Sex Steroids in Women with Liver Cirrhosis

Shaaban, Mamdouh M.; Ghaneimah, Sharaf A.; Hammad, Wafaa; El-Sharkawy, M.M.; Elwan, Sawsan I.; Ahmed, Yousreya A.

doi:10.1002/j.1879-3479.1980.tb00276.x

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…As in chronic alcoholic men with and without liver damage (18,19) and in women with nonalcoholic cirrhosis (42), plasma concentrations of estrone were increased in the patients studied. It is possible that the high plasma estrone levels contributed through negative feedback regulation to the inhibition of gonadotropin secretion in these patients.…”

Section: Discussionmentioning

confidence: 79%

Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

Välimäki

Pelkonen

Salaspuro

et al. 1984

The Journal of Clinical Endocrinology & Metabolism

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Urinary excretion of estrogens and plasma concentrations of estrone, estradiol, LH, FSH, PRL, progesterone, testosterone, and sex hormone binding globulin were measured in nine chronic alcoholic women with cirrhosis or alcoholic fatty liver. They were aged 24-40 yr and all had secondary amenorrhea which had lasted for at least 3 months. The response of pituitary gonadotropin secretion to administration of LHRH and estradiol benzoate and of PRL secretion to TRH were also investigated. Urinary excretion of estrogens in the alcoholic women with liver disease was similar to that in normal postmenopausal women and less than half that in normal women of the same age in the midfollicular phase of the menstrual cycle. Plasma estradiol levels in the alcoholic women were lower than in the menstruating women but higher than in the postmenopausal women, whereas their plasma estrone levels were higher than in the menstruating women. Plasma concentrations of progesterone and testosterone in the alcoholic women did not differ from those in the postmenopausal women but were lower than in the menstruating women. In spite of the relative estrogen deficiency plasma LH and FSH levels were not elevated in the alcoholic women. The responses of LH and FSH to LHRH were similar in the patients and in the menstruating women. Intramuscular administration of estradiol benzoate did not increase plasma LH and FSH concentrations in the alcoholic women. Hyperprolactinemia was not found and there were no differences in the PRL responses to TRH between the patients and the control groups. In conclusion, disturbed regulation of gonadotropin secretion is an important factor in the genesis of estrogen deficiency and amenorrhea in alcoholic women with liver disease, although ovarian function may also be directly impaired.

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Section: Discussionmentioning

confidence: 79%

Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

Välimäki

Pelkonen

Salaspuro

et al. 1984

The Journal of Clinical Endocrinology & Metabolism

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“…Gluud et al showed that the ratio of estrogen to testosterone increases with declining liver function 35. Shaaban et al also reported increased estrogen levels in the patients with chronic liver disease 36. Long‐term exposure to the high levels of estrogen seen in the patients with chronic liver disease may be linked to the increased risk of development of de novo breast cancer.…”

Section: Discussionmentioning

confidence: 99%

De novo breast cancer in patients with liver transplantation: University of Pittsburgh's experience and review of the literature

et al. 2004

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De novo malignancies are one of the current problems in patients with organ transplantation. The incidence has been considered to be higher as a result of increases of oncogenic viruses in immunosuppressed organ recipients. Published reports have shown increased incidence of de novo tumors such as malignant lymphomas and cutaneous neoplasms but decreased incidence of breast cancer. A variety of factors affect de novo breast cancer development in organ recipients, including immunosuppression, viruses, and underlying disease. The aims of this review are to evaluate the incidence and management of patients with de novo breast cancer by giving the University of Pittsburgh's data, and to evaluate the incidence of de novo breast cancer in published reports in light of an age-adjusted rate. According to age-adjusted rates presented by the National Cancer Institute's Surveillance, Epidemiology and End Results data, we found increased incidence rate of de novo breast cancer in the previously published series. The University of Pittsburgh's incidence rate of de novo breast cancer was determined in a fashion similar to that for the Surveillance, Epidemiology and End Results data. Eighty-three percent of all patients were diagnosed at early stages, and it appeared to take longer for de novo breast cancer to develop in patients treated with tacrolimus than in patients treated with cyclosporine. In conclusion, surgical treatment of breast cancer in liver recipients is the same as treatment of breast cancer in patients without transplantation. However, the effects of chemotherapy, radiotherapy, and/or tamoxifen remain unclear in transplanted patients and need to be evaluated in larger studies. (Liver Transpl 2004;10:1-6.) D e novo malignancies are considered one of the serious long-term complications of organ transplantation. McKhann first reported the increased incidence of de novo malignancies, an observation confirmed shortly thereafter by others. 1-4 A variety of factors are considered responsible for the development of de novo malignancies, such as the intensity of the immunosuppressive therapy, the type of transplant, and the use of different immunosuppressive agents. The most frequent cancers among these tumors are malignant lymphomas and cutaneous neoplasms. The observed rate of incidence of de novo malignancies in patients with transplantation range from 4.1% to 16% in different series. 5-8 Although decreased incidence of de novo breast cancers (BCs) has been reported in the transplant literature, 9,10 there are contradictory data concerning the incidence of BC in those patients compared with the overall population. Some previous studies indicate that the incidence of commonly seen tumors such as carcinoma of the breast is not increased in the transplant population. 10 -12 MEDLINE SearchOur review of published data on the incidence of de novo cancers following transplantation was based on English-language articles in the MEDLINE database. For this purpose, all published reports between 1963-2003 were searched in PubMe...

