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Article ; Online: Delayed drug-induced liver injury (DILI) and flare of chronic plaque psoriasis secondary to lisinopril use.

Jarman, Georgeina L / Webb, Gwilym J

BMJ case reports

2024 Volume 17, Issue 1

Abstract: Lisinopril is an ACE inhibitor commonly used in the treatment of cardiovascular and renal disease. Rarely, ACE inhibitors have been associated with cholestatic jaundice and hepatitis, with potential risk of fulminant hepatic failure if continued. There ... ...

Abstract	Lisinopril is an ACE inhibitor commonly used in the treatment of cardiovascular and renal disease. Rarely, ACE inhibitors have been associated with cholestatic jaundice and hepatitis, with potential risk of fulminant hepatic failure if continued. There is limited information available regarding the risk of hepatic failure secondary to lisinopril use, with a handful of case reports demonstrating drug-induced liver injury at varying time scales from drug initiation. In this case, we present a man with symptoms of cholestatic jaundice, a blistering skin rash and flare of chronic plaque psoriasis, 27 months after lisinopril initiation for hypertension. Biochemical, serological and radiological investigations of an alternative cause for his jaundice were unremarkable. Cessation of lisinopril led to a rapid and sustained improvement in liver biochemistry and a significant improvement in his chronic plaque psoriasis.
MeSH term(s)	Male ; Humans ; Lisinopril ; Jaundice, Obstructive ; Psoriasis ; Angiotensin-Converting Enzyme Inhibitors ; Chemical and Drug Induced Liver Injury ; Exanthema
Chemical Substances	Lisinopril (E7199S1YWR) ; Angiotensin-Converting Enzyme Inhibitors
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2023-256317
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Article ; Online: Severe refractory warm autoimmune haemolytic anaemia after the SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA) managed with emergency splenectomy and complement inhibition with eculizumab.

Jackson, Emma Marguerite / Harper, Simon / Webb, Gwilym J / Thomas, Will

BMJ case reports

2022 Volume 15, Issue 8

Abstract: A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of ...

Abstract	A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA). Investigations revealed a warm AIHA picture. Over 4 weeks the patient developed life-threatening anaemia culminating in haemoglobin of 35 g/L (after transfusion), lactate dehydrogenase of 1293 units/L and bilirubin of 228 µmol/L, refractory to standard treatment with corticosteroids and rituximab. An emergency splenectomy was performed that slowed haemolysis but did not completely ameliorate it. Eculizumab, a terminal complement pathway inhibitor, was initiated to arrest intravascular haemolysis and showed a favourable response. AIHA is rare but described after the SARS-CoV-2 Pfizer-BioNTech vaccine. This case highlights the rare complication of AIHA, the use of emergency splenectomy for disease control, and the use of eculizumab.
MeSH term(s)	Adolescent ; Anemia, Hemolytic, Autoimmune/complications ; Antibodies, Monoclonal, Humanized ; BNT162 Vaccine/administration & dosage ; BNT162 Vaccine/adverse effects ; Bilirubin ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Complement Inactivating Agents/therapeutic use ; Hemoglobins ; Hemolysis ; Humans ; Immunologic Factors/therapeutic use ; Lactate Dehydrogenases ; Male ; RNA, Messenger/therapeutic use ; Rituximab/therapeutic use ; SARS-CoV-2 ; Splenectomy/adverse effects
Chemical Substances	Antibodies, Monoclonal, Humanized ; COVID-19 Vaccines ; Complement Inactivating Agents ; Hemoglobins ; Immunologic Factors ; RNA, Messenger ; Rituximab (4F4X42SYQ6) ; eculizumab (A3ULP0F556) ; Lactate Dehydrogenases (EC 1.1.-) ; BNT162 Vaccine (N38TVC63NU) ; Bilirubin (RFM9X3LJ49)
Language	English
Publishing date	2022-08-31
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-250774
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Article ; Online: To NRP or Not to NRP, That Is the Question….

