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C J Lüders

Publications and source records attributed to C J Lüders.

At least 19 recordsLinked to original sources
PubMed1991

[The incidence of endemic sprue/celiac disease in Berlin (West). A prospective study with short discussion of a case].

This study was carried out between June 1986 and May 1988 in Berlin (West). In cooperation with 5 Pathological Departments, we prospectively recorded every bioptical diagnosis of total/subtotal villus atrophy (group S) or of partial villus atrophy (group SV). In addition, we registered anamnestic, clinical and laboratory findings from these patients. The diagnosis of coeliac disease was considered verified if the patient showed an unequivocal improvement of his clinical conditions and laboratory findings within three months on a gluten-free diet. In total, 42 patients were registered, among them were 29 with mucosal alterations typical for coeliac disease and 13 whose biopsies showed partial villus atrophy. The diagnosis of coeliac disease could be verified in 28 patients, among them one woman with intestinal lymphoma after longstanding untreated coeliac disease. A second patient with complete villus atrophy had intestinal lymphoma but without preceeding coeliac disease. Our findings show that the incidence of coeliac disease in Berlin is 1 out of 2113 newborn children. This figure is similar to the data reported from France, yet being clearly lower than those from Western Ireland, Switzerland and Sweden. Women are affected twice as often as men. 20 out of 28 patients were children under five years of age. The most common symptoms were meteorism/flatulence, recurrent diarrhea, loss of body weight, or inappropriate growth. 70% of the patients suffered from anaemia, the D-Xylose-test was pathological in 92% of the patients.

Aged↗
PubMed1987

[Incidence of endemic sprue in Berlin (West). A retrospective study based on biopsy findings].

The incidence of celiac disease in Berlin (West) during the years 1979-1984 has been studied retrospectively by investigating the records of the local Pathological Institutes, which examine small intestinal biopsies, for the occurrence of abnormal specimens typical of celiac disease (group 1) or consistent with the diagnosis of celiac disease (group 2). Group 1 exhibited a constant average incidence of 0.74 per 100,000 inhabitants per year, while group 2 showed a small increase between 1979 and 1984, averaging 1.03 per 100,000 inhabitants per year. Classified according to age the highest incidence was seen in the 0-5 year-olds, namely 8.04 in group 1 and 10.00 in group 2. For those children born and examined during the period of investigation the values ranged between 15.8 and 64.7 per 100,000 births. Girls, with an average frequency of 1:1919 births were more often affected than boys, who averaged 1:4219 births. These figures obtained in Berlin (West) indicate only the lower ranges of incidences and will have to be further supplemented by a prospective study.

Adolescent↗
PubMed1985

Semiquantitative and morphometric investigations on the histopathology of chronic hepatitis non-A, non-B.

Ninety-five cases (202 liver biopsies) with chronic hepatitis Non-A, Non-B (NANB) were investigated histologically. The alterations were analysed semiquantitatively. The histological indices (e. g. volume of the portal tracts, number of acidophilic bodies) of various case groups of chronic hepatitis NANB were determined morphometrically and the results were checked for internal statistical significance and for correlations with comparison groups of chronic hepatitis B. The large number of acidophilic bodies and sinusoidal cells are the sole characteristic histological sign of hepatitis NANB which enable its differential diagnosis, especially from hepatitis B. The chronic post-transfusion hepatitis NANB has a relatively good prognosis and in 80% of the cases shows the course of a chronic persistent hepatitis (CPH). In sporadic hepatitis NANB a chronic aggressive hepatitis (CAH) is present in 60%. The frequency of cirrhosis based on an already chronic stage is 12.6%. An indication for immunosuppressive therapy of sporadic chronic aggressive hepatitis NANB can only be established individually after a sufficiently long observation of the biochemical and histological alterations.

Biopsy↗
PubMed1984

[Laparoscopy findings of the yellow spot, a focal fatty liver infiltration].

