vitamin-b-12 and Hepatitis--Chronic

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Amino Acids; Anabolic Agents; Diet; Diet Therapy; Diuretics; Fatty Acids; Fatty Acids, Essential; Folic Acid; Glucose; Hepatitis; Hepatitis A; Hepatitis, Chronic; Humans; Liver Extracts; Steroids; Vitamin B 12; Vitamin B Complex

In a controlled field study of three years' duration we evaluated the effect of cobalt supplementation on pathological changes in cobalt/vitamin B12-deficient Texel twin lambs grazing the same cobalt-deficient pasture. Semi-quantitative evaluation of the histopathology of liver and brain was done on 44 sets of twins. Pathological changes were related to blood concentrations of vitamin B12, methylmalonic acid, and homocysteine. Lesions were mainly confined to the liver and brain. Acute hepatic changes were characterized by steatosis, hepatocytic degeneration, and single cell necrosis. Chronic changes consisted of bile duct proliferation, the presence of ceroid containing macrophages, and fibrosis in the portal triads. Many non-supplemented lambs showed polymicrocavitation and Alzheimer type II reaction in the brain. Polioencephalomalacia was observed in three non-supplemented lambs but was regarded as a secondary lesion. Our results indicate that the main lesions found in cobalt/vitamin B12-deficient lambs are acute and chronic hepatitis. These lesions were associated with low concentrations of vitamin B12 and high concentrations of methylmalonic acid and homocysteine in the blood. The liver lesions were also associated with polymicrocavitation of the brain, probably as morphological evidence of hepatoencephalopathy.

Topics: Animals; Brain; Brain Diseases; Cobalt; Copper; Diet; Female; Hepatitis, Chronic; Homocysteine; Litter Size; Liver; Male; Methylmalonic Acid; Sheep; Sheep Diseases; Twins; Vitamin B 12; Vitamin B 12 Deficiency

Idiopathic non-cirrhotic intrahepatic portal hypertension (NCIPH) is often mis-diagnosed as cryptogenic cirrhosis. Serum vitamin B12 levels can be raised in cirrhosis, probably because of excess release or reduced clearance. Because NCIPH is characterised by long periods of preserved liver function, we examined whether serum B12 level could be used as a marker to differentiate NCIPH from cryptogenic cirrhosis.. We analysed serum B12 levels in 45 NCIPH and 43 cryptogenic cirrhosis patients from January 2009 to September 2011.. Serum B12 levels were significantly lower in NCIPH patients than in cryptogenic cirrhosis patients (p < 0.001) and were useful in differentiating the two disorders (area under ROC: 0.84; 95% C.I: 0.76-0.93). Low serum B12 level (≤250 pg/ml) was noted in 25/72 (35%) healthy controls, 14/42 (33%) NCIPH patients, and 1/38 (3 %) cryptogenic cirrhosis patients. In patients with intrahepatic portal hypertension of unknown cause, serum B12 level ≤ 250 pg/ml was useful for diagnosing NCIPH (positive predictive value: 93 %, positive likelihood ratio 12.7), and serum B12 level >1,000 pg/ml was useful in ruling out NCIPH (negative predictive value: 86 %, negative likelihood ratio: 6.67). Low serum B12 levels (≤250 pg/ml) correlated with diagnosis of NCIPH after adjusting for possible confounders (O.R: 13.6; 95% C.I:1.5-126.2). Among patients in Child's class A, serum B12 level was ≤250 pg/ml in 14/35 NCIPH patients compared with 1/21 cryptogenic cirrhosis patients (O.R: 13.3; 95% C.I: 1.6-111).. Serum vitamin B12 level seems to be a useful non-invasive marker for differentiation of NCIPH from cryptogenic cirrhosis.

Topics: Adolescent; Adult; Aged; Biomarkers; Child; Female; Hepatitis, Chronic; Humans; Hypertension, Portal; Male; Middle Aged; Odds Ratio; Vitamin B 12; Young Adult

Macrocytosis is most commonly associated with vitamin B(12) and folic acid deficiency, followed by alcoholism, liver disease, and other pathologic conditions. We studied the red cell and vitamin status in 423 consecutive patients with various liver diseases, including 31 with acute viral hepatitis (AVH), 105 with chronic hepatitis (CH), and 134 with alcoholic liver disease (ALD), who consisted of 84 with non-cirrhotic alcoholic liver disease (NCALD) and 50 with alcoholic liver cirrhosis (ALC), 60 with non-alcoholic liver cirrhosis (NALC), and 93 with hepatocellular carcinoma (HCC). The mean corpuscular volume (MCV) and red cell distribution width (RDW) were significantly higher in patients with ALD and NALC, and among them macrocytosis occurred more frequently in patients with ALC. Macrocytic anemia was mostly found in cirrhotic patients, in which the Child-Pugh score was closely related to the development of macrocytic anemia. In ALD, the MCV was significantly correlated with the estimated alcohol consumption and inversely correlated with the serum folic acid level, which, however, was often maintained within the normal range in patients with macrocytic ALC. After abstinence from alcohol, the MCV and RDW were reduced significantly and were associated with an increasing serum folic acid level. This suggests that macrocytic anemia was a common feature of alcoholic and non-alcoholic liver cirrhosis and that alcohol abuse and folic acid deficiency play a secondary role in macrocytosis.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Macrocytic; Erythrocyte Aging; Erythrocyte Indices; Female; Folic Acid; Hepatitis, Chronic; Hepatitis, Viral, Human; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Vitamin B 12

Topics: Alanine Transaminase; Alkaline Phosphatase; Aspartate Aminotransferases; Bilirubin; Biomedical Research; Biopsy; Blood; Clinical Enzyme Tests; Hepatitis; Hepatitis A; Hepatitis, Chronic; Humans; Liver Cirrhosis; Vitamin B 12

Topics: Cobalt Isotopes; Gastrointestinal Tract; Hepatitis; Hepatitis A; Hepatitis, Chronic; Humans; Liver; Metabolism; Radioisotopes; Radionuclide Imaging; Spleen; Urine; Vitamin B 12

Topics: Blood; Bone and Bones; Bone Marrow; Corrinoids; Hepatitis; Hepatitis A; Hepatitis, Chronic; Humans; Vitamin B 12

Topics: Chemical and Drug Induced Liver Injury; Corrinoids; Cytochromes; Hepatitis; Hepatitis, Chronic; Prednisolone; Vitamin B 12

Topics: Hepatitis; Hepatitis A; Hepatitis, Chronic; Humans; Liver Cirrhosis; Vitamin B 12