Annals of hepatology最新文献

{"title":"Kasabach-Merritt syndrome in an adult treated by embolization prior to liver transplantation: a case report.","authors":"Xóchitl García-León, René Malé-Velázquez, Esteban Martínez-Villaseñor, Álvaro Calleros-Camarena","doi":"10.1016/j.aohep.2025.101845","DOIUrl":"10.1016/j.aohep.2025.101845","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatic hemangioma, the most common benign tumor of the liver. Large ones may develop Kasabach Merrit syndrome (KM) if associated with coagulopathy.</div></div><div><h3>Objective</h3><div>to describe diagnostic approach and treatment of hemangioma with KM syndrome in an adult with complications during pregnancy, treated with embolization and liver transplantation, review of the literature.</div></div><div><h3>Materials and Patients</h3><div>A 35-year-old woman referred from Durango by angiology to the hepatology department for a failed laparoscopic biopsy attempt due to the presence of unspecified vascular lesions which presented bleeding due to severe coagulation disorders, controlled in her hospital of origin. During the consultation, imaging and biochemical characteristics of thrombocytopenia and anemia were evaluated and KM syndrome was considered, complementing the diagnosis with Leukocytes 5.3 × 103/uL, HB 10.3 g/dL, Hto 29.8%, VCM 99.2 fL, HCM 34.3 pg platelets 111 × 103/uL, Cr 0.61mg/dL, BT 1. 05mg/dl, FA 64 U/L, GGT 55 U/L AST 15 U/L, ALT 20 U/L, albumin 4.82g/dL, fibrinogen 52, dimer D 49.46 ug/dl, AFP 1.21 ng/ml, carcinoembryonic 0.94 ng/ml, Ca 19-9 2. 0 U/ml TP 14.6 INR 1.0, it was decided to perform a biopsy to rule out hemangioepithelioma, presenting severe hemorrhage requiring transarterial embolization on two occasions. Subsequently, she returned to the clinic with a normoevolutive pregnancy and a considerable increase in the size of the lesions, requiring cesarean section due to placenta accrete, again generating hemorrhage and development of ascites. Due to the hepatic deterioration, a protocol for transplantation was established and successfully performed in March 2024, with a total reversal of the coagulation disorders after the procedure and currently with no alterations.</div></div><div><h3>Results</h3><div>Hepatic hemangiomas are mostly asymptomatic and small; those larger than 10 cm are considered giants and present with non-specific symptoms such as abdominal pain, fatigue, etc. They are diagnosed by tomography (CT) or magnetic resonance imaging (MRI); in CT they are observed as relatively well-defined hypodense nodules, hypoattenuated in relation to parenchyma and centripetal peripheral enhancement with contrast medium, with complete and persistent opacification in late sections. It presents complications such as intralesional hemorrhage, mass effect in adjacent structures, and rupture with intraperitoneal hemorrhage. Some lesions may develop KM syndrome, a vascular disease characterized by thrombocytopenia, microangiopathic hemolytic anemia, coagulopathy and hepatic vascular lesions. The pathogenesis is due to the sequestration of platelets and coagulation factors in the abnormal endothelium of the vascular lesion. It requires biopsy to rule out malignant neoplasms (hemangioepithelioma). Occurs in neonates, rarely in adults. Transarterial embolization and chemoembolization c","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101845"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSH and its Correlation in the Development of Fibrosis in Patients with Hypothyroidism in a Tertiary Care Hospital","authors":"Aranzazu G. Pérez Castañeda ,&nbsp;Jose A. Velarde Ruiz Velasco ,&nbsp;José R. Barrientos Ávalos ,&nbsp;Juan M. Aldana Ledesma ,&nbsp;Edgar S. García Jiménez","doi":"10.1016/j.aohep.2025.101826","DOIUrl":"10.1016/j.aohep.2025.101826","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Fatty liver disease and hypothyroidism are two prevalent conditions in Mexico that pose significant public health challenges. The increase in their incidence over the past decades is due to changes in lifestyle, diet, and access to healthcare. Although hypothyroidism does not directly cause hepatic fibrosis, it is related to the body's metabolic function. Hypothyroidism can slow down metabolism and lead to lipid accumulation in the liver, a condition known as hepatic steatosis or fatty liver. This condition can progress to steatohepatitis and eventually to hepatic