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Polycythemia Vera Presenting With Normal Hemoglobin and Hematocrit: A Rare Variant.
Cureus
June 2020
Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, USA.
Polycythemia vera (PV) is a myeloproliferative neoplasm, and its diagnosis requires elevated hemoglobin level (>16.5 mg/dL in men and >16 mg/dL in women), bone marrow characteristics of PV (hypercellularity for age with trilineage growth), and presence of JAK2 (Janus kinase 2) mutations or subnormal erythropoietin level if JAK2 mutation is not present. There exists a subset of patients with normal hemoglobin and hematocrit due to either from dilution of the blood or from coincidental blood loss anemia but these patients still might have underlying PV.
View Article and Find Full Text PDFThe good, the bad, and the ugly facets of insulin resistance.
Med J Armed Forces India
January 2020
Consultant Endocrinologist, Paras Bliss Hospitals, Panchkula 134114, India.
Insulin is a potent anabolic hormone, and binding to its receptor activates downstream intracellular signaling pathways that regulate the nutrient metabolism, fluid homeostasis, growth, ionic transport, maintenance of vascular tone, and other functions. Insulin resistance (IR) is a condition characterized by subnormal cellular response to physiological levels of insulin. The IR is divided into three types (prereceptor, receptor, and postreceptor) based on the site of pathology.
View Article and Find Full Text PDFLow Testosterone Is Associated With Nonalcoholic Steatohepatitis and Fibrosis Severity in Men.
Clin Gastroenterol Hepatol
February 2021
Division of Endocrinology and Metabolism, Saint Louis University, Saint Louis, Missouri.
With rising prevalence of obesity and diabetes, nonalcoholic fatty liver disease (NAFLD) is now a leading cause of chronic liver disease. One-third of obese or diabetic men have subnormal free and bioavailable testosterone concentrations. Several studies have further shown low testosterone to be associated with imaging-confirmed NAFLD in men, although it is unknown whether low testosterone confers increased risk of more clinically relevant manifestations of NAFLD, including nonalcoholic steatohepatitis (NASH) and NASH fibrosis.
View Article and Find Full Text PDFAdding an orange to the banana bag: vitamin C deficiency is common in alcohol use disorders.
Crit Care
May 2019
Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, 721 Fairfax Ave, Suite 423, Norfolk, VA, 23507, USA.
Background: At least a third of the world's population consumes alcohol regularly. Patients with alcohol use disorders (AUDs) are frequently hospitalized for both alcohol-related and unrelated medical conditions. It is well recognized that patients with an AUD are thiamine deficient with thiamine replacement therapy being considered the standard of care.
View Article and Find Full Text PDFMuscle metabolism and whole blood amino acid profile in patients with liver disease.
Scand J Clin Lab Invest
July 2016
a Department of Medicine V (Hepatology and Gastroenterology) , Aarhus , Denmark.
Objective: Branched-chain amino acids (BCAA) are used in liver cirrhosis to promote protein synthesis, support ammonia detoxification, and treat hepatic encephalopathy. Cirrhosis leads to subnormal BCAA plasma concentrations and studies indicate that levels are decreased due to their role in muscle ammonia removal. Muscle contribution has not been fully elucidated.
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