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Benign Liver Tumors

Abbreviations AFP α-fetoprotein CEA carcinoembryonic antigen CRP C-reactive protein CT computed tomography FNH focal nodular hyperplasia Gd-BOPTA gadobenate dimeglumine GGT γ-glutamyl transpeptidase HCA hepatocellular adenoma HCC hepatocellular carcinoma HNF1α hepatocyte nuclear factor 1α HUMARA human androgen receptor assay IL-6 interleukin 6 Mn DPDP manganese dipyridoxal diphosphate MRI magnetic resonance imaging NRH nodular regenerative hyperplasia RES reticuloendothelial system SAA serum amyloid A SPECT single-photon emission CT Introduction…

Other Malignant Hepatic Tumors

Abbreviations AFP alpha fetoprotein FLHCC fibrolamellar hepatocellular carcinoma HCC hepatocellular carcinoma LT liver transplantation NHL non-Hodgkin lymphoma RCT randomized controlled trial SEER Surveillance, Epidemiology, and End Results TACE transarterial chemoembolization TARE transarterial radioembolization Introduction Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common primary liver cancers. These malignant tumors were discussed in Chapters 46 and 47 . The goal of this chapter is to discuss…

Cholangiocarcinoma

Abbreviations ABC-2 Advanced Biliary Cancer 2 CCA cholangiocarcinoma CDK cell division kinase CI confidence interval COX-2 cyclooxygenase 2 CT computed tomography EBRT external-beam radiation therapy EGF epidermal growth factor EGFR epidermal growth factor receptor ERC endoscopic retrograde cholangiography EUS endoscopic ultrasound FISH fluorescence in situ hybridization FGFR-2 fibroblast growth factor receptor 2 FLIP FLICE-inhibitory protein HBV hepatitis B virus HCC-CCA hepatocellular-cholangiocellular carcinoma HCV hepatitis C virus…

Hepatocellular Carcinoma

Abbreviations DM diabetes mellitus EGF epidermal growth factor HBV hepatitis B virus HCC hepatocellular carcinoma HCV hepatitis C virus HDV hepatitis D virus IGF insulin-like growth factor LI-RADS Liver Imaging Reporting and Data System PDGF platelet-derived growth factor SEER Surveillance, Epidemiology, and End Results VEGF vascular endothelial growth factor Introduction Hepatocellular carcinoma (HCC) is the most common primary liver cancer, with an incidence rate climbing each…

Portal and Splenic Vein Thrombosis

Abbreviations CALR calreticulin CT computed tomography JAK2 Janus kinase 2 MPN myeloproliferative neoplasm MTHFR methylenetetrahydrofolate reductase MVT mesenteric venous thrombosis PVT portal vein thrombosis TIPS transjugular intrahepatic portosystemic shunt Introduction The term portal vein thrombosis (PVT) refers to the development of a thrombus in the portal vein. The thrombus can extend into any of the right and left branches of the portal vein, the superior or…

Budd-Chiari Syndrome and Sinusoidal Obstruction Syndrome

Abbreviations AFP α-fetoprotein BCS Budd-Chiari syndrome BM bone marrow DIPS direct intrahepatic portosystemic shunt ET essential thrombocythemia HCC hepatocellular carcinoma HCT hematopoietic cell transplantation HV hepatic vein IMF idiopathic myelofibrosis IVC inferior vena cava JAK Janus kinase LSECs liver sinusoidal endothelial cells LT liver transplantation MPN myeloproliferative neoplasm NRH nodular regenerative hyperplasia PV polycythemia vera PVT portal vein thrombosis SOS sinusoidal obstruction syndrome TIPS transjugular intrahepatic…

Primary and Secondary Sclerosing Cholangitis

Abbreviations AIH autoimmune hepatitis ALP alkaline phosphatase ALT alanine aminotransferase AMA antimitochondrial antibody ANA antinuclear antibody AST aspartate aminotransferase CA carbohydrate antigen ERC endoscopic retrograde cholangiography FISH fluorescence in situ hybridization GWAS genome-wide association studies HLA human leukocyte antigen IBD inflammatory bowel disease IgG4 immunoglobulin G4 IL-6 interleukin-6 MRC magnetic resonance cholangiography NK natural killer pANCA perinuclear antineutrophil cytoplasmic antibody PBC primary biliary cholangitis PSC primary…