fibrosis, characterized by scar tissue formation. If left untreated, fibrosis can advance to liver cirrhosis with severe complications. Hypothyroidism and fatty liver disease share common risk factors such as obesity, type 2 diabetes, and metabolic disorders. Proper treatment of hypothyroidism and early identification of fatty liver are crucial to prevent progression to fibrosis. It is essential for individuals with hypothyroidism to monitor their liver health and adopt a healthy lifestyle to avoid liver complications. Currently, there are enough studies that validate the association between hypothyroidism and the development of fatty liver with varying degrees of hepatic fibrosis. To identify clinical-demographic characteristics in patients with hypothyroidism evaluated in the endocrinology service and to identify the presence of fibrosis through non-invasive evaluation.</div></div><div><h3>Materials and Patients</h3><div>Patients with hypothyroidism aged 18 to 80 years of both sexes evaluated by the Endocrinology service with a complete medical record, who do not have risk of alcohol consumption, hepatotropic virus infections, or use of drugs causing hepatotoxicity.</div></div><div><h3>Results</h3><div>A review of 85 patients with complete medical records was carried out, and a correlation analysis with numerical variables in the SPSS system found that TSH levels do not correlate with the development of hepatic fibrosis, with a Pearson's r = -0.074 (p = 0.519), which is not significant.</div></div><div><h3>Conclusions</h3><div>In this case series, we report that there is no direct correlation between TSH levels and the development of hepatic fibrosis. However, it is important to highlight that metabolic comorbidities favor the development of fatty liver and, consequently, the possibility of developing hepatic fibrosis. In this series of cases, four cases of advanced fibrosis were found, so it is important to emphasize requesting complete studies in patients with hypothyroidism and to complement with imaging studies.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101826"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pirfenidone Prevents Myocarditis by Restoring Metabolic Hormone Levels in a Mouse MASH Model and its Effect on H9c2 Myoblast Viability under Glucolipotoxicity","authors":"Daniel López-Cifuentes ,&nbsp;Ana S. Sandoval-Rodríguez ,&nbsp;Ángel O. Vázquez-Esqueda ,&nbsp;Jonathan S. Rodríguez-Sanabria ,&nbsp;Juan Armendáriz-Borunda ,&nbsp;Jorge Gutiérrez-Cuevas","doi":"10.1016/j.aohep.2025.101843","DOIUrl":"10.1016/j.aohep.2025.101843","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Obesity, global epidemic, can cause metabolic dysfunction-associated steatohepatitis (MASH) and cardiovascular diseases. Pirfenidone (PFD) has anti-inflammatory and anti-fibrotic properties. We investigated the effects of PFD on metabolic hormones expression and myocarditis in a mouse MASH model and its effect on H9c2 cells viability under glucolipotoxicity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;Twenty-week-old male C57BL/6J mice were divided into two groups: one group was fed a normal diet (ND, 3.1 kcal/g plus normal water, n=7), while the other group was fed a high-fat, high-carbohydrate diet (HFHC, 5.1 kcal/g plus water containing 2.31% fructose, 1.89% sucrose; n=14) for 16 weeks. At week 8, seven HFHC mice were administered PFD at a dosage of 300 mg/kg/day by gavage. Insulin tolerance tests (ITT), dry chemistry analysis, ELISA, histological staining (Hematoxylin-Eosin and Masson's Trichrome), and morphometric analyzes of the tissues were evaluated. H9c2 cells were treated with the following concentrations: 100 μM, 200 μM, 400 μM PA (PA), 15 mM, 30 mM glucose, and 0.3 mM, 0.5 mM, 1 mM 1.5 mM PFD. H9c2 cells viability under glucolipotoxicity were evaluated by MTT assay and Oil red O staining. The data were analyzed using one-way ANOVA followed by Tukey's post-hoc test in Graphpad Prism v10.0.