Diagnosis Of Alcoholic Liver Disease Research Articles

The relevance of IgA deposits in vessel walls of clinically normal skin. A prospective study.

Granular deposits of IgA are known to occur in the walls of superficial vessels in apparently healthy skin of patients with primary IgA nephropathy, Henoch-Schönlein purpura, or alcoholic liver disease, but the specificity of the finding is still a matter of debate. We investigated the disease specificity of these deposits in the skin of patients with kidney and liver diseases. The sensitivity of the finding for the diagnosis of primary IgA was 75%, the specificity was 88%. The sensitivity for the diagnosis of alcoholic liver disease was 71%, but the specificity was only 60%. The specificity for the diagnosis of Henoch-Schönlein purpura, primary IgA nephropathy, or alcoholic disease (in a group of 1,030 patients with various diseases) was 94%. Immunoelectron-microscopic investigation showed the IgA deposits localized within the endothelial cell and in the subendothelial rim.

Discriminant analysis of biochemical tests in the diagnosis of alcoholic liver disease

Discriminant analysis of biochemical tests in the diagnosis of alcoholic liver disease

Peritoneoscopic diagnosis of alcoholic liver disease (ALD)

Peritoneoscopic diagnosis of alcoholic liver disease (ALD)

The diagnosis of alcoholic liver disease

We thank Dr. Cox for his comments on our recently published study. Technetium-99m HIDA and related compounds do indeed localise in the hepatocyte rather than in the reticulo-endothelial system. However, their rapid transit through the liver makes it impossible to use them for the study of intrahepatic disease unless functional images or activity time curves are derived in the manner he suggests.

Problems in the necropsy diagnosis of alcoholic liver disease.

Problem areas in the necropsy diagnosis of alcoholic liver disease are reviewed, potential sources of confusion delineated, and diagnostic guidelines proposed. The entire spectrum of alcoholic liver disease, including alcoholic hepatitis, may be perfectly mimicked by severe obesity, diabetes, and perhexiline maleate toxicity. Focal fatty change in the liver introduces sampling errors in the assessment of steatosis. Nodular regenerative hyperplasia of the liver mimics a micronodular cirrhosis both clinically and macroscopically. Measurement of the liver iron concentration reliably differentiates between alcoholic liver disease with siderosis and idiopathic hemochromatosis. The evaluation of preexisting fibrosis or cirrhosis in cases of massive hepatic necrosis is aided by stains for elastic fibers. Alcohol abusers taking acetaminophen (paracetamol) in excessive, but not suicidal doses are at risk of developing fatal "late" acetaminophen hepatotoxicity. Fatal viral hepatitis may be overlooked in an alcoholic with preexisting liver disease.

A comparison of computed tomography, ultrasound and scintigraphy in the diagnosis of alcoholic liver disease

In 35 alcoholics with histologically proven liver disease, computed tomography (CT), grey scale ultrasonography and liver scintigraphy were evaluated for their abilities to detect an abnormal liver and to identify the patients with cirrhosis. Abnormal studies were present on CT in 83% of patients, in 64% on ultrasound and in 94% on scintigraphy. In 10 control patients specificity was 90% by CT, 100% by ultrasound and 70% by scintigraphy. CT and ultrasound were poor in identifying the alcoholics with cirrhosis. Scintigraphy suggested cirrhosis in all but one of the patients with this diagnosis. Similar images were obtained in half of the patients with fatty change without cirrhosis but, with the exception of one patient, this appeared to be due to co-existent hepatitis. The results suggest that scintigraphy is the best of the imaging tests for screening alcoholics for cirrhosis.

Pattern of Changes in Gammaglutamyl Transpeptidase in Chronic Alcoholics

Serum Gammaglutamyl transpeptidase (YGT) was measured by autoanalyzer in 15 hospitalized chronic alcoholics (M=13; F=2) on admission and at weekly intervals during their treatment. The patients abstained from drinking totally. YGT showed a 37% reduction during the first week, 40% during the second on the average and reduction continued over the next 3–4 weeks towards normal. The present status of YGT in the diagnosis of alcoholic liver disease (ALD) has been briefly reviewed. YGT has been found to be a reliable biochemical marker to monitor progress, hepatic recovery, treatment, claimed abstinence and also for detecting early alcoholics.