Cirrhosis is the result of chronic liver disease due to a variety of causes. It is deemed to be cryptogenic when the leading cause cannot be identified despite extensive laboratory, radiological and pathological investigations. The prevalence of cryptogenic cirrhosis diagnosis has been dramatically reduced in recent years due to the advanced achievement in diagnostic medicine, whereby it is attributed to only about less than 5% of cirrhosis cases. Here, we present a case of a 16-year-old boy with nonsignificant family history, was not taking any regular medication, and presented with progressive intermittent jaundice for a few years due to liver cirrhosis. Although an extensive investigation has been done, the etiology of the cirrhotic liver was still unknown. He had no features to support nonalcoholic steatohepatitis. He was in Child’s Grade B and prophylactically treated with a regular dose of propranolol to prevent portal hypertension complication while waiting for a liver transplant. This case report served the objective of showing that despite the advances in medical diagnostic techniques, cryptogenic cirrhosis is still used as a diagnosis in cases of chronic liver disease of unknown etiology.
Non-alcoholic Fatty Liver Disease ; Cirrhosis, Cryptogenic

Macroenzymes are high molecular weight complexes formed in the serum by self-polymerization or by association with other proteins. Macroenzymes are filtered with difficulty by normal renal glomeruli. Clinically, it is important to detect macroenzymes, because they frequently interfere with the interpretation of serum enzyme results, and as a result they can cause diagnostic and therapeutic errors. Macroamylasemia and macrolipasemia have been found to occur in apparently healthy humans, as well as in a variety of disease states, including liver disease, diabetes, cancer, malabsorption, and autoimmune disorders. We report a patient with alcoholic liver cirrhosis and macroamylasemia and macrolipasemia, the latter two of which were discovered using a screening test.
Alcoholics ; Humans ; Hyperamylasemia ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Mass Screening ; Molecular Weight ; Proteins

No abstract available.
Adult* ; Alcoholics* ; Colitis* ; Humans ; Liver Cirrhosis, Alcoholic* ; Nephritis* ; Purpura*

BACKGROUND/AIMS: The causes and complications of liver cirrhosis are varied and increasing prevalence of alcoholic liver disease has been suspected. We tried to categarize the causes and complications of liver cirrhosis. METHODS: We investigated the 159 patients who are diagnosed as liver cirrhosis at Chungnam National University Hospital during the recent 5 years. RESULTS: 1) HBV infection was the most common cause of liver cirrhosis (48.1%), alcohol was next (42.9%). 2) Alcoholic liver cirrhosis was the most common cause in male (54.2%), postnecrotic cirrhosis (HBV) was the most common cause in female (66.7%). The difference was considered to come from the fact that male drinks more, constantly or habitually. 3) Alcohol was the most common cause of liver cirrhosis above the fifth decade of age and HBV is under 40 yeats of age. 4) The complications of liver cirrhosis are variceal bleeding, most common, splenomegaly and ascites in order. Hepatocellular carcinoma occumd also especially in HBV induced liver cirrhosis. CONCLUSION: Alcoholic liver disease is a common cause of liver cirrhosis.
Ascites ; Carcinoma, Hepatocellular ; Chungcheongnam-do ; Esophageal and Gastric Varices ; Female ; Fibrosis ; Humans ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic ; Liver Diseases, Alcoholic ; Liver* ; Male ; Prevalence ; Splenomegaly

Non-alcoholic fatty liver disease (NAFLD) is one of the most common metabolic liver disorders, and its incidence is expected to increase rapidly in the future as the rate of obesity increases and populations age. The gold standard for diagnosing NAFLD is liver biopsy, which involves sample error, high cost, and can be complicated due to its invasive nature. Therefore, many studies have been reported to establish accurate and convenient models to detect NAFLD using clinical and laboratory parameters. Most were derived from relatively small number of subjects and lack external validation, especially in the Korean population. This article summarizes the established and emerging risk factors for NAFLD and reviews non-invasive diagnostic algorithms for NAFLD including hepatic fibrosis.
Biopsy ; Diagnosis* ; Fibrosis ; Incidence ; Liver ; Liver Cirrhosis ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Risk Factors