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;HFHC mice developed MASH, myocarditis and fibrosis (P≤0.05). Additionally, resistin and AST levels significantly increased (P≤0.05). PFD prevented elevated parameters in HFHC mice (P≤0.05), such as body weight, epididymal fat weight, liver weight and heart weight; including body weight/tibia length ratio, heart weight/tibia length ratio and epididymal fat weight/tibia length ratio; hormone levels: insulin, glucagon, leptin, and plasminogen activator inhibitor-1 (PAI-1); lipid profile: total cholesterol, triglycerides, LDL, and VLDL; adipocyte hypertrophy, inflammatory foci, and fibrosis in liver and cardiac tissues. Additionally, PFD reduced ALT expression and tibia length (P≤0.05). The heart weight/body weight ratio decreased in HFHC mice (P≤0.05), PFD recovered this ratio (P≤0.05). H9c2 cells treated with 400 μM PA showed 50% cell viability (P≤0.05), all other concentrations of the compounds had cell viability &gt; 60% (P≤0.05), including H9c2 cells treated with 150 μM PA, 15 mM glucosa, and 1 mM PFD (P≤0.05). H9c2 cells treated with 150 μM and 200 μM PA showed a significant increase in intracellular lipid accumulation (P≤0.001), and H9c2 cells treated with 150 μM PA and 1.5 mM PDF showed a tendency to reduce intracellular lipid levels.&lt;/div&gt;&lt;div&gt;&lt;strong&gt;&lt;em&gt;Conclusions:&lt;/em&gt;&lt;/strong&gt; PFD restores the expression levels of metabolic hormones, which are involved in lipids and carbohydrates metabolism, improving lipid and aminotransferases levels, thus preventing myocarditis and fibrosis in MASH mice. These findings suggest the potential of PFD for the preventio","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101843"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to L-ornitine L-aspartate in a single intravenous dose in cirrhotic patients with overt hepatic encephalopathy.","authors":"Yvonne Tadeo-Jiménez,&nbsp;Karla E. Pérez-Reséndiz,&nbsp;Aleida Bautista-Santos,&nbsp;Rosalba Moreno-Alcántar","doi":"10.1016/j.aohep.2025.101852","DOIUrl":"10.1016/j.aohep.2025.101852","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in patients with acute and chronic liver disease; It is associated with a higher risk of new episodes and higher mortality at one year. L-ornithine L-aspartate (LOLA) is a stable salt that acts on two key ammonia detoxification pathways: urea synthesis and glutamine synthesis. Its intravenous administration has been studied with repeated doses and at high doses.</div><div>The objective is to describe the response to the administration of a single intravenous dose of L-ornithine L-aspartate in cirrhotic patients with an acute event of overt hepatic encephalopathy.</div></div><div><h3>Materials and Methods</h3><div>Type of study: Retrospective, transversal, observational, analytical, single-center.</div><div>Were included patients over 18 years of age, treated in the continuous admission service for acute event of manifest hepatic encephalopathy grade II to IV according to the West-Haven criteria, who received treatment based on L-ornihine L aspartate in a dose of 20 g. intravenous infusion for 4 hours, with evaluation of the response at the end of infusion. Study period: January 2022 to December 2023. Statistical analysis was performed with frequencies and percentages; For the quantitative variables Student's t or Mann-Whitney U according to the distribution of the variables and to show the difference between the degree of hepatic encephalopathy on admission and after the infusion of l-ornithine l-aspartate, Wilcoxon was used.</div></div><div><h3>Results</h3><div>72 patients with decompensated liver cirrhosis of any etiology were included, mostly Child-Pugh C functional class (56.9%), with a predominance of female sex (75%), and it was found that the most frequent triggering factor was constipation (22.2). %), followed by urinary tract infection (12.5%). Upon admission, the degree of encephalopathy was classified according to the West-Haven clinical scale of which grade II was the most prevalent, the single intravenous dose of L-ornithine, L-aspartate was effective with a significant response p&lt; 0.05</div></div><div><h3>Conclusions</h3><div>The response to a single intravenous dose of 20 g of l-ornithine l-aspartate is effective for the treatment of hepatic encephalopathy, clinically manifesting in an acute episode.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101852"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycogen storage disease, an uncommon cause of portal hypertension in adulthood.","authors":"Jessica Valencia Chávez ,&nbsp;José Luis Moras Villela ,&nbsp;Aleida Bautista Santos ,&nbsp;Fany Gabriela Juárez Aguilar","doi":"10.1016/j.aohep.2025.101853","DOIUrl":"10.1016/j.aohep.2025.101853","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Glycogen storage diseases are inborn errors of metabolism, with an estimated incidence of 1 in 10,000. Type IV represents 3% of this diseases (GBE1 gene 3p14 involvement), presenting with varied clinical features, including a milder form of hepatic involvement, with hepatic integrity described up to 19 years of age.