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1. Liver Dysfunction in Hyperthyroidism

Author

Khongsaengbhak T, Atthakitmongkol T, and Tanwandee T

Subjects
hepatic dysfunction, hyperthyroidism, liver abnormality, thyrotoxicosis, thyroid storm, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Thitichaya Khongsaengbhak,1 Thanapat Atthakitmongkol,2 Tawesak Tanwandee2 1Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Tawesak Tanwandee, Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand, Tel +66 2 419 7281-2, Fax +66 2 411 5013, Email tawesak.tan@mahidol.ac.th; tawesak@gmail.comBackground: Thyrotoxicosis is often associated with abnormal liver tests. This study aimed to characterize the clinical features and laboratory findings in thyrotoxic patients with liver abnormalities and to identify predictive factors for differentiating thyroid storm within this population.Methods: This is a retrospective review of thyrotoxic patients with hepatic dysfunction between January 2015, and January 2021, at Siriraj Hospital, Thailand. Univariate and multivariate analyses were performed to identify the factors associated with thyroid storm.Results: Among 771 thyrotoxic patients, 43 revealed abnormal liver tests within six months of diagnosis (5.58%). The mean age was 53.16 ± 15.10 years, with a female predominance (60.5%), and the majority (97.7%) were diagnosed with Graves’ disease. The most common comorbidities were atrial fibrillation, heart failure, and dyslipidemia. Hepatic dysfunction presented as non-specific, with 46.5% showing a cholestatic pattern, 30.2% a mixed pattern, and 20.9% a hepatocellular pattern. The most possible etiologies of hepatic dysfunction were hyperthyroidism-related hepatitis (41.9%) with atrial fibrillation with congestive hepatopathy (38.9%), concomitant with chronic hepatitis C infection (14.0%), and methimazole-induced hepatic dysfunction (9.3%). The younger age, congestive heart failure, and total bilirubin levels ≥ 3.0 mg/dL were independent factors in distinguishing clinical thyroid storm among thyrotoxic patients without thyroid storm.Conclusion: Liver abnormalities can be observed in patients with thyrotoxicosis. The possible causes are multifactorial, including hyperthyroidism-related hepatitis, atrial fibrillation with congestive hepatopathy, and chronic hepatitis C infection. Younger age, congestive heart failure, and total bilirubin ≥ 3.0 mg/dL were predictive factors for thyroid storm diagnosis among thyrotoxic patients.Keywords: hepatic dysfunction, hyperthyroidism, liver abnormality, thyrotoxicosis, thyroid storm

Published
2024

2. Yellow Urticaria: A Systematic Review

Author

Kulthanan K, Tanwandee T, Chularojanamontri L, Panjapakkul W, and Saengthong-aram P

Subjects
no abstract, Immunologic diseases. Allergy, RC581-607
Abstract

Kanokvalai Kulthanan,1 Tawesak Tanwandee,2 Leena Chularojanamontri,1 Waratchaya Panjapakkul,1 Phuwakorn Saengthong-aram1 1Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Kanokvalai Kulthanan, Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand, Tel +66 2 419 4333, Fax +66 2 411 5031, Email kanokvalai.kul@mahidol.ac.th

Published
2023

23. Randomized trial of albinterferon alfa-2b every 4 weeks for chronic hepatitis C virus genotype 2/3

Author

Pianko S, Zeuzem S, Chuang WL, Foster GR, Sarin SK, Flisiak R, Lee CM, Piratvisuth T, Shah S, Sood A, George J, Gould M, Komolmit P, Thongsawat S, Tanwandee T, Rasenack J, Li Y, Pang M, Yin Y, Feutren G, Jacobson IM, B2202 Study Team, ANDREONE, PIETRO, Pianko, S, Zeuzem, S, Chuang, WL, Foster, GR, Sarin, SK, Flisiak, R, Lee, CM, Andreone, P, Piratvisuth, T, Shah, S, Sood, A, George, J, Gould, M, Komolmit, P, Thongsawat, S, Tanwandee, T, Rasenack, J, Li, Y, Pang, M, Yin, Y, Feutren, G, Jacobson, IM, Craxi, A, Pianko S, Zeuzem S, Chuang WL, Foster GR, Sarin SK, Flisiak R, Lee CM, Andreone P, Piratvisuth T, Shah S, Sood A, George J, Gould M, Komolmit P, Thongsawat S, Tanwandee T, Rasenack J, Li Y, Pang M, Yin Y, Feutren G, Jacobson IM, and B2202 Study Team.