Primary Biliary Cholangitis

Abbreviations AE2 anion exchanger 2 AIH autoimmune hepatitis ALP alkaline phosphatase ALT alanine aminotransferase AMA antimitochondrial antibody ANA antinuclear antibody APRI AST to platelet ratio index AST aspartate aminotransferase ATX autotoxin BMD bone mineral density BSEP 4 bile salt export pump 4 CT computed tomography CTLA-4 cytotoxic T-lymphocyte antigen 4 ELF enhanced liver fibrosis ELISA enzyme-linked immunosorbent assay FXR farnesoid X receptor FIS Fatigue Impact Scale…

Autoimmune Hepatitis

Abbreviations AIH autoimmune hepatitis ANA antinuclear antibody ANCA antineutrophilic cytoplasmic antibody CARD10 caspase recruitment domain family member 10 CTLA-4 cytotoxic lymphocyte antigen-4 DILI drug-induced liver injury ELISA enzyme-linked immunosorbent assay ENA extractable nuclear antigen LC liver cytosol LKM liver kidney microsomes MHC major histocompatibility complex PBC primary biliary cholangitis SLA/LP soluble liver antigen/liver pancreas SLE systemic lupus erythematosus SMA smooth muscle autoantibody SNP single nucleotide polymorphism…

Bacterial and Miscellaneous Infections of the Liver

Abbreviations ADPKD autosomal-dominant polycystic kidney disease AIDS acquired immunodeficiency syndrome APACHE II Acute Physiologic Assessment and Chronic Health Evaluation II APC antigen-presenting cell AS anastomotic stricture AST American Society of Transplantation ASTS American Society of Transplant Surgeons BSI blood stream infection BTI biliary tract infection BUN blood urea nitrogen CC choledocholedochostomy CD cluster of differentiation CDC Centers for Disease Control and Prevention CJ choledochojejunostomy CMV cytomegalovirus…

Parasitic Liver Disease

Abbreviations ALA amebic liver abscess CAA circulating anodic antigen CCA circulating cathodic antigen CIE counterimmunoelectrophoresis EDHS Egypt Demographic and Health Survey ELISA enzyme-linked immunosorbent assay ERCP endoscopic retrograde cholangiopancreatography GASP gut-associated schistosome proteoglycan HCV hepatitis C virus HIV human immunodeficiency virus IFA indirect immunofluorescence assay IHA indirect hemagglutination PAIR puncture, aspiration, injection, reaspiration PCR polymerase chain reaction PPF periportal fibrosis PZQ praziquantel T H 1 T…

Liver Disease Associated With Systemic Viral Infection

Abbreviations AIDS acquired immunodeficiency syndrome ALT alanine aminotransferase AST aspartate aminotransferase CMV cytomegalovirus DHF dengue hemorrhagic fever DSS dengue shock syndrome EBV Epstein-Barr virus ELISA enzyme-linked immunosorbent assay HAART highly active antiretroviral therapy HHV human herpesvirus HIV human immunodeficiency virus HSV herpes simplex virus IgG immunoglobulin G IgM immunoglobulin M PTLD posttransplant lymphoproliferative disease RT-PCR reverse transcription polymerase chain reaction SARS severe acute respiratory syndrome VZV…

HIV and the Liver

Abbreviations ALT alanine aminotransferase APRI AST to platelet ratio index AST aspartate aminotransferase cART combination antiretroviral therapy FIB-4 fibrosis 4 score HA hyaluronic acid HAV hepatitis A virus HBV hepatitis B virus HCC hepatocellular carcinoma HCV hepatitis C virus HDV hepatitis Delta virus HEV hepatitis E virus HIV human immunodeficiency virus MRE magnetic resonance elastography NAFLD/NASH nonalcoholic fatty liver disease/nonalcoholic steatohepatitis TE transient elastography TRAIL TNF-related…

