The coexistence of Wilson disease with Alport syndrome has not previously been reported. The diagnosis of Wilson disease and its ongoing monitoring is challenging when associated with an underlying renal disease such as Alport syndrome. Proteinuria can lead to low ceruloplasmin since it is among serum proteins inappropriately filtered by the damaged glomerulus, and can also lead to increased urinary loss of heavy metals such as zinc and copper. Elevated transaminases may be attributed to dyslipidemia or drug induced hepatotoxicity. The accurate diagnosis of Wilson disease is essential for targeted therapy and improved prognosis. We describe a patient with a diagnosis of Alport syndrome who has had chronic elevation of transaminases eventually diagnosed with Wilson disease based on liver histology and genetics.
Blood Proteins ; Ceruloplasmin ; Copper ; Diagnosis ; Dyslipidemias ; Genetics ; Hepatolenticular Degeneration* ; Humans ; Liver ; Metals, Heavy ; Nephritis, Hereditary ; Prognosis ; Proteinuria* ; Transaminases ; Zinc

We had two cases of hepatitis developing after surgery. Case 1. A 47 year old male underwent surgery for amputation of the lower leg under enflurance anesthesia. Preoperative liver function test were slightly abnormal. On the 25th portoperative day, serum transaminases were elevated and the A/G ratio was reversed. On the 65th postoperative day, the liver function tests returned to near normal leve. Case 2. A 37 year old male underwent the first surgery for reduction of a pateliar fracture under spinal anesthesia. Preoperative serum transaminages were elevated and other laboratory findings at normal levels. On the 20th postoperative day serum transaminases were more elevated and on the 120th postoperative day, ti became normal again. This patient underwent the second surgery for removal of a K-wire under enflurane anesthesia and afterwards hepatitis recurred. On the 60th 2nd postoperative day LEFs became nearer to normal level and he was discharged in good health. Possible causes of the hepatitis in these cases were considered to be the preoperative liver disease, blood transfusion, the stress of the surgery and anesthesia.
Adult ; Amputation ; Anesthesia ; Anesthesia, Spinal ; Blood Transfusion ; Enflurane ; Hepatitis* ; Humans ; Leg ; Liver Diseases ; Liver Function Tests ; Male ; Middle Aged ; Transaminases

BACKGROUND: HMG-CoA reductase is known as a rate limiting enzyme in the synthesis of cholesterol. We studied the clinical efficacy and the side effects of pravastatin, a HMG-CoA reductase inhibitor, in patients with hypercholesterolemia. METHOD: Ten miligrams of pravastatin was administered once daily for 8 weeks in twenty five patients(7 male, 18 female) with hypercholesterolemia(>240mg/dl). Compared with pretreatment levels, pravastatin significantly decreased levels of total cholesterol(286+/-22 versus 234+/-27mg/dl, p<0.005) by 19%LDL-cholesterol(176+/-40 versus 144+/-33mg/dl, p<0.005) by 23% with significantly decreased levels of total cholesterol/HDL-cholesterol ratio(5.5+/-2.0 versus 4.8+/-1.5, p<0.05) and LDL-cholesterol/HDL-cholesterol ratio(3.4+/-1.2 versus 2.9+/-0.9, p<0.05). The level of HDL-cholesterol(52+/-17 versus 54+/-13mg/dl) and triglyceride(241+/-198 verus 178+/-111mg/dl) were not changed significantly. The side effects of pravastatin were mild and transient, including 1 case of headache, 1 dizziness, 1 facial flushing and 2 nausea. The laboratory tests including serum transaminases, uric acid, creatinine, creatine phosphokinase and blood glucose were not changed significant. CONCLUSION: Pravastatin 10mg as a single daily dose is as effective and safe as 5mg two times a day in patients with hypercholesterolemia.
Blood Glucose ; Cholesterol ; Creatine Kinase ; Creatinine ; Dizziness ; Flushing ; Headache ; Humans ; Hypercholesterolemia* ; Male ; Nausea ; Oxidoreductases ; Pravastatin* ; Transaminases ; Uric Acid

OBJECTIVETo study the effects of Compound Ganshao Paste (CGP) on the levels of sex hormones and hepatic transaminases in polycystic ovarian syndrome (PCOS) rat model.

METHODSThe PCOS rat model was established using Kafali modeling method. Rats were randomly divided into five groups, i. e., the normal control group, the PCOS model group, the Diane-35 group, the Compound Ganshao Caspule group, and the CGP group. The levels of sex hormones were detected using radioimmunoassay. The levels of hepatic transferases were detected using method of enzyme coupling ratio.

