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Biomedical subjects

M Lesna

Publications and source records attributed to M Lesna.

28 records · Page 2Linked to original sources
PubMed1976

Evaluation of paracetamol-induced damage in liver biopsies. Acute changes and follow-up findings.

In 100 patients who had taken an acute overdose of paracetamol the liver was biopsied percutaneously on the 4th day or as soon thereafter as recovery of the clotting mechanism allowed. A system for grading the histological changes in the liver is described. The hallmark of severe (grade III) damage is centrizonal necrosis, for which there is probably a dosage threshold. Consequent changes include phagocytosis of cell debris, reticulin collapse, and an inflammatory infiltration; acidophil degeneration of hepatocytes is sometimes prominent; regenerative growth is already evident after 4 days. Mild (grade I) damage is characterized by excess of lipofuscin pigment in centrizonal hepatocytes, sparse focal necrosis of liver cells, and some phagocytosis of lipofuscin. The findings in moderate (grade II) damage are similar but more pronounced. Five patients died in acute hepatic failure, and 22/100 showed severe (grade III) changes but survived. Forty-nine patients representing all three grades of liver damage were rebiopsied after 3 months. Central necrotic zones were found to have been completely reconstituted leaving only minor abnormalities except for one patient who showed mild centrilobular fibrosis and scarring of a nonprogressive nature.

Acetaminophen↗
PubMed1975

Liver damage after paracetamol overdose. Comparison of liver-function tests, fasting serum bile acids, and liver histology.

54 patients have been studied after paracetamol (acetaminophen) overdose. Liver-function tests and fasting serum bile-acids were measured daily; liver biopsy was done in all cases, and slides were examined "blind" to assess liver damage. The plasma-paracetamol was measured on one occasion. A histological abnormality was present in the livers of 53 of the 54 patients, and was minor in 23, moderate in 16, and severe in 14. In 6 patients with moderate and 18 with mild histological abnormality liver-function tests were normal. A serum-aspartate-aminotransferase above 400 units/1 was always associated with severe histological liver damage. Fasting serum bile-acids were raised in 51 of the patients with abnormal liver histology; the serum-bile-acid seemed to be a more sensitive indicator of mild liver-cell damage than was the transaminase level. There was, however, little correlation between increase in bile-acid concentration and the degree of histological abnormality. As a result of these investigations empirically determined levels of plasma-paracetamol have been drawn which give a guide to the likelihood of liver damage after paracetamol overdose.

Acetaminophen↗