Ayorinde, John O O / Webb, Gwilym J / Richards, James A

Transplantation

2019 Volume 103, Issue 12, Page(s) e399

MeSH term(s)	Cell Movement ; Humans ; Liver Transplantation ; Perfusion ; Signal Transduction ; Tissue Donors
Language	English
Publishing date	2019-12-30
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000002877
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Article ; Online: Outcomes of livers from donation after circulatory death donors with extended agonal phase and the adjunct of normothermic regional perfusion.

Richards, James A / Gaurav, Rohit / Upponi, Sara S / Swift, Lisa / Fear, Corrina / Webb, Gwilym J / Allison, Michael E D / Watson, Christopher J E / Butler, Andrew J

The British journal of surgery

2023 Volume 110, Issue 9, Page(s) 1112–1115

MeSH term(s)	Humans ; Tissue Donors ; Perfusion ; Liver ; Organ Preservation ; Tissue and Organ Procurement ; Graft Survival
Language	English
Publishing date	2023-04-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad099
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Article ; Online: Age and comorbidity are central to the risk of death from COVID-19 in liver transplant recipients.

Webb, Gwilym J / Moon, Andrew M / Barnes, Eleanor / Barritt, A Sidney / Marjot, Thomas

Journal of hepatology

2021 Volume 75, Issue 1, Page(s) 226–228

MeSH term(s)	COVID-19 ; Comorbidity ; Humans ; Incidence ; Liver Transplantation ; SARS-CoV-2 ; Transplant Recipients
Language	English
Publishing date	2021-02-05
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	605953-3
ISSN	1600-0641 ; 0168-8278
ISSN (online)	1600-0641
ISSN	0168-8278
DOI	10.1016/j.jhep.2021.01.036
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Article ; Online: Primary biliary cholangitis in 2016: High-definition PBC: biology, models and therapeutic advances.

Webb, Gwilym J / Hirschfield, Gideon M

Nature reviews. Gastroenterology & hepatology

2017 Volume 14, Issue 2, Page(s) 76–78

MeSH term(s)	Chenodeoxycholic Acid/analogs & derivatives ; Chenodeoxycholic Acid/pharmacology ; Humans ; Liver Cirrhosis, Biliary/drug therapy ; Liver Cirrhosis, Biliary/etiology ; Liver Cirrhosis, Biliary/pathology
Chemical Substances	obeticholic acid (0462Z4S4OZ) ; Chenodeoxycholic Acid (0GEI24LG0J)
Language	English
Publishing date	2017-01-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2493722-8
ISSN	1759-5053 ; 1759-5045
ISSN (online)	1759-5053
ISSN	1759-5045
DOI	10.1038/nrgastro.2016.201
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Zs.A 6020: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MG 97: Show issues

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Article ; Online: SARS-CoV-2 Infection and Liver Disease: A Review of Pathogenesis and Outcomes.

Baldelli, Luke / Marjot, Thomas / Barnes, Eleanor / Barritt, A Sidney / Webb, Gwilym J / Moon, Andrew M

Gut and liver

2022 Volume 17, Issue 1, Page(s) 12–23

Abstract: The impact of the coronavirus disease 2019 (COVID-19) pandemic has been immense, and it continues to have lasting repercussions. While the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus primarily infects the respiratory system, other ... ...

Abstract	The impact of the coronavirus disease 2019 (COVID-19) pandemic has been immense, and it continues to have lasting repercussions. While the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus primarily infects the respiratory system, other organ systems are affected, including the liver. Scientific knowledge on the role of SARS-CoV-2 infection and liver injury has evolved rapidly, with recent data suggesting specific hepatotropism of SARS-CoV-2. Moreover, additional concerns have been raised in regard to long-term liver damage, related to emerging cases of post-COVID-19 cholangiopathy and chronic cholestasis. Great effort has also been focused on studying how specific subpopulations with chronic medical conditions might be disproportionately impacted by COVID-19. One such population includes individuals with chronic liver disease (CLD) and cirrhosis, with an expanding body of research indicating these patients being particularly susceptible to adverse outcomes. In this review, we provide an updated summary on the current pathogenesis and mechanism of liver injury in the setting of SARS-CoV-2 infection, the association between health outcomes and SARS-CoV-2 infection in patients with CLD, and the unique consequences of the COVID-19 pandemic on the routine care of patients with CLD.
MeSH term(s)	Humans ; COVID-19/complications ; SARS-CoV-2 ; Pandemics ; Liver Diseases/complications ; Liver Diseases/epidemiology
Language	English
Publishing date	2022-12-02
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2399010-7
ISSN	2005-1212 ; 1976-2283
ISSN (online)	2005-1212
ISSN	1976-2283
DOI	10.5009/gnl220327
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Article ; Online: The Epidemiology of UK Autoimmune Liver Disease Varies With Geographic Latitude.

