Serum galectin-3 levels in patients with hepatocellular carcinoma, liver cirrhosis and chronic viral hepatitis

Background: hepatocellular carcinoma [HCC] represents a global health problem. It is the fifth most common solid tumor and the third cause of cancer-related mortality per year. In Egypt, it represents 75% of malignant liver tumors. Early detection and diagnosis of these cases are required for successful treatments and improved outcomes

Aim of the Work: this study aimed to detect serum galactin-3 levels in patients with HCC, liver cirrhosis and chronic viral hepatitis [HBV, or HCV] patients

Patients and Methods: this prospective study was conducted on a total of 60 patients, 20 of them with chronic viral hepatitis B or C, 20 with cirrhosis secondary to chronic viral hepatitis and 20 with HCC secondary to chronic viral hepatitis. It was carried out at the Clinical Pathology Department, Tanta University Hospital

Results: the mean galectin-3 levels were 15.5 ng/mL [ +/- 5.5] in HCC patients, 20.46 ng/mL [ +/- 7.56] in cirrhotic patients and 7.003 ng/mL [ +/- 4.24] in chronic viral hepatitis group. There were statistical differences between HCC and cirrhotic patients [P < 0.03], but they were lower in chronic hepatitis group statistically compared to cirrhosis and HCC [P < 0.001]

Conclusion: serum galectin-3 levels in patients with chronic HBV or HCV may guide us about progression to cirrhosis or HCC and prognosis of the disease. In these patients, if galectin-3 levels were found to be high, serum alpha feto protein level and ultrasonographic examination could be repeated at more frequent intervals. This may also guide us in terms of the treatment plan

Recommendations: it was recommended to measure changes of galectin-3 in hepatitis carries. Measurement of galectin-3 in a large scale of patients to explore its prognostic value

Study of intrahepatic cholestasis of pregnancy before and after treatment with ursodeoxycholic acid

To investigate bile acids patterns in patients with intrahepatic cholestasis of pregnancy [ICP] and to test the efficacy of ursodeoxycholic acid [UDCA] treatment. The study included a reference group comprised ten healthy pregnant women and 21 patients with ICP, who were randomly divided into 2 groups, one received UDCA for 21 days and followed until delivery [11 cases] and the other received vitamin B as a placebo and followed in time same manner [10 cases]. Bile acids were analyzed by gas chromatography-mass spectrometry in maternal serum at the start, 21 days later and after delivery. They were also analyzed in amniotic fluid and neonatal meconium after delivery. UDCA treatment improved bile acid levels after 21 days and markedly after delivery. Amniotic fluid levels of bile acids were lower in UDGA treated cases than placebo treated cases. Neonatal meconium bile acids were higher in placebo treated ICP cases than reference cases. After delivery, serum TBA and cholic acid in UDC'A treated cases were correlated with those in amniotic fluid [r = 0.91, r = 0.6], with positive correlations with neonatal meconium TBA [r= 0.39]. The obstetric and neonatal outcomes were better in UDCA treated cases tf compared to placebo cases. Ursodeoxycholic acid is effective and safe in patients with intrahepatic cholestasis of pregnancy. It attenuates pruritus, corrects bile acid abnormalities in the mothers and improves fetal and neonatal outcomes

Fingernail creatinine as a predictor of prior renal function in children

It is often difficult to distinguish acute renal failure clinically from chronic renal failure, especially in children who do not have records of their medical history. The objective of this study was undertaken to re-examine the history the association between fingernail creatinine [NCr] and serum creatinine [SCr] in children with renal diseases as nephrotic syndrome, acute renal failure and chronic renal failure and the possibility of clinical use of this association. In this study, clipped fingernail specimen from 10 normal control children [mean age 9.5 +/- 2.57 years 6 males and 4 females], 8 children with nephrotic syndrome [mean age 9.93 +/- 2.2 years 5 males and 3 females], 7 children with acute renal failure [mean age 9.57 +/- 3.06 years 4 males and 3 females] and 10 children with chronic renal failure [mean age 10.15 +/- 2.44 years 6 males and 4 females] under regular hemodialyis were analysed for creatinine by autoanalyser using Jaffe's reaction. The results show that Ncr level of nephrotic syndrome [23.4 +/- 4.02 mg/100 mg nail] and Ncr of children with acute renal failure [22.05 +/- 4.27 mg/100 mg nail] were similar to that of NCr of normal control group [23.99 +/- 4.46 mg/100 mg nail] and significantly lower than NCr of the children with chronic renal failure [61.88 +/- 6.3 mg/100 gm nail]. Also, there were a strong positive correlations between NCr of children with chronic renal failure and SCr[r = 0.401] and duration of renal failure [r = 0.410]. This study confirms that the NCr measurement is of valid clinical value in differentiating acute from chronic renal failure

Urinary iron children with nephrotic syndrome

Urinary transferrin loss is a typical feature in relapse of the idiopathic nephrotic syndrome [I.N.S.], also, there is increased urinary iron in animals and humans with nephrotic syndrome. Urinary N-acetyl-beta-D- gluosaminidase [NAG] is indicator for renal damage. To estimate the urinary iron and urinary NAG in children with idiopathic nephrotic syndrome, and the possible role of iron in the different histopathological types of the disease. Our study was performed on 2 groups of patients, minimal change nephrotic syndrome [MC NS] group 10 children [6 boys and 4 girls] mean age 9.75 +/- 2.2 years, focal segmental glomerulosclerosis. [FSGS] group 8 children [5 boys and 3 girls] mean age 9.63 +/- 1.9 years with 12 children [7 boys and 5 girls] of matched ages as a control group. Laboratory parameters hemoglobin concentration [HB], serum albumin, serum iron, serum ferritin, serum transferrin, serum creatinine, BUN, urinary protein per 24 H, urinary transferrin, urinary iron and urinary NAG were evaluated. The results proved decrease in HB in both group of N.S., decrease serum albumin, serum iron, serum ferritin and serum transferrin in both groups of N.S. especially FSGS and significant increase in urinary protein per 24H, urinary transferrin, urinary iron and urinary NAG in both groups of N.S especially FSGS group. There was an increased urinary transferrin and this is accompanied by corresponding increase in a reactive iron species and this could incite tubulo-interstitial injury and renal damage. Measuring urinary iron and urinary NAG could be a respectable method for follow up and prediction of the prognosis in children with idiopathic nephrotic syndrome