Usefulness of antithrombin III and α2-plasmin inhibitor in early differentiation of fulminant hepatitis and severe form of acute hepatitis

Abstract

To evaluate the usefulness of antithrombin III (AT III) and alpha 2-plasmin inhibitor (alpha 2PI) in early differential diagnosis of fulminant hepatitis from the severe form of acute hepatitis, the activities of AT III and alpha 2PI were measured in plasma of 15 patients with fulminant hepatitis and 6 patients with severe form of acute hepatitis. The activities of prothrombin time (PT), hepaplastintest (HPT) and thrombotest (TT) were also evaluated. The mean values and the standard errors (SE) for PT, HPT and TT were 21.1 +/- 2.6%, 14.0 +/- 1.6% and 10.3 +/- 1.7%, respectively, in the early stage of fulminant hepatitis and 25.3 +/- 2.4%, 21.6 +/- 4.6% and 15.8 +/- 3.6%, respectively, in the severe form of acute hepatitis. No significant difference in the tests between these two diseases was noted. On the other hand, the mean values +/- SE for AT III and alpha 2PI were 13.7 +/- 4.6% and 25.6 +/- 8.6% in fulminant hepatitis and 70.2 +/- 28.5% and 98.7 +/- 9.7% in the severe form of acute hepatitis. A significant difference between the two diseases was observed. From the above, it is concluded that measuring AT III and alpha 2PI along with PT, HPT and TT is useful for early diagnosis of fulminant hepatitis.

Liver stiffness measured by acoustic radiation force impulse elastography reflects the severity of liver damage and prognosis in patients with acute liver failure

“…The study was retrospective, and included 63 consecutive patients with acute liver disease (25 men and 38 women; mean age, 51.1 ± 16.8 years; age range, 18–79 years) admitted to our institution between April 2010 and December 2013. The subjects included 41 patients with acute hepatitis (AH), 16 patients with severe AH (SAH), who had no HE despite a plasma prothrombin time (PT) of 40% or less, and six patients with FH diagnosed according to the criteria of the Japanese Study Group, with a PT of 40% or less, in whom severe HE of grade II or more developed within 8 weeks of the onset of symptoms . The diagnostic criteria of ALF in Japan are different from those in the USA and Europe, where ALF is diagnosed when patients show coagulopathy with PT international normalized ratio of 1.5 or more and any degree of HE within 24 weeks after the onset of disease .…”

Haemostatic abnormalities in liver disease: could some haemostatic tests be useful as liver function tests?

“…As earlier studies were restricted to limited types of liver disease and haemostatic parameters [6][7][8][9][10][11], the present study includes a wide spectrum of liver affections ranging from symptomless viral carriers through to chronic as well as acute liver disease, in addition to the hepatocellular carcinoma; that is, an approach that offers LFTs ranging from normal to very severe derangement.…”

Ratio of circulating follistatin and activin A reflects the severity of acute liver injury and prognosis in patients with acute liver failure

“…Blood samples from 11 healthy adults (10 men and 1 woman; mean age, 34 years) with normal liver and renal function were used as normal controls (NC). Patients were classified into three disease types according to the severity of hepatic damage: 32 patients with AH; 23 patients with acute severe hepatitis (ASH) in whom hepatic encephalopathy did not develop during the course of the disease despite a low prothrombin time (PT) of 40% or less; 17 and 16 patients with ALF in whom grade II or greater severe hepatic encephalopathy developed within 8 weeks of the onset of hepatitis symptoms, with PT being 40% or less 18,19 …”