosis with stupor and coma. Medicine 48:161–172, 1969 Google Scholar 3. Davis M, Peters R, Redeker A, et al: Appraisal of the mortality in acute fulminant viral hepatitis.[link.springer.com]

Workup

Enlargement of the Liver
  • At autopsy massive hepatic necrosis was found, associated with enlargement of the liver.[ncbi.nlm.nih.gov]
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]
Bordetella Pertussis
  • pertussis and other bordetella sp infections; herpes simplex; toxoplasmosis; pneumocystis and other less common fungal infections; and healthcare-associated infections in the nursery Keep up with the most relevant topics in fetal/neonatal infectious[books.google.de]
Hepatic Necrosis
  • 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]
  • Abstract Serum concentrations of alpha-fetoprotein (AFP) were measured by radioimmunoassay in 12 patients with massive hepatic necrosis, 11 of whom died.[ncbi.nlm.nih.gov]
  • The morphogenesis of hepatocytes after massive hepatic necrosis to recovery through liver cell regeneration has not been fully understood.[ncbi.nlm.nih.gov]
  • 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]
  • A 2-yr-old child developed massive hepatic necrosis caused by an unusual hypersensitivity response to phenobarbital that was prescribed for presumed febrile seizures.[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]
  • Immunosuppressive drug treatment may favor replication of HBV, resulting in massive hepatocyte destruction when the immune response recovers following withdrawal of chemotherapy.[ncbi.nlm.nih.gov]
  • The present report describes a rare case of massive hepatic necrosis with partial gastric, splenic, and pancreatic infarctions after local treatment of liver HCC with ethanol ablation and discusses the reasons for this complication.[ncbi.nlm.nih.gov]
  • Right portal vein ligation (PVL) is a safe and widespread procedure to induce controlateral liver hypertrophy for the treatment of bilobar colorectal liver metastases.[ncbi.nlm.nih.gov]
  • Form a definitive diagnosis and create the best treatment plans possible using evidence-based recommendations and expert guidance from world authorities.[books.google.de]

Prognosis

  • 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]
  • 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]
  • 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]
  • This carries a poor prognosis with a mortality rate of more than 50% in most series ( 1 ).[nature.com]

Etiology

  • 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]
  • –6 seconds or more (INR 1.5), and there is any evidence of altered sensorium, the diagnosis of ALF should be strongly suspected, and hospital admission is mandatory. [20] Initial laboratory examination must be extensive in order to evaluate both the etiology[en.wikipedia.org]

Epidemiology

  • 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]
Sex distribution
Age distribution

Pathophysiology

  • "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. PMID 14523680.[en.wikipedia.org]
  • Pathophysiology After taken orally, paracetamol is well absorbed from the stomach and small intestine. It reaches a peak plasma concentration in one hour but this may be 30 minutes if taken in liquid or rapidly absorbed form.[patient.info]
  • The metabolic syndrome: definition, global impact, and pathophysiology. Nutr Clin Pract. 2009;24:560-77. [140] Prentice AM, Jebb SA. Fast foods, energy density and obesity: a possible mechanistic link. Obes Rev 2003;4:187-94. [141] Reaven GM.[deutsche-apotheker-zeitung.de]

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]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!