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M Atiyeh

Publications and source records attributed to M Atiyeh.

7 recordsLinked to original sources
PubMed1991

Congenital hepatic fibrosis in Saudi Arabia.

Congenital hepatic fibrosis (CHF) is a recognized cause of portal hypertension with oesophageal varices, gastro-intestinal haemorrhage and cholangitis in children without significant impairment of hepatic or renal function. This report describes the varied clinical presentation of CHF as seen at King Faisal Specialist Hospital and Research Centre (KFSH & RC) and emphasizes the clinical patterns that should enable a pediatrician to consider the diagnosis. Fourteen children with CHF were diagnosed between 1981 and 1988. The age at presentation ranged from 1.8-14 years (mean: 7.5 years); clinical manifestations at diagnosis were splenomegaly (12), hepatomegaly (11), failure to thrive (10), marked abdominal distention (4), and fever (4). Liver function tests were normal except for high alkaline phosphatase. Eight patients had polycystic kidneys confirmed on ultrasound examination. Upper gastro-intestinal endoscopy showed oesophageal varices of variable severity in all eight patients examined. Splenoportography revealed splenic vein occlusion in one patient. One patient died within days of admission with convulsions, coma, and aspiration pneumonia. One patient was lost to follow-up. The remaining 12 patients are all alive and receive regular follow-up. Two patients required splenorenal shunt. In view of the prevalence of consanguinity in Saudi Arabia, the diagnosis of CHF should be considered in children with hepatomegaly despite normal liver function tests, and particularly in those with renal abnormalities and/or evidence of portal hypertension.

Adolescent↗
PubMed1987

Decreased drug absorption in a patient with Behçet's syndrome.

Observing a lack of response to orally administered drugs in a patient with Behçet's disease, we studied the absorption of amitriptyline, diazepam, carbamazepine, phenytoin, and acetaminophen in this patient after single and (or) multiple dose administrations. The relative oral/intramuscular bioavailability of amitriptyline was only 13%, and the steady-state concentrations of this drug on four consecutive days were acutely subtherapeutic (i.e., 3.6, 3.7, 3.9, and 3.7 micrograms/L). The concentrations of diazepam, phenytoin, and acetaminophen in plasma were nonmeasurable. Examination of the gastrointestinal tract by endoscopy and by light and electronic microscopy of a biopsy section revealed inflammatory and vascular changes in the duodenum. In the absence of clinical evidence for malabsorption syndrome, we believe that the decreased drug absorption observed in this patient was caused by inflammatory changes associated with Behçet's syndrome.

Acetaminophen↗
PubMed1984

Diabetes mellitus in chronic active hepatitis and cirrhosis.

One hundred consecutive patients with nonautoimmune chronic active hepatitis (51% HBsAg-positive), 50 patients with cirrhosis (38% HBsAg-positive), 25 patients with chronic persistent hepatitis, and 118 patients with hepatoma who were seen at this hospital were reviewed to determine the prevalence and characteristics of glucose intolerance and diabetes in these conditions. Diabetes (fasting serum glucose greater than 7.8 mmol/L, 140 mg/dl on two separate occasions) was present in 8% of patients with chronic persistent hepatitis and mild chronic active hepatitis, 44% of patients with severe chronic active hepatitis, 40% of patients with cirrhosis, and 15% of patients with hepatoma, compared with 7% of all other patients aged 35 yr or over, undergoing liver biopsy. Compared with this high prevalence of diabetes in liver disease, only 3% of diabetic patients referred to the hospital diabetic clinic had chronic hepatitis or cirrhosis. Glucose tolerance was similar in chronic active hepatitis and cirrhosis and was characterized initially by basal hyperinsulinemia, normal basal glucose levels but elevated serum glucose following glucose loading, and evidence of insulin resistance. We suggest that the high prevalence of diabetes in chronic active hepatitis and cirrhosis in Saudi Arabia is due to the insulin resistance of chronic liver disease acting over many years in a population with a high genetic predisposition to diabetes.

Adrenal Cortex Hormones↗
PubMed1982

Intestinal absorption in Saudi Arabia: an evaluation of the one hour blood xylose test.

The screening value of the one-hour blood xylose test, corrected for body surface area, was prospectively studied in Saudi Arabian adults and children under investigation for suspected intestinal malabsorption. Sensitivity of discrimination between patients with and without upper small bowel disease was 91%, compared to 85% for the five-hour urine xylose test. Primary small bowel disorder was rare. In a three-year review, no cases of adult coeliac disease or tropical sprue were found. The most common causes of malabsorption were intestinal tuberculosis, abdominal lymphoma and immunoproliferative small intestinal disease. Despite its acceptability as an index of proximal small bowel function, the blood xylose test alone is an inadequate screening test for any of these conditions.

Adolescent↗
PubMed1980

Primary hepatocelluar carcinoma in Saudi Arabia. A clinicopathological study of 54 cases.

A high incidence of primary hepatocelluar carcinoma in the Orient and Africa has been reported. It is also seen frequently in Saudi Arabia. In a series of 54 consecutive patients diagnosed histologically, the male to female ratio was 10:1--the highest reported. The peak age was between 40-60 years and the mean survival was eight months. This is in contrast to hepatocelluar carcinoma in Africa where the age is between 25-35 years and the disease runs a quick downhill course simulating an abscess. Macronodular cirrhosis was diagnosed histologically or suggested clinically in 80% of the cases. Serum was positive for HBsAg in 55% of the patients, compared with 8% in healthy blood donors. These figures are as significant as reports from high incidence areas and point strongly to a possible causal relationship between HBV infection and the development of primary hepatocellular carcinoma.

Adult↗