From 1976 to 1982 in 279 patients amongst 3719 laparoscopies focal fatty liver infiltrates were found at the right and/or left liver edge next to the insertion point of the round ligament. These so-called "yellow spots" mainly could be recognized in case of normal liver tissue and in cases suffering from chronic hepatitis insofar as a cirrhotic transformation or a significant fibrosis had not taken place. The localization and the shape of these focal lesions indicate, that an abnormality in the portal blood supply of the corresponding area may play an etiologic role for the development of the fatty infiltration.

Fatty Liver↗
PubMed1983

[Ketoconazole-induced hepatitis. Case report].

Since Oct. 1981 a new systemic antifungal drug Ketoconazole is available in the Federal Republic of Germany that has proven effective even in severe cases with fungal infections. This case-study will call attention on a rare but important side effect, namely Ketoconazole induced hepatitis. As an acute icteric viral hepatitis, type Non-A-Non-B-hepatitis possibly misdiagnosed only a carefully compiled history of the recent intake of drugs points at the real cause of hepatitis. In our case-report we observed a considerable increase in serum enzymes, especially GOT, GPT and GLDH after a drug-challenge with two tablets. We recommend so-called liver functions tests 2 to 3 weeks after beginning of therapy and further-on in monthly intervals. Histologically at that time toxic hydropic changes of the liver cells and a mesenchymal reaction with portal and intralobular mainly eosinophilic infiltration could be established. The serum enzymes came to normal only after 12 weeks.

Alanine Transaminase↗
PubMed1982

[Laparoscopic aspect and clinical relevance of cholangiofibromas].

In a current series of 1160 laparoscopies in 38 cases (3.2%) we found cholangiofibromas. The picture of single, sporadic and multiple cholangiofibromas as well as cholangiofibromatosis is both described and documented by laparoscopic photography. Clinically it seems remarkable that only patients with alcohol- or drug-induced liver injury showed such alterations. The prevalence of cholangiofibromas in toxic liver damage suggests that we are here not dealing with embryonal aberrations (hamartomas) but apparently with cellular inductive phenomena.

Adenoma, Bile Duct↗
PubMed1981

Morphometric investigations on the portal tracts of the liver, the differentiation of variable progression in chronic persistent hepatitis.

Morphometric investigations were carried out on the portal tracts of the liver in different forms of chronic hepatitis. The investigation groups each contained 25 liver biopsies, which were subdivided into cases with normal liver, a subsiding acute virus hepatitis, three different forms of chronic persistent hepatitis (CPH) and chronic aggressive hepatitis type IIa (CAH IIa). Determinations of the volume and surface of the portal tracts and their components enabled three forms of COH (type Ia, Ib, Ic) to be characterised. Preliminary clinical and semiquantitative histological investigations were correlated with a significant difference in the histological characteristics and prognosis. HBsAg-positive and HBsAg-negative cases showed no significant morphologically detectable differences in all grups investigated. Morphometry is suitable for investigation of pathological changes in liver tissue, especially the portal tracts.

Adult↗
PubMed1981

[Propafenon-induced cholestatic liver injury--a further example for allergic drug hepatitis (author's transl)].

In the course of cholestatic liver injury after propafenonhydrochloride medication, a high increase of the glutamatedehydrogenase up to the twenty fold of the normal range was followed by a marked raise of SGOT and SGPT. Cholestatic enzymes like gamma-glutamyl transpeptidase and alkaline phosphatase reached their maxima a week later. Within two weeks the hepatic cell enzymes and within four weeks the cholestatic enzymes have returned spontaneously to normal.

Adrenergic beta-Antagonists↗
PubMed1979

[Chronic persistent hepatitis. Histological and clinical study of different forms of the course of CPH].