Subjects
Adult, Male, ANTIVIRAL TREATMENT, Genotype, Interleukins, Interferon-alpha, Hepacivirus, Hepatitis C, Chronic, Middle Aged, Viral Load, Antiviral Agents, Albinterferon alfa-2b, Treatment Outcome, Albumins, Humans, RNA, Viral, Female, Interferons, hepatitis C, hepatitis c
Abstract

Albinterferon alfa-2b (albIFN) is a fusion protein of recombinant human albumin/recombinant interferon (IFN)-α-2b, with ∼200-h half-life. Safety/efficacy of albIFN q4wk was evaluated in 391 treatment-naive patients with chronic hepatitis C virus (HCV) genotype 2/3. Patients were randomized 3:4:4:4 to one of four open-label treatment groups: pegylated IFN (Peg-IFN)-α-2a 180 μg qwk or albIFN 900, 1200 or 1500 μg q4wk, plus oral ribavirin 800 mg/day, for 24 weeks. Primary efficacy endpoint was sustained virologic response (SVR; HCV RNA

Published
2012

24. FRI-266 - Real-world rates of hepatitis B surface antigen seroclearance in patients with chronic hepatitis B: a systematic review, conventional aggregated data meta-analysis and individual patient data meta-analysis

Author

Yeo, Y.H., Ho, H.J., Yang, H.-I., Tseng, T.-C., Kwak, M.-S., Park, Y.M., Fung, Y.Y.J., Ferret, M.B., Rodríguez, M., Preda, C.M., Ungtrakul, T., Charatcharoenwitthaya, P., Li, X., Huan Le, M., Wei, B., Zou, B., Le, A., Jeong, D., Chien, N., Kam, L., Hosaka, T., Barciela, M.R., Suzuki, F., Kobayashi, M., Sriprayoon, T., Chong, Y., Tanwandee, T., Yuen, M.-F., Lee, H.-S., Kao, J.-H., Lok, A., Wu, C.-Y., and Nguyen, M.

Published
2018
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25. THU-334 - Unexpected findings from a large Asian HCV real life study

Author

Lim, S.G., Phyo, W.W., Shah, S., Win, K.M., Hamid, S.S., Piratvisuth, T., Tan, S.S., Dan, Y.Y., Lee, Y.M., Ahmed, T., Yang, W.L., Chen, K.P., Kamat, M., Wadhawan, M., Madan, K., Mehta, R., Shukla, A., Dhore, P., Eapen, C.E., Abraham, P., Tyagi, S., Koshy, A., Aung, H.B., Jafri, W., Abid, S., Arisar, F.A.Q., Tanwandee, T., Yin, T.P., Tee, H.P., Said, R.B.H.M., Goh, K.L., Ho, S.H., Mohamed, R., and Bakar, N.A.

Published
2018
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26. Responses are durable for up to 5 years after completion of peginterferon alfa‐2a treatment in hepatitis B e antigen‐positive patients.

Author

Chuang, W.‐L., Jia, J., Chan, H. L. Y., Han, K.‐H., Tanwandee, T., Tan, D., Chen, X., Gane, E., Piratvisuth, T., Chen, L., Xie, Q., Sung, J. J.‐Y., Messinger, D., Wat, C., Bakalos, G., and Liaw, Y. F.

Subjects
INTERFERON alpha, HEPATITIS B treatment, SEROCONVERSION, TREATMENT duration, ALANINE aminotransferase
Abstract

Summary: Background: In the large randomised NEPTUNE study, peginterferon alfa‐2a 180 μg/wk for 48 weeks produced higher hepatitis B e antigen (HBeAg) seroconversion rates 24 weeks post‐treatment (36%) than a lower dose (90 μg/wk) and/or shorter duration (24 weeks) (range 14%‐26%). Aim: To determine seroconversion rates 5 years after completion of treatment in NEPTUNE. Methods: HBeAg‐positive patients who completed 24 weeks’ follow‐up in NEPTUNE (with peginterferon alfa‐2a 90 μg/wk × 24 weeks [group 1]; 180 μg/wk × 24 weeks [2]; 90 μg/wk × 48 weeks [3] or 180 μg/wk × 48 weeks [4]) were followed up. Results: Three hundred and eighty three of the 544 patients in the original study were enrolled in the long‐term follow‐up study. Many patients (196 overall; more in groups 1‐3 than 4) received nucleos(t)ide analogues or immunomodulators during follow‐up, and more patients had missing data at year 5 in groups 2 and 4 (48 weeks, 50/112) than in groups 1 and 3 (24 weeks, 23/103), which confounds the planned per‐protocol analysis. HBeAg seroconversion rates in groups 1, 2, 3 and 4 at year 5 were 47.5%, 50.7%, 52.2% and 67.1%, respectively, (odds ratio for group 4 versus 1‐3: 2.02; 95% CI 1.21, 3.38), using multiple imputation methods for missing measurements. Conclusion: Seroconversion rates are durable for up to 5 years after completion of peginterferon alfa‐2a therapy and, consistent with NEPTUNE, the results suggest that the licensed regimen (180 μg × 48 weeks) is more efficacious for HBeAg‐positive patients than a lower dose and/or shorter treatment duration. [ABSTRACT FROM AUTHOR]

