Cross Sectional study on Metabolic Bone disease in non cholestatic chronic liver disease.

Anand, T K (2013) Cross Sectional study on Metabolic Bone disease in non cholestatic chronic liver disease. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Cirrhosis (chronic liver disease) represents a disorder which causes progressive hepatic fibrosis characterized by distorted liver architecture and the formation of nodules which are regenerative. Cirrhosis of any cause is usually not reversible when it is in the advanced stages at which the only option available may be liver transplantation. However, in recent times reversal of cirrhosis has been reported in several forms of liver disease following treatment of the underlying cause if detected in its early stages. Patients with cirrhosis are prone to a variety of complications. Some of the common cause for cirrhosis are 1. Alcoholic liver disease, 2. Viral hepatitis B & C, 3. Autoimmune hepatitis, 4. Hereditary hemochromatosis, 5. Wilson’s disease, 6. Alfa-1 antitrypsin deficiency, 7. Nonalcoholic fatty liver disease, 8. Primary biliary cirrhosis, 9. Primary sclerosing cholangitis, Complications of cirrhosis include 1. Variceal bleed, 2. Hepatic encephalopathy, 3. Ascites, 4. Spontaneous bacterial peritonitis, 5. Hepatorenal syndrome, 6. Hepatopulmonary syndrome, 7. Hepatocellular carcinoma. Metabolic complications commonly encountered in patients with chronic liver disease are malnutrition, hyponatremia and metabolic bone disease. Common chronic cholestatic liver disorders are primary sclerosing cholangitis and primary biliary cirrhosis. Hepatic osteodystrophy is known to occur in chronic cholestatic liver diseases. Osteopenic bone disease with fracturing is a complication of chronic cholestatic liver diseases. But data regarding the occurrence of metabolic bone disease (hepatic osteodystrophy) in the setting of non cholestatic chronic liver disease is scanty. AIM OF THE STUDY : To study the frequency of metabolic bone disease in noncholestatic chronic liver disease. 58 CONCLUSION : Inference from this study done in our department include, 1. Hepatic osteodystrophy was common in people with non cholestatic chronic liver disease. 2. There was a slight male predominance noted in the study. 3. Bilirubin and prothrombin levels were significantly low in patients with low bone mineral density compared to patients with normal bone mineral density. 4. Longer duration of symptoms in the cirrhotic patients was significantly related to the bone mineral loss. 5. Severity of the liver disease was significantly related to the bone mineral loss. 6. There was no correlation of vitamin D, calcium, parathyroid hormone levels with bone mineral loss. 7. In view of high frequency of metabolic bone disease in patients with non cholestatic chronic liver disease, screening for bone mineral loss with DEXA scan should be done.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Metabolic Bone disease ; non cholestatic ; chronic liver disease ; Cross Sectional study.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 13 Jul 2017 04:09
Last Modified: 13 Jul 2017 04:09
URI: http://repository-tnmgrmu.ac.in/id/eprint/1561

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