RESULTSCompared with the normal control group, the serum levels of luteinizing hormone (LH), testosterone (T), follicle stimulating hormone (FSH), estradiol (E2), and progesterone (P) decreased, showing statistical difference (P<0.05). Compared with the model group, the serum levels of LH, T, and FSH decreased, while serum E2 and P increased in the three medication groups, showing statistical difference (P<0.05). There was insignificant difference in the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among the normal control group, the model group, and the CGP group (P>0.05). Compared with the Diane-35 group and the Compound Ganshao Capsule group, the levels of hepatic transaminases of the CGP group was lower with statistical difference (P<0.05).

CONCLUSIONSCGP could improve the ovarian functions through adjusting the endocrine functions of PCOS model rats, thus stimulating the follicular development and ovulation. CGP did not add the hepatic burden.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gonadal Steroid Hormones ; blood ; Liver ; enzymology ; Phytotherapy ; Polycystic Ovary Syndrome ; blood ; drug therapy ; Rats ; Rats, Sprague-Dawley ; Transaminases ; blood

OBJECTIVETo evaluate the influence of Chinese drug Dahuang Zhechong pill on the hepatocellular function.

METHODThirty-seven patients with hepatocirrhosis and twelve normal controls were performed the hepatobiliary scintgraphy with Tc-99m labeled ethylene hepatobiliary iminodiacetic acid (99 mTc-EHIDA), and the biochemical examination of hepatic function. There was 19 cases repeated the imaging after 6 months treated with chineses drug. By the three compartmental model configurations, the function parameters of hepatocellular extraction and excretion were calculated.

RESULTIn the hepatocirrhosis groups, the hepatocellular uptake peak time and mean residence index were higher than those in normal controls (P < 0.01). Compared to normal controls, the uptake index, uptake speed index and descendent speed index were decreased markedly (P < 0.05). After treatment for 6 months with Chinese drug, the level of serum transaminase, globulin and bilirubin was lower than that before treatment. The uptake peak time and mean residence index decreased notably after treatment for 6 months (P < 0.01), and the uptake index increased, (P < 0.05).

CONCLUSIONChinese drug Dahuang Zhechong pill may improve the hepatocellular function and liver function status in patients with hepatocirrhosis.

Adult ; Bilirubin ; blood ; Drugs, Chinese Herbal ; pharmacology ; Globulins ; metabolism ; Hepatocytes ; drug effects ; metabolism ; Humans ; Liver Cirrhosis ; blood ; drug therapy ; metabolism ; Liver Function Tests ; Male ; Middle Aged ; Transaminases ; blood

OBJECTIVE: Obstructive sleep apnea hypopnea syndrome (OSAHS) and non-alcoholic fatty liver disease (NAFLD) are both strongly associated with obesity. Whether OSAHS is an independent risk factor for liver injury or not is uncertain. To assess the hypothesis that OSAHS is associated with liver injury independent of obesity. METHOD: One hundred and thirty children with OSAHS and 77 children with primary snoring(PS) were enrolled. Polysomnography was performed. Body mass index (BMI), liver function tests, serum lipids, fasting plasma glucose (FPG), and insulin (INS) were measured. RESULT: Seventeen children of OSAHS had elevated serum aminotransferase levels,while only 2 children of non-OSAHS had elevated serum aminotransferase in healthy control group (chi2 = 5.18, P < 0.05; OR = 5.64 CI 1.27-24.97). Fifteen children of obese had elevated serum aminotransferase levels, while only 4 children had elevated serum aminotransferase in non-obese group (chi2 = 4.58, P < 0.05; (OR = 1.97 CI 1.06-3.67). Seventy cases of obese children, 15 cases of elevated aminotransferase levels (21.4%), namely fatty liver patients, of these children, 14 had OSAHS (93.3%). In contrast, OSAHS was present in only 67.3% of obese children without elevated aminotransferase. CONCLUSION OSAHS may be a risk factor for liver injury independent of obesity; Increased liver enzyme levels are frequently found in obese snoring children, particularly among those with OSAHS.
Adolescent ; Blood Glucose ; analysis ; Body Mass Index ; Case-Control Studies ; Child ; Fatty Liver ; blood ; enzymology ; Female ; Humans ; Insulin ; blood ; Male ; Obesity ; blood ; complications ; Risk Factors ; Sleep Apnea, Obstructive ; blood ; complications ; Snoring ; blood ; Transaminases ; blood

PURPOSE: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. METHODS: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. RESULTS: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p<0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). CONCLUSION: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Child* ; Cholesterol ; Education ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Humans ; Hyperlipidemias ; Liver* ; Obesity ; Parents ; Pediatric Obesity ; Prevalence* ; Transaminases ; Triglycerides ; Weight Loss

