Cholestatic liver disease blood

Xanthomas xanthoma tuberosum) display a straw-like yellow through to greyish yellow hue. These are round, well circumscribed, plaque-like raised or papuloid deposits in the skin, which predominantly occur on the extensor sides of the extremities, the elbow and knee area, the external ear, parts of the buttocks and back, occasionally also on the hands and soles of the feet. They can appear in cholestatic liver diseases, particularly in biliary cirrhosis as a result of CDNC. Their occurrence depends on the lipid and cholesterol content of the blood, (l) These changes are considered to be late symptoms, (s. p. 235) (s. figs. 4.15, 4.16)... 

Cholestatic liver disease may occur in infancy. One particularly severe symptom is the inability to walk. The neurological symptoms can be treated with weekly injectiorrs of 100 mg a-tocopherol over half a year. Vitamin E deficiency in newborns has been associated with hemolytic anemia. Anemia is a decreased eoncen-trahon of red blood cells in whole blood as well as a drop in the hemoglobin level... 

The possible hnk between hypermanganesemia and cholestasis has been investigated in patients receiving long-term parenteral nutrition (68). The authors concluded that cholestatic liver disease does not contribute to increased blood manganese concentrations in such patients, and that plasma concentrations reflect recent manganese exposure and impaired excretion when cholestasis is present. They also emphasized that serum concentrations are a poor marker and that erythrocyte manganese concentrations should be used instead. 

Children who suffer from cholestatic liver disease or who have gastrointestinal disorders that mandate they be given parenteral nutrition may be at increased risk from overexposure to manganese. Increased manganese concentrations in blood and brain, and symptoms of neuromotor dysfunction were observed in an... 

The clinical usefulness of the LP-X test is well established in the literature. The cumulative specificity is almost 100%. This means that persons without cholestasis can be classified very accurately. Consequently the positive predictive value is almost 100%. This means, the presence of LP-X invariably indicates cholestasis, i.e., the presence of biliary lipids in the blood. The quantitative determination of LP-X is useful in the differentiation of mechanical cholestasis and cholestatic hepatitis. In hepatitis the relative contribution of LP-X to total cholesterol is much higher than in mechanical cholestasis. A high percentage of cholesterol carried by LP-X in combination with a GPT activity below 100 U/1 is helpful in ruling out metastatic liver disease. 

The Increase In AP activity is stimulated by bile acids. A rise in bile acids, which is considered to be the most sensitive and earliest marker of cholestasis, precedes any elevation in AP. The latter derives from enzyme synthesis with increased secretion into the blood. Under pathological conditions, bile duct AP is formed, which is a sensitive marker for hepatobiliary diseases, cholestasis and space-occupying lesions of the liver. The sensitivity is 80-100% in cholestatic diseases. AP activity is usually higher in obstructive jaundice and cholangitis than in intrahepatic obstructions, and it is highest in the vanishing bile duct disease or in complete obstruction. (13, 39, 41) (s. tabs. 5.9 13.2-13.4)... 

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