Value of computed tomography and magnetic resonance imaging for assessing severity of liver cirrhosis secondary to viral hepatitis
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Viral Hepatitis
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It has come to our attention that the units for both serum MFAP4 and ascites MFAP4 were erroneously reported as U/L in our article rather than the correct units, U/ml. Please see the corrected version of the article here. This error has also been corrected in the online supplementary file. We apologise for this error and any inconvenience caused. Corrigendum to ‘Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis’ [JHEP Reports 3 (2021) 100287]JHEP ReportsVol. 3Issue 5PreviewPrognostic models of cirrhosis underestimate disease severity for patients with cirrhosis and ascites. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein linked to hepatic neoangiogenesis and fibrogenesis. We investigated ascites MFAP4 as a predictor of transplant-free survival in patients with cirrhosis and ascites. Full-Text PDF Open AccessLevel of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosisJHEP ReportsVol. 3Issue 3PreviewPrognostic models of cirrhosis underestimate disease severity for patients with cirrhosis and ascites. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein linked to hepatic neoangiogenesis and fibrogenesis. We investigated ascites MFAP4 as a predictor of transplant-free survival in patients with cirrhosis and ascites. Full-Text PDF Open Access
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To examine the relationship between serum-ascites albumin concentration gradient(SAAG) measurements and the occurrence of gastrointestinal(GI) haemorrhage in patients with cirrhosis and ascites.Albumin levels in the serum and ascites and esophageal varices(EV) and portal vein diameter were studied,and the correlation berween these parameters was assessed in 62 patients with cirrhosis detected.In patients with cirrhosis and ascites,the presence of EV and GI is associated with high SAAG.The level of SAAG in patients with GI bleeding was 21.34 g/L±2.46g/L and in patients without GI bleeding was 15.57g/L±1.7g/L.The diameter of portal vein in patients with GI bleeding was 1.43 cm±0.12cm and in patients without GI bleeding was 1.08cm±0.14cm.There was a statistical significance between them.The high levdl of SAAG and great diameter of portal vein were useful means to predict the presence of EV and GI in patients with cirrhosis and ascites.
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Cancer antigen 125 (CA-125) is usually used to monitor the course of epithelial ovarian cancer. It has recently been reported that liver cirrhosis is associated with elevated serum CA-125, especially in the presence of ascites. The aim of the study was to evaluate CA-125 as a marker of ascites in patients with liver cirrhosis. Seventy-two (72) patients with liver cirrhosis of different aetiology were studied. Ca-125 levels were measured in stored serum collected from the patients. Ca-125 concentrations were elevated in patients with liver cirrhosis and ascites, irrespective of patients' sex and cirrhosis aetiology. CA-125 concentrations were normal in cases of liver cirrhosis without ascites. Elevated cancer antigen 125 is a sensitive marker of cirrhotic ascites. An inappropriate use of this test in cases of liver cirrhosis in females may suggest the ovarian cancer incident and lead to unnecessary surgical intervention.
Cancer antigen
Liver Cancer
Etiology
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Background Ascites due to cirrhosis may be difficult to distinguish from ascites due to heart failure by clinical features alone. More invasive testing is usually necessary, such as measurement of the hepatic venous pressure gradient, or paracentesis with measurement of the ascitic fluid total protein. Aim The aim of this study is to determine the diagnostic accuracy of serum NT-proBNP (N-terminal–pro-brain-type natriuretic peptide) in distinguishing patients with ascites from heart failure or cirrhosis. Methods Using a bank of previously collected fluid, we measured the serum and ascitic NT-proBNP levels in 58 patients with known cirrhosis, and 18 patients with known heart failure. Patients with both disease processes were excluded. The total protein levels in ascites was also measured and compared with serum NT-proBNP levels. Results The median serum NT-proBNP level was 165.7 pg/mL (range, 29.9 to 1795) in the cirrhosis group and 6100 pg/mL (range, 1110 to 116,248) in the heart failure group (P<0.001). Similar values were also found when using ascitic fluid NT-proBNP levels. Using a value of 1000 pg/mL, the sensitivity of serum NT-proBNP in ruling out cirrhosis as the cause for ascites was 100%. Conclusions Serum NT-proBNP seems to be an extremely powerful marker in distinguishing ascites due to cirrhosis from ascites due to heart failure. Serum NT-proBNP may potentially replace the more invasive testing presently in use.