</div></div><div><h3>Materials and Patients</h3><div>We present a 22-year-old woman with a history of low weight since childhood, she presented episodes of hematemesis and melena, and she underwent panendoscopy, documenting esophageal varices requiring variceal ligation. Extensive studies demonstrated indirect signs of portal hypertension, partial portal vein thrombosis, and multiple liver lesions, located in segments V, VI and VII, with an irregular heterogeneous morphology, partially defined borders, with a peripheral hypodense halo, the hyperdense center even in simple and porta phases, with the largest lesion being 8.2 × 7.8 × 8.1 cm. A defect in the filling of the left branch of the portal vein was identified, as well as compression of the right branch due to mass effect. Differential diagnoses included cholangiocarcinoma, hepatocellular carcinoma, and hepatic tuberculosis.</div></div><div><h3>Results</h3><div>Infectious-viral or autoimmune etiologies were ruled out through investigation. Percutaneous liver biopsy guided by ultrasound was performed. The histopathological report showed morphological findings suggestive of metabolic deposit disease. Tiny intracytoplasmic granules, PAS positive, F2 fibrosis on the metavir scale (Masson's trichrome staining); all of these findings consistent with glycogen storage disease type IV (branching enzyme deficiency) with non-progressive hepatic subtype was reached. Based on the history and evolution of the patient she was at the advanced stage of the disease with evidence of fibrosis and portal hypertension. She presented a torpid clinical course, with poor oral tolerance, we identified she had cardiomyopathy with left ventricular hypertrophy, manifesting with cardiac arrhythmia, managed with medical treatment.</div><div>This was a challenging case, as the diagnosis was made at an advanced stage of the disease, with multiple complications, limiting the prognosis and therapeutic options for the patient. She was referred to the genetics service for further evaluation.</div></div><div><h3>Conclusions</h3><div>We present a clinical case of a challenging diagnosis, due to the multiple clinical expressions and variants of glycogen storage disease. It can primarily affect the liver, heart, and neuromuscular system, according to enzymatic deficiency, with milder phenotypes having residual enzymatic activity.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101853"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver donor with hepatitis c virus false positive in negative recipient. A case report","authors":"Yenni J. Cruz-Ramírez,&nbsp;Reina S. Velez-Ramírez,&nbsp;Fancisco I García-Juarez,&nbsp;Norma N. Parra-Holguin","doi":"10.1016/j.aohep.2025.101834","DOIUrl":"10.1016/j.aohep.2025.101834","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The growing disparity that exists between the number of available donors and patients on the waiting list, transplant centers have presented initiatives to take into account patients diagnosed with hepatitis C virus (HCV), the objective of liver transplantation being the extension of the patient's life.</div></div><div><h3>Materials and Patients</h3><div>62-year-old female patient, with a diagnosis of liver cirrhosis diagnosed in 2012, secondary to primary biliary cholangitis (PBC). Evaluated in August 2023, a clinical approach was performed identifying uncontrolled liver cirrhosis, reporting in the last year she had three episodes of hepatic encephalopathy West Haven (WH) II and III, plus two events of upper gastrointestinal bleeding secondary to grade III esophageal varices performing 3-bundle variceal ligation, prognostic scales were calculated, Child Pugh B 8 points, MELD NA 15 POINTS, biochemistry: TORCH negative, profile for non-reactive hepatitis A, B and C viruses, non-reactive human immunodeficiency virus (HIV), positive PPD purified protein derivative skin test, evaluated by infectious disease who reports that he has latent tuberculosis with a plan to start treatment. Liver sonographic ultrasound (USG) was performed, reporting chronic liver disease, ascites, no portal hypertension, magnetic resonance imaging (MRI) of the liver: reported diffuse chronic liver disease, no evidence of tumor activity, ascites, decompensated portal hypertension, panendoscopy reported Dagradi III esophageal varices plus ligation of 3 variceal bundles. The liver transplant protocol is completed and presented to the liver transplant (LT) committee, referring the patient to be enlisted to be a liver recipient.