Among 4903 liver biopsies were found 96 cases (241 biopsies) of non-active hepatitis persisting for longer than one year (up to 12 years). Three forms of the course of chronic persistent hepatitis could be delimited in morphological terms taking into account clinical laparoscopic and clinical chemical data. The type Ia presents the picture of a largely subsided, lobular accentuated acute virus hepatitis. The type Ib corresponds to a chronic inflammation with emphasis on the portal system without destruction of the limiting plate, without fibrosis and with only slight intralobular involvement. The type Ic is characterized by a portal and slight septal fibrosis with round-cell infiltrates and a slight facultative periportally active inflammation as well as a moderate intralobular mesenchyme reaction. The typing permits a clear subdivision and a differentiated prognosis: 10% of the cases of type Ic pass into an active chronic hepatitis of the type IIa.

Adult↗
PubMed1976

[Corelations between thrombocyte count, clinical diagnosis, and liver pathology in chronic liver diseases].

In 1488 cases of chronic liver disease thrombocyte content of peripheral blood, clinical diagnosis and histologic findings of the liver biopsy were correlated. Ranging from fatty infiltration to fatty cirrhosis or from slightly active chronic hepatitis to active postnecrotic cirrhosis, according to the extent of the liver injury a significant decrease of thrombocyte-count was evaluated. In case of non-active liver disease and posthepatitic status a thrombocytopenia also could be found. Cirrhotic transformation or proliferation of the connective tissue mainly in the periportal fields and inflammatory activity showed a significant correlation to the frequency of a thrombocyte decrease. A pathogenetic relation is ascribed to an increased thrombocyte storage in the spleen depending on the extent of the liver injury and the alteration of the portal blood stream up to a portal hypertension. Our results indicate such correlations of liver injury, portal pressure and platelet-pooling to thrombocyte-count even if the causal dependency cannot be proved.

Adult↗
PubMed1975

[Histomorphology of the liver by damage with phenolisatine-containing laxatives (Recurrent chronic cholangiohepatitis)].

In the case of 36 female patients who were anamnestically known to have taken laxatives, semiquantitative histological investigations with laparoscopically obtained liver needle biopsies were effected after the exposition with preparations containing phenolisatine. The time gap until exposition was 12 to 24 h (16 cases), 48 h (8 cases), 72 to 96 h (4 cases) and 7 to 14 days (4 cases). The histological result after the exposition is an acute cholangiolitis of the allergic-hyperergic type with edema and a dense eosinophile infiltration of the portal fields with destruction of the epithelium of preformed bile ducts and portally proliferated ductles. In addition, the parenchyma of the liver shows a pleomorphism of the cells in form and colour with a cellular edema and with disseminated acidophilic necroses and necrobioses of the individual cells as well as with little reactive proliferation of the Kupffer's cell. After a period of 8 days the acute process has more or less subsided. Also, in the majority of cases there are histological signs of an aggressive chronic hepatitis of type IIa, partially in the active stage with piece-meal necroses and partially stabilized or in the process of healing. A transition to the picture of hepatitic cirrhosis is possible. In serious cases the picture of a chronic non-purulent destructive cholangitis can be simulated by the hepatocellular and canalicular damage. Thirty-one bioptic pre-examinations from the same results, whereby the acute cholangiolitical exacerbation can be attributed to an exposition of the patients themselves. The clinical picture of the phenolisatine damage in its entirety is induced by medication and is described as a recurrent chronic cholangiohepatitis. Similarities exist between the liver damages caused by chlorpromazine and arsphenamine. When medication is discontinued, the morphologic substrate recedes leaving behind an inactive fibrosis or cirrhosis. The formal and known causal pathogenetic connections are discussed with regard to this clinically important liver disease. Guidelines are then given for histological diagnosis of this damage caused by medication. 14% of the female patients with a histological picture of aggressive chronic hepatitis and hepatitic cirrhosis are affected by this type of liver damage.

Adult↗
PubMed1975

[Liver damage due to N-propyl-ajmalin bitartrate (NPAB)].

The authors report on four cases of immediate hepatotoxic reaction following diagnostic re-exposure. In checking 27 patients who had received NPAB treatment for the first time, four were found to have a hepatotoxic reaction that developed within 13--20 days after beginning the treatment. In view of the significance of NPAB for the treatment of cardiac rhythm disorders, further such studies are required in order to define the actual risk involved in this procedure.

Adult↗