Chronic liver disease and still's disease

Tesser, John; Pisko, Edward J.; Hartz, John W.; Weinblatt, Michael E.

doi:10.1002/art.1780250514

Cited by 22 publications

(5 citation statements)

References 15 publications

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“…This negative association was far greater than that observed with any other comorbidity or category of Charlson Comorbidity Index suggesting that mortality in hospitalised patients with ArLD and COVID-19 may partly be explained by differential allocation of healthcare resources. These findings are alarming particularly since the incidence of harmful drinking, ArLD and alcohol-related hospital admissions has dramatically increased since the onset of the pandemic 76…”

Section: Covid-19 In Patients With Chronic Liver Diseasementioning

confidence: 99%

COVID-19 and liver disease

Dufour

Marjot

Becchetti

et al. 2022

Gut

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Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review COVID-19 liver manifestations and pathophysiological aspects related to SARS-CoV-2 infection in patients without liver disease as well as the impact of COVID-19 in patients with chronic liver disease (CLD), particularly cirrhosis and liver transplantation (LT). SARS-CoV-2 infection has been associated with overt proinflammatory cytokine profile, which probably contributes substantially to the observed early and late liver abnormalities. CLD, particularly decompensated cirrhosis, should be regarded as a risk factor for severe COVID-19 and death. LT was impacted during the pandemic, mainly due to concerns regarding donation and infection in recipients. However, LT did not represent a risk factor per se of worse outcome. Even though scarce, data regarding COVID-19 specific therapy in special populations such as LT recipients seem promising. COVID-19 vaccine-induced immunity seems impaired in CLD and LT recipients, advocating for a revised schedule of vaccine administration in this population.

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Section: Covid-19 In Patients With Chronic Liver Diseasementioning

confidence: 99%

COVID-19 and liver disease

Dufour

Marjot

Becchetti

et al. 2022

Gut

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“…Cytokine production and sustained macrophage activation have been implicated to play a role in the liver manifestations [87,91]. Previous descriptions of hepatic histopathology in AOSD consist of portal inflammatory infiltrates in most cases [92], mild interstitial hepatitis [93], mild portal fibrosis, focal hepatitis with necrosis [94], and mild chronic necroinflammatory change [95].…”

Section: Liver Involvementmentioning

confidence: 99%

Life-threatening complications of adult-onset Still’s disease

2014

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Adult-onset Still's Disease (AOSD) since its description in 1971 has proven to be a very complex and challenging disease entity. This rare auto-inflammatory disease is classically described by the "Still's triad" of fever, rash, and arthritis, although the atypical cases frequently outnumber the typical ones. The exact pathogenesis and etiologic factors responsible for the clinical features remain largely obscure, despite recent suggestive cytokine biology findings. Diagnosis is made on clinical grounds, following the exclusion of mimickers of infectious, autoimmune or neoplastic etiology, with the additional consideration of non-specific laboratory abnormalities such as peripheral leukocytosis and elevation of serum ferritin and other acute phase reactants. The disease manifestations are protean and can include diverse complications, affecting multiple organ systems. Moreover, the severity of the organ involvement can vary considerably, representing a wide spectrum from the self-limited to severe. The mainstay of therapy has evolved from the traditional use of corticosteroids and oral immunosupressants to the newer targeted treatments with biologic agents. The scope of this review is to alert the clinician to the existence of life-threatening AOSD complications, namely the macrophage activation syndrome, disseminated intravascular coagulopathy, thrombotic thrombocytopenic purpura, diffuse alveolar hemorrhage, and pulmonary arterial hypertension. Such knowledge may lead in earlier recognition, prompt treatment, and, ideally, improved patient outcomes.

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“…In patients with AOSD,the liver biopsy findings have included infiltration of inflammatory cells into portal areas ( 1 ), mild interstitial hepatitis (8), mild portal fibrosis, focal hepatitis with necrosis (7) , and mild chronic necro-inflammatory changes (9). Massive hepatic necrosis has been described in a case report ofAOSD( 1 1 ).…”

Section: Discussionmentioning

confidence: 99%