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The hyperventilation of cirrhosis: Progesterone and estradiol effects

et al. 1997

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treat hypoventilation disorders. 12 Although plasma progesProgesterone and estradiol are metabolized in the terone is elevated in cirrhotic patients because of decreased liver and are elevated in patients with cirrhosis. Progeshepatic metabolism, progesterone has not been proved to terone stimulates ventilation by activating progesterone cause their hyperventilation. receptors in the central nervous system; estradiol mayWe propose estradiol as a contributing factor to respiratory facilitate progesterone's actions by increasing progesalkalosis, although this has not been examined in humans. terone receptors. This study evaluated whether progesEstradiol is metabolized by the liver into estriol, which has terone and estradiol contribute to the respiratory alkaminimal estrogen effects. Estradiol has no direct respiratory losis common in cirrhotic patients. Arterial blood gases stimulatory effect; 13 however, estradiol increases the number and progesterone and estradiol levels were obtained in of progesterone receptors in animals and may facilitate pro-50 patients with cirrhosis. Multiple linear regression regesterone's actions. 14,15 vealed a statistically significant correlation between This report examines the roles of hyperprogesteronemia P a CO 2 and progesterone and estradiol (r Å .54, P õ .05).and hyperestradiolemia in producing hyperventilation in paPatients with severe hyperventilation (P a CO 2°3 0 mm tients with cirrhosis. Hg) had statistically higher levels of progesterone and estradiol than did patients with mild hyperventilation PATIENTS AND METHODS (30 õ P a CO 2°3 5) or normal ventilation (P a CO 2 ú 35) (P õ .05). Although the progesterone levels were two orders With written patient consent and approval from the University of of magnitude lower than those associated with hyper-Rochester Investigational Review Board, we prospectively studied 50 ventilation in pregnant patients, the increased ventila-patients presenting to liver clinic for possible liver transplantation. tory effect may be because of the altered blood-brain Premenopausal women, patients with chronic obstructive pulmonary disease or acute encephalopathy, or patients taking hormonal medibarrier (BBB) present in cirrhotic patients. Progestercations, narcotics, or benzodiazepines were excluded. All patients one and estradiol appear to contribute to the hyperven- 58.)the wrist. A 20-gauge catheter was then placed in a sterile fashion into the radial artery and taped in place. To ensure no hyperventilation from anxiety or pain, arterial blood was drawn into a heparinized Respiratory alkalosis is common in patients with hepatic syringe after several minutes, the arterial blood was placed on ice, cirrhosis 1,2 although the cause has proved elusive. Proposed and sent to the lab for immediate determination of blood gas results. mechanisms include increased ammonia, 3 decreased albuBlood was also sent for determination of estradiol and progesterone min, 4 hypoxia, 5 and elevated progesterone. 6 levels. Albumin and bilirubin levels and prothrombi...

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Sex Steroids in Women with Liver Cirrhosis

Cited by 10 publications

References 12 publications

Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

De novo breast cancer in patients with liver transplantation: University of Pittsburgh's experience and review of the literature

The hyperventilation of cirrhosis: Progesterone and estradiol effects

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