</div></div><div><h3>Results</h3><div>Anti HCV 1.40 S/40 CO= REACTIVE Viral load of hepatitis c virus: RNA not detected.</div></div><div><h3>Conclusions</h3><div>In the following case, the donor presents positive antibodies for hepatitis C virus, a viral load is done reporting undetectable RNA, considering a false positive result, it is emphasized that if positive, there is no contraindication for the transplant, since previous studies have shown results similar to those of organ transplantation from HCV negative donors.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101834"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lophocereus schotti Polar Fraction Reduces TGFB1 Expression in Chemically Induced Hepatocarcinogenesis","authors":"Marina Campos-Valdez ,&nbsp;Jaime Sánchez-Meza ,&nbsp;Arturo Orozco-Barocio ,&nbsp;José A. Domíngez-Rosales ,&nbsp;Juliana M. Godínez-Rubí ,&nbsp;Sarai C. Rodríguez-Reyes ,&nbsp;Erika Matínez-López ,&nbsp;Miriam R. Bueno-Topete ,&nbsp;Manuel A. Castro-García ,&nbsp;Guillermo M. Zúñiga-González ,&nbsp;Laura V. Sánchez Orozco","doi":"10.1016/j.aohep.2025.101886","DOIUrl":"10.1016/j.aohep.2025.101886","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The anticancer effect of <em>Lophocereus schottii</em> polar fraction (LsPF) has been tested in models of lymphoma; however, its action in hepatocellular carcinoma remains to be elucidated. The present study aims to analyse the effect of LsPF on the progress of damage induced by diethylnitrosamine (DEN) and N-2-Fluorenylacetamide (2-AAF) chronic administration.</div></div><div><h3>Materials and Patients</h3><div>Male Wistar rats (180-200 g) were grouped as follows: a) Control (Ctl; n=5); no treatment (Tx), b) LsPF (n=4), treated with LsPF (50 mg/Kg i.g.) 3 times a week; c) Damage (Dmg; n=6), treated with DEN (50 mg/Kg, i.p) the first day, and with 2-AAF (25 mg/Kg, i.g.) on the third day; d) Damage+LsPF (Dmg+LsPF; n=5) received the Dmg group Tx; then, Tx with LsPF started to be administrated along with the Dmg Tx at the seventh week. The Txs were sustained for 13 weeks; livers and serum were collected afterward. Hematoxylin &amp; Eosin and Masson's Trichrome stains, and serum biochemistry were performed. Statistical parametric Student's t-tests or nonparametric Kruskal-Wallis and Mann-Whitney U were performed using the software GraphPad Prism, version 8. A <em>p</em> value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>In contrast to Ctl and LsPf groups, the weights of the groups administrated with Dmg Tx were decreased. Additionally, the Dmg Tx produced discoloration and tumors in the liver of the treated rats, and a significant increase in the ratio between the liver and animal weight. Furthermore, serum ALT, AST, ALKP, GGT, total bilirubin, and total proteins levels were increased; significant differences between the Dmg and the Dmg+LsPF groups were not found. The gene expression analysis demonstrated that expression of <em>CAT, SOD, COL1A,</em> and <em>TGFB1</em> was significantly increased in the Dmg groups compared to the Ctl group; when these results were compared to the Ctl and the Dmg+LsPF, significant differences were not found. Moreover, <em>TGFB</em>1 expression levels were lower in the Dmg+LsPF compared to Dmg group. LsFP tx increased the ALT and total protein levels in serum, and the expression of <em>CAT</em> and <em>COL1A</em> by itself. Nevertheless, the histological analysis did not display any alterations due to the administration of this fraction.</div></div><div><h3>Conclusions</h3><div>LsPF administration did not show a significant effect over the damage on the liver; however, the gene expression analysis provided indications that this fraction might be acting over genes related to HCC development.