Paracentesis
Ascitic fluid
Liver disease
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sObjectives: Cardiogenic ascites has been well described regarding its pathophysiology and fluid characteristics in prior literatures. However, ascites in patients with cardiac cirrhosis has not been characterized as a separate entity despite its unique pathophysiology and clinical aspects. This study aims to describe the fluid profile of ascites of cardiac cirrhosis and explore the utility of ascitic fluid protein (AFP) to predict concurrent cardiac cirrhosis.Methods and materials: We retrospectively selected and reviewed samples from the patients with cardiogenic ascites with and without concurrent cardiac cirrhosis. Epidemiologic characters, serum laboratory values, and fluid characteristics were directly compared between the groups.Results: We analyzed 20 samples of ascitic fluid from the patients of cardiac cirrhosis and compared with 48 samples of non-cirrhotic cardiac ascites. The AFP was significantly lower in patients with cardiac cirrhosis (3.66g/dl) as compared to non-cirrhotic patients (4.31g/dl, p < .01); while there was no difference in serum-ascites albumin gradient (1.48g/dl vs. 1.47g/dl, p = .95). AFP equal to or less than 4.3g/dl predicted cirrhosis with a sensitivity of 95% and negative likelihood ratio of 0.10; the corresponding ROC curve of AFP has an AUC of 0.777, higher than AUC of other noninvasive prediction models.Conclusions: We presented the first fluid characterization of ascites in patients with cardiac cirrhosis. AFP was significantly lower than that from non-cirrhotic cardiac ascites, likely secondary to decreased serum protein level. AFP equal to or less than 4.3g/dl could be utilized to screen for concurrent cardiac cirrhosis with high sensitivity in patients with cardiogenic ascites without other predisposing factors for liver injury.
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Objective It is to discuss the relationship between the levels of CA125,CA199 and AFP of cirrhosis patients and ascites.Methods The levels of CA125, CA199 and AFP in serum of 217 cirrhosis patients and 50 healthy people were detected with radioimmunoassay.The levels of CA125,CA199 and AFP in ascites of 92 cases were detected at the same time.Results The CA125 levels in serum of cirrhosis patients were significantly higher than that of healthy control group,and were added by the worsened of cirrhosis.The levels of CA125 in serum of ascites patients were obviously raised,and compared with the same child classification without ascites patients,it had statistics value.With the addition of ascites quantity,the levels of CA125 in serum were upward trend.The levels of CA199 and AFP in cirrhosis patients rose slightly,but it wasn't clearly correlation with cirrhosis degree and ascites quantity.Conclusion The levels of CA125 in serum will be definitely consulting value in weighing the prognosis of cirrhosis patients and the ascites quantity.The levels of CA199 and AFP in cirrhosis patients rose slightly,but it wasn't clearly correlation with ascites quantity.
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[Objective] To investigate the value of serum and ascites CA199, CA125 and CA153 levels in patients with cirrhosis and to explore possible factors associated with them. [Methods] A total of 54 patients and 32 cases of normal controls were studied. Group I consisted of 31 patients with cirrhosis without ascites. Group II consisted of 23 patients with cirrhosis with ascites. And group III consisted of 32 cases of normal controls. CA199, CA125 and CA153 levels were measured in serum of all the patients and also simultaneously in ascitic fluids of 23 patients. [Results] Serum CA199,CA125 and CA153 levels were elevated in patients with cirrhosis, especially in those with ascites. Serum CA199, CA125 and CA153 levels were correlated with Child-Pugh scores (r =0.39) but it was marginally significant (P 0.05). [Conclusions] The elevation of serum or ascites CA199, CA125 and CA153 can be act as an index in patients with cirrhosis.
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HERNIA is known to be more frequent among patients with cirrhosis of the liver, especially with ascites, than among those without liver disease. Chapman et al.1 reported a rate of 10 per cent in 58 patients without ascites whereas among those with ascites, the figure was 23.8 per cent (47 out of 112 cases). Henrikson2 stated that hernia occurred in 16 per cent (26 out of 162 cases) of patients with cirrhosis (with and without ascites).It is well recognized that surgical procedures, including herniorrhaphy, are often poorly tolerated when cirrhosis is severe. Thus, poor wound healing might be expected . . .
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Objective To study the relationship between CRP and ascites due to cirrhosis complicated with infection. Methods One hundred and sixty-two cases of ascites due to cirrhosis complicated with infection were detected CRP with lactoprene coagulant glass test method and compared the results before and after treatment. Results In the patients with ascites due to cirrhosis complicated with infection,CRP was higher than that without infection (P0.05). Senitivity of CRP was higher than that of the temperature and differential white blood count (P0.05). Conclusion CRP is a sensitive mark to diagnose infection in the early stage of the patient with ascites due to cirrhosis complicated with infection.
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Background: Liver cirrhosis represents one of the major causes of death worldwide.Many complications can be detected in liver cirrhosis.Among these complications is ascites which seems to be the most frequent one.Patients with cirrhosis and ascites show a higher susceptibility to bacterial infections mainly because of the inadequate defense mechanisms.In those patients, the most frequent infectious complication that occurs and at the same time the most severe one is spontaneous bacterial peritonitis. Aim of Study:To identify the frequency of spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites at Tanta University Hospitals.Patients and Methods: This study included three hundred patients with liver cirrhosis and ascites.Data were collected including; clinical, demographic and laboratory data.Ascitic fluid analysis and/or culture were done for diagnosis of SBP.Statistical analysis was carried out for all collected data using IBM & SPSS Version 20.Statistical significance was determined at a p-value <0.05. Results:The frequency of spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites at Tanta University Hospitals represented by 41.7%. Conclusions:The frequency of spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites at Tanta University Hospitals represented by 41.7% of the collected cases.
Spontaneous bacterial peritonitis
Ascitic fluid
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