Hypoxic Hepatopathy: Pathophysiology and Prognosis

Birrer, Richard B.; Takuda, Yasuharu; Takara, Tsuyoshi

doi:10.2169/internalmedicine.46.0059

Cited by 189 publications

(204 citation statements)

References 27 publications

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“…Cellular membrane changes allow for their systemic discharge. Similar enzymatic changes have been experimentally described through arterial hypoxia, hypoperfusion or endotoxins injury (13).…”

Section: Pathophysiologysupporting

confidence: 62%

“…The presence of elevated total and, more specifically, unconjugated bilirubin up to 2-3 mg/dL is a negative prognostic marker. Only one third of patients develop jaundice (13). One study found high levels of bilirubin being correlated with the arterial pressure level, but not with cardiac output (19).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Septic shock prevalence varies from 11% to 16% and 23% (12,13). The pathophysiologic mechanisms of IH/HH in patients with septic shock are different from cardiogenic shock.…”

Section: Pathophysiologymentioning

confidence: 99%

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Ischemic Hepatitis – Intercorrelated Pathology

Ciobanu

Gherasim

2018

Maedica

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Section: Pathophysiologysupporting

confidence: 62%

Section: Clinical Manifestationsmentioning

confidence: 99%

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Ischemic Hepatitis – Intercorrelated Pathology

Ciobanu

Gherasim

2018

Maedica

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“…9 Insults reported to cause ischaemic hepatitis include cardiac failure, hypovolaemic or septic shock, respiratory failure, and toxic insults/poisoning. 8,10 The prognosis of ischaemic liver damage depends on the underlying disease, but in surviving patients the impairment of hepatic function is characteristically transient and reversible. 8,10 Liver biopsy is not required for the diagnosis of ischaemic hepatitis, 10 and was not performed in our patient due to the resolution of liver function and also the patient's general clinical and psychological condition.…”

Section: Discussionmentioning

confidence: 99%

Recurrent acute hepatic dysfunction in severe anorexia nervosa

Dowman

Ramakrishnan

Chesner

2010

Intl J Eating Disorders

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Anorexia nervosa (AN) is an eating disorder predominantly affecting young women. Abnormal liver function tests (LFT's) resulting from AN is well-described but to date few cases of dramatic rises in liver enzymes have been described. We report a 32-year-old women with severe anorexia having dramatic rise in LFT's with liver failure during extremely poor nutritional status. Acute rise in liver enzymes observed on several occasions in this patient resulted from ischaemic hepatitis secondary to liver hypoperfusion. Clinicians caring for patients with severe AN should monitor haemodynamic parameters with the knowledge that acute liver failure can be a consequence of sudden liver hypoperfusion. Therapeutic intervention comprising volume support with gradual nutritional support results in normalization of LFT's.

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“…Liver enzyme abnormalities are commonly observed in acute MI, possibly due to hypoxic liver damage [20], and it recently was suggested that hypoxic liver injury (defined as serum transaminase level more than twice the upper limit of normal) is closely associated with post-PCI left ventricular dysfunction and mortality in STEMI [13]. ALP levels are also slightly elevated in the presence of hypoxic liver injury, which can lead to confounding of the prognostic effect of ALP.…”

Section: Discussionmentioning

confidence: 99%