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101886"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplification of the diagnostic approach and treatment of Hepatitis C Virus.","authors":"Clara C. Sanchez-Rodriguez ,&nbsp;Ana M. Mendoza-Martínez ,&nbsp;Héctor R. Sánchez-Nuncio ,&nbsp;Jorge H. Luna-Domínguez","doi":"10.1016/j.aohep.2025.101806","DOIUrl":"10.1016/j.aohep.2025.101806","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Twenty-five years after the discovery of the hepatitis C virus (HCV), it is the chronic infection with the greatest impact on diagnosis and treatment. The objective of this study is to describe the simplification of HCV management for a cohort of 270 patients evaluated from 2018 to 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;A prospective cohort study was carried out to evaluate patients with HCV (Ac vs HCV +). In 2018 we had direct-acting antivirals (DAA) to treat HCV genotype 1; in addition to the HCV viral load (HCV RT-PCR), we required the viral genotype and liver elastography, 2019 we already had pan-fibrotic pangenotypic schemes, so genotype and liver elastography were excluded; however, due to the capacity of HCV to infect lymphocytes, screening prior to treatment with DAAs for diabetes, kidney disease, thyroid disease, rheumatic musculoskeletal disease, and associated proliferative disorders continues to be necessary. To B lymphocytes and in patients with cirrhosis determination of alpha fetoprotein (AFP) and liver ultrasound. In the clinical presence of cutaneous purpura, determination of cryoglobulins, rheumatoid factor and complement fractions, in addition to excluding coinfections with the Hepatitis B Virus and the human immunodeficiency virus. In the initial assessment, the risk factors for HCV were obtained by questioning. Patients who received treatment were evaluated every month during the months of treatment and the sustained viral response 12 weeks after completing treatment (SVR12) and every 6 months thereafter.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;269 patients with chronic HCV infection were included, sent from 11 first-level medical units and 3 second-level hospitals in Northeast Mexico. 53% were women with an average age of 54 years. The main risk factor identified was blood transfusion followed by intravenous drug use (IVDU). 28% had previous treatment with pegylated interferon and ribavirin. 30% had compensated cirrhosis. Fibrosis was calculated using the APRI algorithm, finding 53/130 with &gt;1.5 and 60/130 with &gt;3.25, which predicted F3-4. Liver elastography was performed in 55/130 patients, with 37 at F3-4. Among the diseases possibly related to chronic HCV infection we found 29 diabetes, 21 hypothyroidism, 9 cutaneous vasculitis with cryoglobulins, 1 diffuse large cell non-Hodgkin lymphoma, 1 monoclonal gammopathy of uncertain origin, 1 chronic lymphocytic leukemia and 3 cases of hepatocellular carcinoma., a patient with HCV relapse in a transplanted liver. Of these, 155 (58%) presented positive HCV RT-PCR with genotype 1 in 80% of the patients. 130 (84%) received treatment, the most used regimens were those based on sofosbuvir with SVR12 in 97% (Table 1).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The diagnostic approach and treatment of chronic HCV infection has been simplified with the rapid test for detection and mainly due to the safety of the new treat","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101806"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and outcome of acute kidney injury in hospitalized patients with cirrhosis, kidney injury and bacterial infection.","authors":"Karina Cazarin-Chávez,&nbsp;Paloma M. Diego-Salazar,&nbsp;Diego F. Abendaño-Rivera,&nbsp;Santiago Camacho-Hernández,&nbsp;Fatima Higuera-De la Tijera,&nbsp;José L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101823","DOIUrl":"10.1016/j.aohep.2025.101823","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Acute kidney injury (AKI) in hospitalized patients with cirrhosis occurs in 60%, is often precipitated and one cause is bacterial infections (BI), worsening the course of cirrhosis. The aim of this work is to report mortality and renal function outcomes in patients with cirrhosis, AKI and IB.</div></div><div><h3>Materials and Patients</h3><div>We analyzed a retrospective cohort from August 2022 to January 2023 with 201 patients (55.42±10.41 years, 52.7% men). We included patients with a diagnosis of decompensated cirrhosis secondary to different precipitants, including IB, who did or did not develop AKI. We report the frequency of AKI associated with IB and divide the population between those who presented with IB and those who did not. Qualitative data are expressed as percentages and quantitative data as mean±SD. Statistical comparison was performed with the two-tailed unpaired Student's t-test or chi-square, as appropriate Alpha=0.05<strong><em>.