RESUMO
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.
Assuntos
Leucócitos/efeitos dos fármacos , Lítio/farmacologia , Cirrose Hepática Alcoólica/tratamento farmacológico , Idoso , Feminino , Ácido Fólico/uso terapêutico , Granulócitos/efeitos dos fármacos , Encefalopatia Hepática/etiologia , Humanos , Contagem de Leucócitos , Lítio/efeitos adversos , Lítio/sangue , Lítio/uso terapêutico , Carbonato de Lítio , Cirrose Hepática Alcoólica/complicações , Masculino , Pessoa de Meia-Idade , Tremor/induzido quimicamenteRESUMO
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.