In this study, the potential hepatotoxicity of 1,3-dichloro-2-propanol and its hepatotoxic mechanisms in rats was investigated. The test chemical was administered orally to male rats at 0, 27.5, 55, and 110 mg/kg body weight. 1,3-Dichloro-2-propanol administration caused acute hepatotoxicity, as evidenced by an increase in serum aminotransferases, total cholesterol, and total bilirubin levels and a decrease in serum glucose concentration in a dose-dependent manner with corresponding histopathological changes in the hepatic tissues. The significant increase in malondialdehyde content and the significant decrease in glutathione content and antioxidant enzyme activities indicated that 1,3-dichloro-2-propanol-induced hepatic damage was mediated through oxidative stress, which caused a dose-dependent increase of hepatocellular apoptotic changes in the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay and immunohistochemical analysis for caspase-3. The phosphorylation of mitogen-activated protein kinases caused by 1,3-dichloro-2-propanol possibly involved in hepatocellular apoptotic changes in rat liver. Furthermore, 1,3-dichloro-2-propanol induced an inflammatory response through activation of nuclear factor-kappa B signaling that coincided with the induction of pro-inflammatory mediators or cytokines in a dose-dependent manner. Taken together, these results demonstrate that hepatotoxicity may be related to oxidative stress-mediated activation of mitogen-activated protein kinases and nuclear factor-kappa B-mediated inflammatory response.
Animals ; Bilirubin ; Blood Glucose ; Body Weight ; Caspase 3 ; Cholesterol ; Cytokines ; Glutathione ; Humans ; Liver ; Male ; Malondialdehyde ; Mitogen-Activated Protein Kinases* ; Oxidative Stress ; Phosphorylation ; Rats ; Transaminases

The present study evaluated the effect of various dosages of soybean isoflavone extract on body weight changes, glucose tolerance and liver function in streptozotocin-induced diabetic rats. One group of normal rats (normal control) was fed an AIN-76-based experimental diet and four groups of diabetic rats were fed the same diet supplemented with four different levels of soybean isoflavone extract for seven weeks. The daily dosages of pure isoflavone for four diabetic groups were set to be 0 mg (diabetic control), 0.5 mg (ISO-I), 3.0 mg (ISO-II) and 30.0 mg (ISO-III) per kilogram of body weight, respectively. The daily consumption of isoflavone at the level of 3.0mg per kilogram of body weight resulted in the suppression of body weight loss and increased the survival rate of diabetic animals one and half times compared to that of the diabetic control group. Blood glucose levels in a fasting state and after the oral administration of glucose were significantly lower in the ISO-II group during the oral glucose tolerance test. The ISO-II group showed a tendency to elongate the gastrointestinal transit time. The activity of serum aminotransferases, indicator of liver function, was not negatively affected by any intake level of isoflavone. The present study demonstrated that the soybean isoflavone extract may be beneficial to diabetic animals by improving their glucose tolerance and suppressing weight loss without incurring hepatotoxicity at the daily dosage of 3.0 mg per kg of body weight.
Administration, Oral ; Animals ; Blood Glucose ; Body Weight ; Body Weight Changes ; Diet ; Fasting ; Gastrointestinal Transit ; Glucose Tolerance Test ; Glucose* ; Liver ; Rats* ; Soybeans* ; Streptozocin ; Survival Rate* ; Transaminases ; Weight Loss

BACKGROUND: During the Pringle maneuver (PM), the increase of systemic vascular resistance (SVR) and the active constriction of the intrahepatic capacitance vessels could minimize arterial blood pressure change. Pressor reactivity to sympathetic agonists is impaired and blood volume buffering capability is less efficient in a cirrhotic liver. Accordingly, we evaluated the relations between hemodynamics during PM and preoperative liver function test (LFT) by serum aminotransferase and Indocyanine Green (ICG) clearance. METHODS: Twenty-seven patients undergoing hepatectomy with PM were classified into two groups according to the liver function state assigned by serum aminotransferases and ICG clearance test. Sequential changes of hemodynamics were measured with Doppler flowmeter during PM. Hemodynamic data were analyzed by using ANOVA for repeated measurement. Correlation between LFTs were sought using Pearson correlation and logistic regression. RESULTS: During the PM, cardiac output decreased significantly compared to the preclamping period in the abnormal LFT group. There were no significant changes in any other hemodynamic variables in the normal LFT group. When comparing the two groups during PM, mean arterial blood pressures and cardiac output were significantly lower in the abnormal LFT groups compared to the normal LFT groups (P< 0.05). CONCLUSIONS: These differences may suggest that cardiovascular responsiveness to reflex autonomic stimulation during the PM is significantly impaired in patients with abnormal LFT compared with normal LFT subjects.
Arterial Pressure ; Blood Volume ; Cardiac Output ; Constriction ; Flowmeters ; Hemodynamics* ; Hepatectomy ; Humans ; Indocyanine Green ; Liver Function Tests ; Liver* ; Logistic Models ; Reflex ; Transaminases ; Vascular Resistance