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HELLP syndrome is a complication of pregnancy; the acronym stands for hemolysis, elevated liver enzymes, and low platelet count. [1] It usually begins during the last three months of pregnancy or shortly after childbirth. [1]
Acute fatty liver of pregnancy is a rare life-threatening complication of pregnancy that occurs in the third trimester or the immediate period after delivery. [1] It is thought to be caused by a disordered metabolism of fatty acids by mitochondria in the fetus, caused by long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency. [2]
As the disease progresses, it can cause life-threatening liver dysfunction or liver failure. [3] Infants are chronically ill from birth and rarely survive beyond the first year of life. In 2015, an enzyme replacement therapy, sebelipase alfa, was approved in the US and EU.
First-pass metabolism may occur in the liver (for propranolol, lidocaine, clomethiazole, and nitroglycerin) or in the gut (for benzylpenicillin and insulin). [4] The four primary systems that affect the first pass effect of a drug are the enzymes of the gastrointestinal lumen, [5] gastrointestinal wall enzymes, [6] [7] [8] bacterial enzymes [5] and hepatic enzymes.
All plasma proteins except Gamma-globulins are synthesised in the liver. [1] Human serum albumin, osmolyte and carrier protein; α-fetoprotein, the fetal counterpart of serum albumin; Soluble plasma fibronectin, forming a blood clot that stops bleeding; C-reactive protein, opsonin on microbes, [2] acute phase protein; Various other globulins
Ischemic hepatitis, also known as shock liver, is a condition defined as an acute liver injury caused by insufficient blood flow (and consequently insufficient oxygen delivery) to the liver. [5] The decreased blood flow ( perfusion ) to the liver is usually due to shock or low blood pressure.
The enzymes that are defective in GS – UDP glucuronosyltransferase 1 family, polypeptide A1 (UGT1A1) – are also responsible for some of the liver's ability to detoxify certain drugs. For example, Gilbert syndrome is associated with severe diarrhea and neutropenia in patients who are treated with irinotecan , which is metabolized by UGT1A1.
Liver function tests (LFTs or LFs), also referred to as a hepatic panel or liver panel, are groups of blood tests that provide information about the state of a patient's liver. [1] These tests include prothrombin time (PT/INR), activated partial thromboplastin time (aPTT), albumin , bilirubin (direct and indirect), and others.