Published
2018
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28. P0612 : Interferon-gamma-inducible protein 10 promoter polymorphism related with end-of-treatment HBsAg levels and had complementary role in prediction of sustained virologic response to peginterferon in HBeAg-negative chronic hepatitis B: Multicenter study

Author

Thanapirom, K., Suksawatamnuay, S., Sukeepaisarnjareon, W., Tanwandee, T., Thongsawat, S., Leerapun, A., Piratvisuth, T., Boonsirichan, R., Bunchorntavakul, C., Pattanasirigool, C., Pornthisarn, B., Tantipanichtheerakul, S., Sripariwuth, E., Jeamsripong, W., Sanpajit, T., Poovorawan, Y., and Komolmit, P.

Published
2015
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36. A multi-society Delphi consensus statement on new fatty liver disease nomenclature

Author

Rinella, Mary E, Lazarus, Jeffrey V, Ratziu, Vlad, Francque, Sven M, Sanyal, Arun J, Kanwal, Fasiha, Romero, Diana, Abdelmalek, Manal F, Anstee, Quentin M, Arab, Juan Pablo, Arrese, Marco, Bataller, Ramon, Beuers, Ulrich, Boursier, Jerome, Bugianesi, Elisabetta, Byrne, Christopher, Castro Narro, Graciela E, Chowdhury, Abhijit, Cortez-Pinto, Helena, Cryer, Donna, Cusi, Kenneth, El-Kassas, Mohamed, Klein, Samuel, Eskridge, Wayne, Fan, Jiangao, Gawrieh, Samer, Guy, Cynthia D, Harrison, Stephen A, Kim, Seung Up, Koot, Bart, Korenjak, Marko, Kowdley, Kris, Lacaille, Florence, Loomba, Rohit, Mitchell-Thain, Robert, Morgan, Timothy R, Powell, Elisabeth, Roden, Michael, Romero-Gómez, Manuel, Silva, Marcelo, Singh, Shivaram Prasad, Sookoian, Silvia C, Spearman, C Wendy, Tiniakos, Dina, Valenti, Luca, Vos, Miriam B, Wong, Vincent Wai-Sun, Xanthakos, Stavra, Yilmaz, Yusuf, Younossi, Zobair, Hobbs, Ansley, Villota-Rivas, Marcela, Newsome, Philip NVeeral Ajmeral, William Alazawi, Maryam Alkhatry, Naim Alkhouri, Alina Allen, Michael Allison, Khalid Alswat, Mario R Alvares-da-Silva, Michele Alves-Bezerra, Matthew J Armstrong, Diego Arufe, Pablo Aschner, Gyorgy Baffy, Meena Bansal, Pierre Bedossa, Renata Belfort, Thomas Berg, Annalisa Berzigotti, Michael Betel, Cristiana Bianco, Clifford Brass, Carol L Brosgart, Elizabeth Matthews Brunt, Maria Buti, Steve Caldwell, Rotonya Carr, Teresa Casanovas, Laurent Castera, Cyrielle Caussy, Eira Cerda, Naga Chalasani, Wah Kheong Chan, Phunchai Charatcharoenwitthaya, Michael Charlton, Amanda Cheung, Daniela Chiodi, Ray Chung, David Cohen, Kathleen Corey, Helma P Cotrim, Javier Crespo, Anuradha Dassanayake, Nicholas Davidson, Robert De Knegt, Victor De Ledinghen, Münevver Demir, Sebastian Diaz, Anna Mae Diehl, Bruce Dimmig, Melisa Dirchwolf, Ajay Duseja, Karel Dvorak, Mattias Ekstedt, Reda El Wakil, María Lucía Ferraz, Scott Friedman, Michael Fuchs, Amalia Gastaldelli, Anja Geerts, Andreas Geier, Marcos Girala, George Goh, Nicolas Goossens, Isabel Graupera, Hannes Hagström, Zachary Henry, Bela Hunyady, Alan Hutchison, Scott Isaacs, François Jornayvaz, Cynthia Kemp, Denise Kile, Won Kim, David Kleiner, Rohit Kohli, Marcelo Kugelmas, Joel Lavine, Mariana Lazo, Nathalie Leite, Adelina Lozano, Panu Luukkonen, Paula Macedo, Dina Mansour, Christos Mantzoros, Giulio Marchesini, Sebastián Marciano, Kim Martinez, Lyudmila Vladimirova Mateva, Jose M Mato, Alexis McCary, Luca Miele, Ivana Mikolasevic, Veronica Miller, Rosalba Moreno, Cynthia Moylan, Atsushi Nakajima, Jean Charles Nault, Suzanne Norris, Mazen Noureddin, C P Oliveira, Arlin Ong, Martín Padilla, Raluca Pais, Arturo Panduro, Manas K Panigrahi, George