Renal and humoral effects of ibopamine, a dopamine agonist, in patients with liver cirrhosis

Article Abstract:

Many patients with cirrhosis of the liver, a disease causing liver cells to be covered with fiber-like tissue, have problems with their kidneys retaining salt. Although the mechanism of salt retention is not well understood, one of many the theories implicates dopamine, a chemical made by the body that is important for proper transmission of nerve signals. It is suggested that dopamine regulates the handling of salt by the kidneys. A disadvantage of dopamine therapy to control salt retention is that it must be given intravenously, over a long period of time. Ibopamine, a drug similar to dopamine, can be given by orally. Patients with cirrhosis of the liver were given either short-term dopamine or ibopamine. The patients in this study were divided into two groups: those with high-salt and those with low-salt excretion in the urine. Patients with low-salt excretion had evidence of ascites, an abnormal collection of fluid in the abdominal cavity. Ibopamine increased the output of urine, the glomerular filtration rate (the rate at which the kidneys filter blood), and the rate of salt excretion in the group of patients with high-salt excretion. Less salt excretion was seen in the patients having low-salt excretion before ibopamine administration. Dopamine administration produced similar results in both groups of patients. Therefore, short-term administration of ibopamine improved salt excretion only in patients having initially high salt excretion. Long-term administration studies may produce different results. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dopamine, Sodium in the body, Sodium (Nutrient), Sodium metabolism disorders

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Gynecomastia and cirrhosis of the liver

Article Abstract:

Gynecomastia, or breast enlargement in men, may be caused by cirrhosis of the liver, a chronic disease characterized by accumulation of fatty substances, structural changes, and degeneration of liver tissue. The prevalence of gynecomastia was shown to be associated with body mass and age. The body mass and prevalence of gynecomastia were similar in patients with cirrhosis without edema or fluid accumulation and normal subjects. However, patients with severe cirrhosis and edema within the abdomen or other body sites, are generally thin or have low body mass. The prevalence of gynecomastia and levels of the sex hormones testosterone, estrogen, and estradiol, were assessed in 18 patients with severe cirrhosis and 18 nonobese subjects. Gynecomastia was detected in 50 percent of normal subjects and correlated with body mass, and in 44 percent of patients with severe cirrhosis, but was not associated with body mass. Patients with cirrhosis had lower levels of testosterone, but higher estrogen to testosterone and estradiol to testosterone ratios, compared with normal subjects. However, these ratios were similar among cirrhotic patients with or without gynecomastia. The results suggest that factors other than the estrogen to testosterone ratio are involved in the development of gynecomastia in cirrhotic patients and normal subjects. It is also possible that the sensitivity of the breast tissue to the increased estrogen-testosterone ratio may vary widely. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Complications and side effects, Testosterone, Estrogen, Estrogens, Gynecomastia

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Methotrexate-induced cirrhosis requiring liver transplantation in three patients with psoriasis

Article Abstract:

Psoriasis is a common chronic skin disease, characterized by reddened papules or pimple-like lesions, which form plaques or patches that later develop into scaly lesions. The lesions can develop at any site, although the scalp, knees, elbows, umbilicus or abdominal area, and genitals are most often affected. Less than 50 percent of patients undergo long-term remission, and severity may vary from a cosmetic problem to a life-threatening condition. Arthritis or inflammation of the joints develops in 5 percent of patients with psoriasis. This skin disorder may be treated with the anticancer agent methotrexate. However, methotrexate may have adverse effects on liver function. Three cases are described of patients who developed methotrexate-related cirrhosis, a chronic liver disease, which is characterized by fat accumulation, abnormal tissue development, and tissue deterioration within the liver. These patients had received long-term methotrexate treatment resulting in total doses exceeding 1.5 grams; none had undergone routine liver biopsy. Liver transplantations were required in all three cases. These reports demonstrate the importance of following guidelines for patient selection, monitoring total drug dose, and performing liver biopsies before and each year after the start of methotrexate therapy. It is recommended that methotrexate be used with caution because of its potential to cause toxic effects on the liver. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Liver, Liver transplantation, Psoriasis, Methotrexate

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