Webb, Gwilym J / Ryan, Ronan P / Marshall, Tom P / Hirschfield, Gideon M

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2021 Volume 19, Issue 12, Page(s) 2587–2596

Abstract: Background & aims: The epidemiology of autoimmune liver disease (AILD) is challenging to study because of the diseases' rarity and because of cohort selection bias. Increased incidence farther from the Equator has been reported for multiple sclerosis, ... ...

Abstract	Background & aims: The epidemiology of autoimmune liver disease (AILD) is challenging to study because of the diseases' rarity and because of cohort selection bias. Increased incidence farther from the Equator has been reported for multiple sclerosis, another autoimmune disease. We assessed the incidence of primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH) in relation to latitude. Methods: We performed a retrospective cohort study using anonymized UK primary care records from January 1, 2002, to May 10, 2016. All adults without a baseline diagnosis of AILD were included and followed up until the first occurrence of an AILD diagnosis, death, or they left the database. Latitude was measured as registered general practice rounded down to whole degrees. Results: The cohort included 8,590,421 records with 53.3 × 10 Conclusions: We describe an association in the United Kingdom between more northerly latitude and the incidence of PBC and AIH that requires both confirmation and explanation.
MeSH term(s)	Adult ; Autoimmune Diseases ; Cholangitis, Sclerosing ; Female ; Hepatitis, Autoimmune/epidemiology ; Humans ; Liver Cirrhosis, Biliary ; Liver Diseases ; Male ; Retrospective Studies
Language	English
Publishing date	2021-01-22
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2021.01.029
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Article ; Online: Localized Liver Injury During Normothermic Ex Situ Liver Perfusion Has No Impact on Short-term Liver Transplant Outcomes.

Martin, Jack L / Rhodes, Freya / Upponi, Sara / Udeaja, Yagazie / Swift, Lisa / Fear, Corina / Webster, Rachel / Webb, Gwilym James / Allison, Michael / Paterson, Anna / Gaurav, Rohit / Butler, Andrew J / Watson, Christopher J E

Transplantation

2024

Abstract: Background: Normothermic ex situ liver perfusion (NESLiP) has the potential to increase organ utilization. Radiological evidence of localized liver injury due to compression at the time of NESLiP, termed cradle compression, is a recognized phenomenon ... ...

Abstract	Background: Normothermic ex situ liver perfusion (NESLiP) has the potential to increase organ utilization. Radiological evidence of localized liver injury due to compression at the time of NESLiP, termed cradle compression, is a recognized phenomenon but is poorly characterized. Methods: A retrospective analysis of a prospectively collected database was performed of transplanted livers that underwent NESLiP and subsequently had a computed tomography performed within the first 14 d posttransplant. The primary study outcome was 1-y graft survival. Results: Seventy livers (63%) were included in the analysis. Radiological evidence of cradle compression was observed in 21 of 70 (30%). There was no difference in rate of cradle compression between donor after circulatory death and donated after brain death donors (P = 0.37) or with duration of NESLiP. Univariate analysis demonstrated younger (area under the receiver operating characteristic, 0.68; P = 0.008; 95% confidence interval [CI], 0.55-0.82) and heavier (area under the receiver operating characteristic, 0.80; P < 0.001; 95% CI, 0.69-0.91) livers to be at risk of cradle compression. Only liver weight was associated with cradle compression on multivariate analysis (odds ratio, 1.003; P = 0.005; 95% CI, 1.001-1.005). There was no difference in 1-y graft survival (16/17 [94.1%] versus 44/48 [91.6%]; odds ratio, 0.69; P = 0.75; 95% CI, 0.07-6.62). Conclusions: This is the first study assessing the impact of cradle compression on outcome. We have identified increased donor liver weight and younger age as risk factors for the development of this phenomenon. Increasing utilization of NESLiP will result in the increased incidence of cradle compression but the apparent absence of long-term sequelae is reassuring. Routine postoperative axial imaging may be warranted.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004970
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Work in Progress: Drugs in Development.