Papatheodoridis, Serena Pelusi, Marlene Pérez, Juanita Perez Escobar, Gianluca Perseghin, Mario Pessoa, Salvatore Petta, Massimo Pinzani, Monica Platon Lupsor, Atoosa Rabiee, Stefano Romeo, Yaron Rotman, Ian Rowe, Riina Salupere, Sanjaya Satapathy, Jörn M Schattenberg, Wendy Schaufert, Bernd Schnabl, Lynn Seim, Lawrence Serfaty, David Shapiro, Ashwani K Singal, Lubomir Skladany, Norbert Stefan, Jonathan Stine, Shikha Sundaram, Gianluca Svegliati-Baroni, Gyonzgi Szabo, Frank Tacke, Tawesak Tanwandee, Giovanni Targher, Norah Terrault, Brent Tetri, Maja Thiele, Baron Tisthammer, Aldo Torre Delgadillo, Michael Trauner, Emmanuel Tsochatzis, Laurens Van Kleef, Saskia Van Mil, Lisa VanWagner, Jose Antonio Velarde Ruiz Velasco, Mette Vesterhus, Eduardo Vilar-Gomez, Kymberly Watt, Julia Wattacheril, Fonda Wilkins, José Willemse, Amany Zekry, Shira Zelber-Sagi, Mary E, R, Jeffrey V, L, Vlad, R, Sven M, F, Arun J, S, Fasiha, K, Diana, R, Manal F, A, Quentin M, A, Juan Pablo, A, Marco, A, Ramon, B, Ulrich, B, Jerome, B, Elisabetta, B, Christopher, B, Graciela E, C, Abhijit, C, Helena, C, Donna, C, Kenneth, C, Mohamed, E, Samuel, K, Wayne, E, Jiangao, F, Samer, G, Cynthia D, G, Stephen A, H, Seung Up, K, Bart, K, Marko, K, Kris, K, Florence, L, Rohit, L, Robert, M, Timothy R, M, Elisabeth, P, Michael, R, Manuel, R, Marcelo, S, Shivaram Prasad, S, Silvia C, S, C Wendy, S, Dina, T, Luca, V, Miriam B, V, Vincent, W, Stavra, X, Yusuf, Y, Zobair, Y, Ansley, H, Marcela, V, Newsome, NVeeral Ajmeral, P, Alazawi, W, Alkhatry, M, Alkhouri, N, Allen, A, Allison, M, Alswat, K, R Alvares-da-Silva, M, Alves-Bezerra, M, J Armstrong, M, Arufe, D, Aschner, P, Baffy, G, Bansal, M, Bedossa, P, Belfort, R, Berg, T, Berzigotti, A, Betel, M, Bianco, C, Brass, C, L Brosgart, C, Matthews Brunt, E, Buti, M, Caldwell, S, Carr, R, Casanovas, T, Castera, L, Caussy, C, Cerda, E, Chalasani, N, Kheong Chan, W, Charatcharoenwitthaya, P, Charlton, M, Cheung, A, Chiodi, D, Chung, R, Cohen, D, Corey, K, P Cotrim, H, Crespo, J, Dassanayake, A, Davidson, N, De Knegt, R, De Ledinghen, V, Demir, M, Diaz, S, Mae Diehl, A, Dimmig, B, Dirchwolf, M, Duseja, A, Dvorak, K, Ekstedt, M, El Wakil, R, Lucía Ferraz, M, Friedman, S, Fuchs, M, Gastaldelli, A, Geerts, A, Geier, A, Girala, M, Goh, G, Goossens, N, Graupera, I, Hagström, H, Henry, Z, Hunyady, B, Hutchison, A, Isaacs, S, Jornayvaz, F, Kemp, C, Kile, D, Kim, W, Kleiner, D, Kohli, R, Kugelmas, M, Lavine, J, Lazo, M, Leite, N, Lozano, A, Luukkonen, P, Macedo, P, Mansour, D, Mantzoros, C, Marchesini, G, Marciano, S, Martinez, K, Vladimirova Mateva, L, M Mato, J, Mccary, A, Miele, L, Mikolasevic, I, Miller, V, Moreno, R, Moylan, C, Nakajima, A, Charles Nault, J, Norris, S, Noureddin, M, P Oliveira, C, Ong, A, Padilla, M, Pais, R, Panduro, A, K Panigrahi, M, Papatheodoridis, G, Pelusi, S, Pérez, M, Perez Escobar, J, Perseghin, G, Pessoa, M, Petta, S, Pinzani, M, Platon Lupsor, M, Rabiee, A, Romeo, S, Rotman, Y, Rowe, I, Salupere, R, Satapathy, S, M Schattenberg, J, Schaufert, W, Schnabl, B, Seim, L, Serfaty, L, Shapiro, D, K Singal, A, Skladany, L, Stefan, N, Stine, J, Sundaram, S, Svegliati-Baroni, G, Szabo, G, Tacke, F, Tanwandee, T, Targher, G, Terrault, N, Tetri, B, Thiele, M, Tisthammer, B, Torre Delgadillo, A, Trauner, M, Tsochatzis, E, Van Kleef, L, Van Mil, S, Vanwagner, L, Antonio Velarde Ruiz Velasco, J, Vesterhus, M, Vilar-Gomez, E, Watt, K, Wattacheril, J, Wilkins, F, Willemse, J, Zekry, A, Zelber-Sagi, S, and Vincent Wai-Sun, W

