RESUMEN
So as to assess the effects of lithium carbonate on peripheral leucocyte levels of hepatic cirrhosis patients, 10 cirrhotic patients were studied with less than 4,500 leukocytes per cubic ml and without contraindications for lithium salts that were administered for three weeks at a dose of 90 mg daily. At the end of each week total peripheral leukocytes, differential formula, platelet count and serum lithium concentration determinations were made. In the basal stage, total leukocyte average was 3,400 +/- 527 (X +/- DE) and granulocyte average was 2,090 +/- 341. After the first week of lithium treatment a significant increase was observed in total leukocyte and granulocyte levels whose averages at the end of the third week of treatment were 4,800 +/- 1,052 (p less than 0.01) and 3,694 +/- 1,003 (p less than 0.001) respectively. There was no correlation between the magnitude of leukocyte increase and serum lithium levels obtained that ranged from 0.28 and 1.32 mEq/l. Three patients showed transient gross tremor and two suffered hepatic coma. We can conclude that lithium carbonate increases peripheral leucocytes at the expense of neutrophilia in patients with secondary granulocytopenia and hypersplenism resulting in liver cirrhosis.
Asunto(s)
Leucocitos/efectos de los fármacos , Litio/farmacología , Cirrosis Hepática Alcohólica/tratamiento farmacológico , Anciano , Femenino , Ácido Fólico/uso terapéutico , Granulocitos/efectos de los fármacos , Encefalopatía Hepática/etiología , Humanos , Recuento de Leucocitos , Litio/efectos adversos , Litio/sangre , Litio/uso terapéutico , Carbonato de Litio , Cirrosis Hepática Alcohólica/complicaciones , Masculino , Persona de Mediana Edad , Temblor/inducido químicamenteRESUMEN
Liver biopsy was taken from 20 patients with chronic and acute alcoholism. The patients had been hospitalized for diverse reasons, had no clinical manifestations of alcoholic hepatitis nor cirrhosis, but did have abnormal liver function tests. The most common abnormal test results were low serum albumin, polyclonal gamma-globulin elevation, and S G O T and Alk P rise. In all patients one or more types of hepatic lesiones were found: steatosis (15), polynuclear and mononuclear infiltrates (15), and portal (7), interstitial (13), or centriobular (8) fibrosis. Two patients had cirrhosis. None had hepatic cell necrosis. These findings justify a motivated search for liver damage in patients with alcoholism who have slight alterations in liver function tests, even in the absence of clinical manifestations of liver disease.
Asunto(s)
Hepatopatías Alcohólicas/patología , Adulto , Anciano , Femenino , Humanos , Hepatopatías Alcohólicas/diagnóstico , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
It was diagnosed hypothyroidism in a 53-year-old man with chronic renal failure, with blood urea of 306 mg/dl and serum creatinine of 14.9 mg/dl. At three months of triiodothyronine therapy, the patient became asymptomatic and blood urea and serum creatinine diminished to 49 and 1.1 mg/dl respectively. The possible mechanisms responsible of that reversible uremia of such unusual amount in this hypothyroid patient are discussed.