The emergence of non-alcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide raises some concerns. In particular, NAFLD is closely tied to sedentary lifestyle habits and associated with other metabolic diseases, such as obesity and diabetes. At the end of the disease spectrum, non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma (HCC), representing a serious health problem to modern society. Recently, an increasing number of HCC cases originating from this progressive disease spectrum have been identified, with different levels of severity and complications. Updating the current guidelines by placing a bigger focus on this emerging cause and highlighting some of its unique features is necessary. Since, the drivers of the disease are complex and multifactorial, in order to improve future outcomes, having a better understanding of NASH progression into HCC may be helpful. The risks that can promote disease progression and currently available management strategies employed to monitor and treat NASH-related HCC make up the bulk of this review.
Carcinoma, Hepatocellular/etiology* ; Humans ; Liver Cirrhosis ; Liver Neoplasms/etiology* ; Non-alcoholic Fatty Liver Disease ; Obesity

Biopsy ; Humans ; Liver/pathology* ; Liver Cirrhosis/pathology* ; Non-alcoholic Fatty Liver Disease/pathology*

Nonalcoholic fatty liver disease (NAFLD) is a type of metabolic stress liver injury that is closely associated with insulin resistance and genetic susceptibility. The continuum of liver injury in NAFLD can range from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and even lead to cirrhosis and liver cancer. The pathogenesis of NAFLD is complicated. Pro-inflammatory cytokines, lipotoxicity, and gut bacterial metabolites play a key role in activating liver-resident macrophages (Kupffer cells, KCs) and recruiting circulating monocyte-derived macrophages (MoDMacs) to deposit fat in the liver. With the application of single-cell RNA-sequencing, significant heterogeneity in hepatic macrophages has been revealed, suggesting that KCs and MoDMacs located in the liver exert distinct functions in regulating liver inflammation and NASH progression. This study focuses on the role of macrophage heterogeneity in the development and occurrence of NAFLD and NASH, in view of the fact that innate immunity plays a key role in the development of NAFLD.
Humans ; Non-alcoholic Fatty Liver Disease/pathology* ; Liver/pathology* ; Macrophages/metabolism* ; Liver Cirrhosis/complications* ; Disease Progression

PURPOSE: We compared the hepatic perfusion indices obtained using hepatic perfusion CT with the wedge hepatic venous pressure (WHVP) and hepatic venous pressure gradient (HVPG) to determine the efficacy of the use of liver perfusion CT for the evaluation of portal hypertension. MATERIALS AND METHODS: Thirty-five patients with liver cirrhosis underwent hepatic vein catheterization to measure WHVP and HVPG and underwent a liver perfusion CT examination. Arterial perfusion, portal perfusion, total perfusion and the hepatic perfusion index (HPI) were calculated by the methods described by Miles and Blomley. The overall correlation coefficients (r) between the perfusion indices and WHVP and HVPG were calculated. An additional correlation coefficient of 23 alcoholic cirrhosis patients was calculated. RESULTS: Using Blomley's equation, HPI had a positive correlation with WHVP (r = .471; p < .05) and HVPG (r = .482; p < .05). For the alcoholic liver cirrhosis patients, HPI had a higher positive correlation with WHVP (r = .500; p < .05) and HVPG (r= .539; p < .05) than for the non-alcoholic cirrhosis patients. There was no statistical difference between the use of Miles' equation and Blomley's equation for the evaluation of portal hypertension. CONCLUSION: This preliminary study showed that HPI positively correlated with WHVP and HVPG, especially in alcoholic cirrhosis patients. Liver perfusion CT may be useful in the evaluation of portal hypertension.
Catheterization ; Catheters ; Fibrosis ; Hepatic Veins ; Humans ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Perfusion ; Venous Pressure

OBJECTIVETo investigate the expression of the lysosomal enzyme acid sphingomyelinase (ASMase) in alcohol-induced hepatic fibrosis using a rat model.

METHODSThe model of liver fibrosis was induced by administration of alcohol and high fat diet using 20 rats. Six rats given no alcohol and normal diet served as the control group. Real-time PCR, western blotting, and immunohistochemistry were used to evaluate fibrosis-related changes in the mRNA and protein expressions of ASMase.

RESULTSThe fibrotic liver tissues of the model rats showed significantly higher expression levels of ASMase than the non-fibrotic liver tissues of the control rats (P less than 0.05).

CONCLUSIONExpression of ASMase is increased in the fibrotic liver tissue of an alcohol-induced hepatic fibrosis rat model, suggesting that this lysosomal enzyme may contribute to development of this disease condition.

Animals ; Liver ; enzymology ; Liver Cirrhosis, Alcoholic ; enzymology ; Liver Cirrhosis, Experimental ; enzymology ; Male ; Rats ; Rats, Sprague-Dawley ; Sphingomyelin Phosphodiesterase ; metabolism