</em></strong></div></div><div><h3>Results</h3><div>The 73 patients with IB (54.48±9.58 years. 54.8% male) did not differ in age or sex compared to the 128 patients without IB (55.95±10.85 years, 51.6% male, p=0.65) (Figure 1). Patients with IB had a higher risk of mortality at 28 (42.5% vs. 6.3%, p&lt;0.0001) and 90 days (50.7% vs. 10.9%, p&lt;0.0001) (figure 2). Of the total patients who developed AKI with IB (78.1% vs. 43%), it was observed that they had the worse outcome of renal function (complete resolution 37%, incomplete resolution 9.6% and no resolution 31.5% vs 32.8%, 2.3% and 7.8%, p=0.0036), more days of in-hospital stay (7.64±5.31 days vs. 4.23±3.29, p&lt;0. 0001) and analyzing risk factors, they also had significantly higher creatinine numbers (2.26±1.38 vs. 1.43±1.01, p&lt;0.0001), as well as Child Pugh scores (A=1. 4%, B=15.1% and C= 83.6% vs. 18.8%, 46.1% and 35.2%, p&lt;0.0001), MELD Na (27.22±8.38 vs. 18.85±8.7, p&lt;0.0001) and ACLF grades (1=20.5%, 2=32.9% y 3=13.7% vs. 14.1%, 7.8% y 1.6%, p&lt;0.0001). Urinary tract infection 32 (43.8%) was the most frequent type of infection<strong><em>.</em></strong></div></div><div><h3>Conclusions</h3><div>In patients with cirrhosis, AKI associated with IB increases mortality and worsens renal function outcome. Therefore, IB is not only a precipitant of cirrhosis decompensations but also represents a significant risk factor for a severe clinical course.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101823"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Liver Failure: Cohort of patients treated at the La Raza National Medical Center Specialty Hospital.","authors":"Karenn Garcia-Campos,&nbsp;Francisca Martinez-Silva","doi":"10.1016/j.aohep.2025.101814","DOIUrl":"10.1016/j.aohep.2025.101814","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Identify the clinical, biochemical behavior, complications and mortality of patients with acute liver failure admitted to the hospital.</div></div><div><h3>Materials and Patients</h3><div>A descriptive, cross-sectional and retrospective observational study was carried out on all patients who entered the gastroenterology service of the CMN La Raza Specialty Hospital from April 2022 to April 2024 with a diagnosis of Acute Liver Failure. Information was taken from the electronic medical, radiological and laboratory care records. Taking demographic data, clinical and biochemical behavior of the patients, the presence of complications, comorbidities and the outcome. The results were analyzed using measures of central tendency to obtain percentages and arithmetic mean.</div></div><div><h3>Results</h3><div>78 patients admitted to the service in this period were registered, of them 11 women (14%) and 67 men (85.4%). The average age was 34.7 years (18-64 years). The most frequent cause was attributable to Hepatitis A virus (61%), autoimmune hepatitis (9.75), acute fatty liver of pregnancy (7.3%); However, in 9.7% of patients, no cause was determined (Graphic 1). More than half of the patients presented without other comorbidity (58.5%). Of the patients with comorbidities, Systemic Arterial Hypertension was the most frequent in 17%. The most frequent complications were acute kidney injury (78%), ascites (14.6%), metabolic acidosis (14.6%); upper gastrointestinal bleeding (12.1%) and diffuse cerebral edema (9.7%). Some patients required some type of renal function replacement therapy, such as Hemodialysis (19.5%). 7.3% required therapy with PRISMA and 34.1% with MARS. Mortality is significant in 48.7% of patients despite therapy. Of the patients, 28.2% met transplant criteria, and only 25% of these were transplanted (Table 1).</div></div><div><h3>Conclusions</h3><div>We have noticed an increase in the incidence of Acute Liver Failure in general, highlighting this in young patients of economically productive age and reproductive age, which emphasizes enhancing prevention campaigns in vaccination against virus A in this population, being the cause, of more frequent in our cohort.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101814"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}