Subjects
steatotic liver disease, MASLD, alcohol, steatohepatiti, MetALD, NASH, nonalcoholic, Delphi, Fatty liver disease, NAFLD, cardiometabolic, nomenclature, mafld, type 2 diabetes, MED/13 - ENDOCRINOLOGIA
Abstract

Unlabelled: The principal limitations of the terms nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favour of a change in nomenclature and/or definition. Methods: A modified Delphi process was led by three large pan-national liver associations. Consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. Results: A total of 236 panellists from 56 countries participated in four online surveys and two hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83% and 78%, respectively. 74% of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms 'non-alcoholic' and 'fatty' were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease (SLD) was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease (MASLD). There was consensus to change the definition to include the presence of at least one of five cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic SLD. A new category, outside pure MASLD, termed MetALD was selected to describe those with MASLD who consume greater amounts of alcohol per week (140 to 350g/week and 210 to 420g/week for females and males respectively). Conclusions: The new nomenclature and diagnostic criteria are widely supported, non-stigmatising and can improve awareness and patient identification.

Published
2023

50. Global multi-societies endorsement of the MAFLD definition.

Author

Alboraie M, Tanwandee T, Xu X, Nikolova D, Estupiñan EC, Ghazinyan H, Alawadhi S, Ocama P, Aghayeva G, Piscoya A, Farahat T, Prasad P, Lesmana CRA, Joshi SR, Al-Busafi S, Milivojevic V, Kayamba V, Lee YY, Alam S, Tang C, Xie WF, Derbala M, Nan Y, Ndububa D, Zheng H, Zhao J, Alkhalidi N, Ghanem Y, Charatcharoenwitthaya P, Mahtab M, Hegazy NN, Sinkala E, Dovia CK, Mahamat MA, El-Shabrawi M, Hang DV, Vinker S, Hotayt B, Tahiri M, Bogomolov P, Afredj N, Shaltout I, Elwakil R, Hamed AE, Kamani L, Abdulla M, Assi C, Baatarkhuu O, Tarrah MA, Ajlouni Y, Abidine B, Muñoz C, Ali M, Salama E, Elamin A, Memon IA, Mirijanyan A, Jamil S, Nersesov AV, Ekanem N, Hamoudi W, Bright B, Casanovas T, Itodo E, Torres EA, Karin M, Zerem E, Turcan S, Dulskas A, Lupasco I, Jucov A, Tzeuton C, Sombie R, Lapshyna K, Dorofeyev A, Awuku YA, Duda HÜ, Ande R, Koofy NE, Kamal N, Pan Z, Peltec A, Qiao L, Rakotozafindrabe ALR, Salama A, Soliman R, Wafaa B, Debu M, Micah EA, Shiha G, Eslam M, and Fouad Y

Abstract

Competing Interests: Declaration of interests None.

Published
2024
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