Hepatitis E

Abbreviations ALT alanine aminotransferase FHF fulminant hepatic failure GBS Guillain-Barré syndrome HEV hepatitis E virus HIV human immunodeficiency virus ORF open reading frame Introduction For many years hepatitis E virus (HEV) was thought to be largely restricted to endemic developing countries and only of clinical relevance in developed countries in returning travelers. In the last few years this notion has been shown to be mistaken, as…

Hepatitis A

Abbreviations HAV hepatitis A virus IgG immunoglobulin G IgM immunoglobulin M Introduction The hepatitis A virus (HAV) is a nonenveloped, small, single-stranded RNA picornavirus that replicates within hepatocytes, producing symptomatic or asymptomatic infection in humans. Hepatitis A induces an immune response that causes hepatic inflammation and interferes with hepatic function. Hepatitis A leads to an acute and generally self-limited infection with symptoms including fever, nausea, abdominal…

Hepatitis D

Abbreviations ALT alanine aminotransferase HBsAg hepatitis B surface antigen HBV hepatitis B virus HCC hepatocellular carcinoma HCV hepatitis C virus HDV hepatitis delta virus Introduction Hepatitis delta virus (HDV) is the sole member of the genus Deltavirus and is estimated to infect 15 million to 20 million people of all age groups worldwide. HDV is a human pathogen, and HDV infection can exist as an acute…

Treatment of Hepatitis B

Abbreviations ALT alanine aminotransferase anti-HBc hepatitis B core antibody anti-HBe hepatitis B e antibody anti-HBs hepatitis B surface antibody Cas9 clustered regularly interspaced short palindromic repeats–associated 9 CHB chronic hepatitis B CRISPR clustered regularly interspaced short palindromic repeats HBeAg hepatitis B e antigen HBsAg hepatitis B surface antigen HBV hepatitis B virus HCC hepatocellular carcinoma HIV human immunodeficiency virus IFN interferon NUC nucleoside/nucleotide analog PEG-IFN pegylated…

Epidemiology, Diagnosis, and Natural History of Hepatitis B

Abbreviations AFP α-fetoprotein ALT alanine aminotransferase anti-HBc hepatitis B core antibody anti-HBe hepatitis B e antibody anti-HBs hepatitis B surface antibody APRI AST to platelet ratio index AST aspartate aminotransferase GGT γ-glutamyl transpeptidase GN glomerulonephritis HBcAg hepatitis B core antigen HBeAg hepatitis B e antigen HBsAg hepatitis B surface antigen HBV hepatitis B virus HCC hepatocellular carcinoma HCV hepatitis C virus HDV hepatitis D virus HIV…

Virology and Pathogenesis of Hepatitis B

Abbreviations ALT alanine aminotransferase cccDNA covalently closed circular DNA HBeAg hepatitis B e antigen HBV hepatitis B virus HCC hepatocellular carcinoma HCV hepatitis C virus IFN interferon LT lymphotoxin NTCP sodium-taurocholate cotransporting polypeptide NK natural killer pgRNA pregenomic RNA rcDNA relaxed circular DNA Introduction Hepatitis B virus (HBV) has had a very long and successful relationship with humans. The detection of hepadnavirus genomes in Mesozoic birds…

Treatment of Hepatitis C

Abbreviations AASLD American Association for the Study of Liver Diseases AUC area under the curve CKD chronic kidney disease CYP3A cytochrome P450 3A DAA direct-acting antiviral DNA deoxyribonucleic acid DRESS drug reaction, eosinophilia, systemic symptoms ESRD end-stage renal disease GFR glomerular filtration rate HCC hepatocellular carcinoma HCV hepatitis C virus HIV human immunodeficiency virus IDSA Infectious Diseases Society of America IL-28B interleukin-28B P-gp P-glycoprotein Peg-IFN pegylated…