Focal nodular hyperplasia of the liver associated with intracranial vascular malformations

Article Abstract:

Focal nodular hyperplasia is an uncommon condition involving the liver, in which an area of rapidly dividing liver cells surrounds a fibrous scar that contains a small artery and several bile ducts. Focal nodular hyperplasia is usually asymptomatic, and is most often diagnosed at autopsy or during surgery for other causes. While the cause of this condition is not known, women who are taking oral contraceptives appear to be more susceptible. It was recently suggested that focal nodular hyperplasia may be one component of a syndrome characterized by liver abnormalities, vascular malformations within the brain, and neoplasms of the brain and meninges (tumors of the brain and the membranes encasing the brain and spinal cord). A review of autopsy records revealed three cases of focal nodular hyperplasia associated with intracranial vascular malformations. One case involved a 57-year-old man who died shortly after he was admitted to the hospital for headache associated with unconsciousness. At autopsy, lesions of the liver were noted, and the cause of death was determined to be a ruptured aneurysm (weakened, swollen segment of artery) within the brain. The second case was a 46-year-old woman admitted to the hospital in a coma, who died without regaining consciousness. Autopsy revealed hepatic lesions typical of focal nodular hyperplasia; the cause of death was a ruptured aneurysm of the cerebral artery (within the brain). The final case involved a 65-year-old woman who died following complications resulting from a heart attack. Autopsy revealed inflammation of the membrane surrounding the heart, and a rupture of the septum (wall) separating the left and right heart ventricles. The liver had numerous small lesions, and the cerebral arteries within the brain showed fatty degeneration. These findings suggest that patients diagnosed before death as having focal nodular hyperplasia of the liver should be considered to be at high risk for cerebrovascular disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Cerebrovascular disease, Cerebrovascular disorders, Aneurysms, Aneurysm

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Severe chronic active hepatitis (autoimmune type) mimicked by coinfection of hepatitis C and human immunodeficiency viruses

Article Abstract:

Hepatitis is an inflammatory disease of the liver that may occur in a variety of forms, resulting in death in about 50 percent of affected patients within two years. Severe chronic active hepatitis is a type of hepatitis thought to result from the production of antibodies against the body's own tissues (autoimmune disease), characterized by infection with hepatitis B virus, metabolic disorders, and primary biliary cirrhosis (obstruction of pathways through the liver). A case is reported in which infection with hepatitis C virus (a much less virulent type of hepatitis) combined with infection by the human immunodeficiency virus (HIV) mimicked severe chronic active hepatitis. A 38-year-old man was admitted to the hospital for treatment of syphilis. He had suffered repeatedly from infection with sexually transmitted diseases, and had tested positive for the presence of anti-HIV antibodies (indicative of infection with the HIV virus) the previous year. He exhibited elevated blood levels of transaminase (a liver enzyme that increases in severe chronic active hepatitis) and gamma globulin (a blood fraction in which immune antibodies are found), and met the other generally accepted diagnostic criteria for chronic active hepatitis. The presence of HIV antibodies, combined with the patient's sexual habits led to a suspicion of hepatitis C infection, which was subsequently verified when an in vitro diagnostic test for this virus became available. The patient was treated with alpha-interferon (a protein produced by the body in response to viral infection), following which the hepatitis symptoms underwent complete remission. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, HIV infection, HIV infections, Hepatitis C, Hepatitis B

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Hepatic alcohol dehydrogenase activity in alcoholic subjects with and without liver disease

Article Abstract:

There are three systems in the body which metabolize alcohol, the most important of which is the liver enzyme alcohol dehydrogenase (ADH). Alcoholics are at high risk for liver disease and they also tend to have lower levels of ADH. To determine whether low levels of ADH are a consequence of alcohol consumption or liver disease, ADH activity in liver biopsies was measured in nonalcoholic and alcoholic subjects with and without liver disease. The results of data from 123 patients suggested that decreased liver ADH activity found in patients with alcoholic liver disease results from liver damage and is not related to alcohol consumption. Therefore, the increased metabolism of alcohol that often occurs in alcohol abusers is unrelated to the ADH pathway. These results do not support previous studies that did not correlate ADH activity with disease severity. Additional studies of ADH activity, liver damage, and alcohol consumption are needed to confirm these findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Measurement, Alcoholism, Alcohol dehydrogenase, Alcohol dehydrogenases

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