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Rapid normalization of severe hypercholesterolemia mediated by lipoprotein X after liver transplantation in a patient with cholestasis - a case report

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Jankowski K., Wyzgał A., Wierzbicka A., Tronina O., Durlik M., Pruszczyk P.
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issue 3
621-623
EN
Hypercholesterolemia is a common disorder in adult population, but total cholesterol concentrations beyond 1000 mg/dl occur rarely, and are found in patients with homozygous familial hypercholesterolemia and familial lecithin-cholesterol acyltransferase deficiency, in chronic graft-versus-host disease of the liver, after intravenous infusion of fat emulsion (intralipid), in newborn infants with immature liver function, and in obstructive biliary cholestasis. Cholestasis induces a dramatic increase in plasma cholesterol and the appearance of an abnormal lipoprotein, lipoprotein X (LpX), in the plasma. We report a case of severe hypercholesterolemia mediated by LpX in a patient transplanted for primary biliary cirrhosis (PBC), who was qualified for liver re-transplantation (re-LTx) due to chronic cholestasis. Four months after re-LTx, the cholesterol concentration was normal. The problems in diagnosis and treatment are discussed.
2
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Coma in the course of severe poisoning after consumption of red fly agaric (Amanita muscaria)

100%
Mikaszewska-Sokolewicz M., Pankowska S., Janiak M., Pruszczyk P., Łazowski T., Jankowski K.
Acta Biochimica Polonica
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2016
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vol. 63
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issue 1
181-182
EN
Red fly agaric poisoning is rare. It can be consumed for suicidal purposes or its psychedelic effect. The paper describes the case of a young men, who fell into a coma after ingestion of the red toadstools. Quick identification of the poison, early use of gastric lavage and symptomatic treatment resulted in regression of symptoms and lead to the patient's discharge from the hospital on the third day after intoxication. Authors discussing the poisonous alkaloids contained in the red toadtools: ibotenic acid, muscimol, muscasone and muscarine and theirs properties, responsible for the symptoms of intoxication.
3
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Prognostic value of perioperative assessment of plasma cardiac troponin I in patients undergoing liver transplantation

84%
Jankowski K., Trzebicki J., Bielecki M., Łągiewska B., Kurnicka K., Koczaj-Bremer M., Pacholczyk M., Pruszczyk P.
Acta Biochimica Polonica
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2017
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vol. 64
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issue 2
331-337
EN
Abstract. An elevation in plasma cardiac troponins is an indicator of increased perioperative risk in orthopaedic and vascular surgery, however, data on liver transplantation (LTx) are scarce. The aim of the study was to evaluate the prevalence of cardiac troponin I (cTnI) elevation in the perioperative period of LTx, and its potential relationship with 1-year mortality. Material and methods. Analysis included 79 patients with liver cirrhosis. During LTx all patients underwent hemodynamic measurements. cTnI level was determined before the operation, 24, 48 and 72 hours afterwards. One-year mortality was assessed. Results. 12.7% patients died, all during in-hospital period. cTnI level on day 1. was identified as the most promising marker of increased death risk with optimal cut-off value of 0.215 ng/mL (the sensitivity of 60.0%, specificity of 87.0%, positive predictive value of 40.0%, negative predictive value of 93.8%). The most important predictor of cTnI increase was the duration of the LTx procedure followed by amount of packed red blood cells transfused, basic stroke volume index, and cardiac output index. In conclusion: value of cTnI level assessed 24 hours post-surgery was a reliable predictor of death following LTx with optimal cut-off value of 0.215 ng/mL. The surgery time was the most important predictor of cTnI elevation.
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