Document Detail

"Acute liver failure": the heart may be the matter.
MedLine Citation:
PMID:  21837938     Owner:  NLM     Status:  MEDLINE    
Hypoxic hepatitis secondary to heart failure is a known and treatable cause of liver failure. The diagnosis may be difficult, especially when symptoms of heart failure are absent. We present two patients who were transferred to our hospital with the diagnosis of acute liver failure to be screened for a liver transplantation. Both patients had increased serum levels ofaminotransferases, lactic acidosis, coagulation disorders, and non-specific clinical symptoms. Echocardiography revealed right ventricular dysfunction. Treatment with inotropes resulted in a fast normalization of liver enzymes, acidosis and coagulation, confirming the diagnosis hypoxic hepatitis. In conclusion, when the cause of acute liver dysfunction is unclear, hypoxic hepatitis due to heart failure should be considered and echocardiography should be performed, even when symptoms are non-specific for heart failure.
K de Leeuw; J H J M Meertens; I C C van der Horst; A P van der Berg; J J M Ligtenberg; J E Tulleken; J G Zijlstra
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta clinica Belgica     Volume:  66     ISSN:  1784-3286     ISO Abbreviation:  Acta Clin Belg     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-08-15     Completed Date:  2011-09-06     Revised Date:  2014-03-18    
Medline Journal Info:
Nlm Unique ID:  0370306     Medline TA:  Acta Clin Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  236-9     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Anoxia / complications*
Diagnosis, Differential
Heart Failure / complications*,  ultrasonography
Hepatitis / diagnosis,  etiology*
L-Lactate Dehydrogenase / blood
Liver / enzymology
Liver Failure / diagnosis,  etiology*
Middle Aged
Transaminases / blood
Ventricular Dysfunction, Left / complications,  ultrasonography
Reg. No./Substance:
EC Dehydrogenase; EC 2.6.1.-/Transaminases

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