Clinical Spectrum and Therapeutic Approach to Hepatocellular Injury in Patients With Hyperthyroidism.

Clinical spectrum and therapeutic approach to hepatocellular injury in patients with hyperthyroidism.

Clin Exp Gastroenterol. 2013; 6: 9-17
de Campos Mazo DF, de Vasconcelos GB, Pereira MA, de Mello ES, Bacchella T, Carrilho FJ, Cançado EL

Liver dysfunction in patients with hyperthyroidism includes abnormalities associated with the effects of thyroid hormone excess, those secondary to drug-induced liver injury, and changes resulting from concomitant liver disease. Our goal was to describe clinical, biochemical, and histopathological patterns in patients suffering from hyperthyroidism and concomitant liver dysfunction and to propose an algorithm of procedures to facilitate diagnosis and management of such cases. This study describes seven patients with liver biochemistry abnormalities detected after diagnosis of hyperthyroidism and one with undiagnosed decompensated hyperthyroidism and acute hepatitis. Two patients showed autoantibody reactivity which, together with liver histology, suggested the diagnosis of classic autoimmune hepatitis. Three patients experienced hepatotoxicity induced by propylthiouracil, the manifestations of which ranged from a benign course after drug withdrawal in one, a longstanding course in another suggesting drug-induced autoimmune hepatitis, and a more severe clinical condition with acute liver failure in a third patient, requiring liver transplantation. The three remaining patients showed no precipitating factors other than thyroid hyperactivity itself. They could be interpreted as having a thyroid storm with different clinical presentations. In conclusion, this series of patients illustrates the most frequent patterns of hepatocellular damage associated with hyperthyroidism and provides an algorithm for their diagnosis and treatment. HubMed – drug


Bleeding manifestations and management of children with persistent and chronic immune thrombocytopenia: data from the Intercontinental Cooperative ITP Study Group (ICIS).

Blood. 2013 Apr 2;
Neunert CE, Buchanan GR, Imbach P, Bolton-Maggs PH, Bennett CM, Neufeld E, Vesely SK, Adix L, Blanchette VS, Kühne T

Key points Severe thrombocytopenia is rare and major hemorrhage is uncommon in children with children with persistent and chronic ITPIn children with persistent or chronic ITP there is a trend towards reserving drug therapy for those experiencing significant bleeding. HubMed – drug


BDNF-TrkB signaling pathway is involved in pentamethylenetetrazole-evoked progressing in epileptiform activities of hippocampal neurons in anaesthetized rats.

Neurosci Bull. 2013 Apr 2;
Liu X, Liu J, Liu J, Liu XL, Jin LY, Fan W, Ding J, Peng LC, Wang Y, Wang X

Pentylenetetrazole (PTZ) is a widely used convulsant drug in epilepsy study, which generates stable seizure animal model by subcutaneous injection. In the current study, we compared the stimulatory effects of PTZ via intravenous and subcutaneous routes on evoking the progressive epileptiform activities of hippocampal CA1 neurons in anaesthetized rats. The involvement of BDNF-TrkB pathway was further studied. When PTZ was given intravenously, it induced epileptiform burst activity with a short latency in a dosage-dependent manner. However, when PTZ was given subcutaneously, it induced slow developing pattern of the epileptogenesis as of first generating the multiple population spike peaks, and then the spontaneous interictal discharge-like spike towards the final of the ictal discharge-like highly synchronized bursting firing in hippocampal CA1 pyramidal layer. K252a, a TrkB receptor antagonist, when given by intracerebral ventricular injection, significantly reduced the probability of PTZ subcutaneous injection-induced multiple population spike peaks, delayed the latency of spontaneous spike, and suppressed the burst frequency. Our results indicate that PTZ stimulates the progressive change of the neuronal epileptiform activities in the hippocampus, and the BDNF-TrkB signaling pathway involves mainly the early phases of the epileptogenesis, but not the epileptic seizure related synchronized neuronal burst activities in the PTZ animal model. These results provide basic insights of the hippocampal neuronal activity change pattern during PTZ seizure model development, and establish in vivo electrophysiological seizure model useful for future epilepsy study. HubMed – drug



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