Osteodystrophy in post hepatitic liver cirrhosis: prevalence, severity, and prediction

Metabolic bone disease has long been recognized in chronic liver disease, especially cholestatic or alcoholic liver diseases. However, data in post hepatitic liver cirrhosis is relatively scant. Aims: To determine prevalence and severity of low bone mineral density [BMD] in post hepatitic cirrhosis and correlation of its incidence with the clinical severity of cirrhosis and to investigate whether age, severity of underlying liver disease, and/or laboratory tests are predictive of the diagnosis. Patients And 30 male patients with post hepatitic cirrhosis and 10 healthy controls were enrolled in a cross-sectional study. All subjects underwent standard laboratory tests and bone densitometry at lumber spine and femoral neck by dual x-ray absorptiometry [DEXA]. Bone mass was significantly reduced at both sites in patients compared to controls. The prevalence of low BMD in post hepatitic liver cirrhosis, defined by the World Health Organization criteria, was 56.7% at lumber spine [26.7% osteoporosis, 30% osteopenia], 16.7% at femoral neck [all osteopenia] and 0% to controls at both sites. Bone density significantly decreased with age at both sites. BMD significantly decreased with progression of liver dysfunction. No significant changes in corrected calcium, ionized calcium, phosphorus, vitamin D3 or PTH levels in patients than controls. So osteoporosis most probably is the actual from of low BMD. Low BMD is highly prevalent in patients with post hepatitic cirrhosis. Older patients and patients with severe hepatic dysfunction experienced more advanced bone disease. The laboratory tests routinely determined in patients with liver disease did not reliably predict low BMD

H. pylori stool antigen [HpSA]: anew simple test for detection of infection

Thirty patient with duodenal ulcer who underwent upper gastrointestinal endoscopy were selected for assessment of HpSA immunoassay test in detection of H.pylori infection [16 male [53.3%], 14 female [46.7%] mean age 42 +/- 1 year]. Patients with previous surgery, use of antibiotics, proton pump inhibitors or any compound containing bithmus up to one month before study were excluded. All patients were assessed clinically, upper endoscopy and biopsies from antrum were taken for urease test and culture, blood samples were analyzed for H.pylori IgG antibodies by ELIZA. Stool samples were taken for HpSA immunoassay using [Medridian-Diagnostic-inc-cinncina oH immunoassay]. From the 27 patients diagnosed by culture as H.pylori positive, urease test detected 96%, IgG antibodies were positive in 93% and HpSA immunoassay detected 70%. The sensitivity and the specificity of HpSA test in comparison to culture were 70.4% and 100% respectively and to urease test were 73.1% and 100% respectively. HpSA immunoassay test is simple rapid non invasive, specific test for detection of H.pylori infection