Webb, Gwilym J / Hirschfield, Gideon M

Clinics in liver disease

2018 Volume 22, Issue 3, Page(s) 501–515

Abstract: Primary biliary cholangitis is an archetypal autoimmune disease that causes cholestasis, fibrosis, and liver failure. Ursodeoxycholic acid and obeticholic acid are approved for its treatment. Not all patients respond, some are intolerant, many have ... ...

Abstract	Primary biliary cholangitis is an archetypal autoimmune disease that causes cholestasis, fibrosis, and liver failure. Ursodeoxycholic acid and obeticholic acid are approved for its treatment. Not all patients respond, some are intolerant, many have ongoing symptoms, and new therapies are required. Herein we describe drugs in development and potential future biological targets. We consider compounds acting on the farnesoid X receptor/fibroblast growth factor 19 pathway, fibrates and other agonists of the peroxisome proliferator-activated receptor family, transmembrane-G-protein-receptor-5 agonists, and several immunological agents. We also consider the roles of bile acid reuptake inhibitors, nalfurafine, and fibrates in pruritus management.
MeSH term(s)	Abatacept/therapeutic use ; Acetates/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antirheumatic Agents/therapeutic use ; Bezafibrate/therapeutic use ; CD40 Antigens/antagonists & inhibitors ; CD40 Ligand/antagonists & inhibitors ; Chalcones/therapeutic use ; Chemokine CX3CL1/antagonists & inhibitors ; Chenodeoxycholic Acid/analogs & derivatives ; Chenodeoxycholic Acid/therapeutic use ; Cholic Acids/therapeutic use ; Drug Development ; Fenofibrate/therapeutic use ; Fibroblast Growth Factors/analogs & derivatives ; Humans ; Hypolipidemic Agents/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Janus Kinase Inhibitors/therapeutic use ; Liver Cirrhosis, Biliary/complications ; Liver Cirrhosis, Biliary/drug therapy ; Methylamines/therapeutic use ; PPAR alpha/agonists ; PPAR delta/agonists ; PPAR gamma/agonists ; Peroxisome Proliferator-Activated Receptors/agonists ; Propionates/therapeutic use ; Pruritus/drug therapy ; Pruritus/etiology ; Receptors, Cytoplasmic and Nuclear/agonists ; Receptors, G-Protein-Coupled/agonists ; Thiazepines/therapeutic use ; Triazoles/therapeutic use ; Ustekinumab/therapeutic use
Chemical Substances	(2-methyl-4-(5-methyl-2-(4-trifluoromethyl-phenyl)-2H-(1,2,3)triazol-4-ylmethylsulfanyl)phenoxy)acetic acid ; 2-(2,6-dimethyl-4-(3-(4-(methylthio)phenyl)-3-oxo-1-propenyl)phenoxyl)-2-methylpropanoic acid ; 3-((((3R,5R)-3-butyl-3-ethyl-7-(methyloxy)-1,1-dioxido-5-phenyl-2,3,4,5-tetrahydro-1,4-benzothiazepin-8-yl)methyl)amino)pentanedioic acid ; 6alpha-ethyl-23(S)-methylcholic acid ; Acetates ; Antibodies, Monoclonal ; Antirheumatic Agents ; CD40 Antigens ; Chalcones ; Chemokine CX3CL1 ; Cholic Acids ; E6011 ; FGF19 protein, human ; GPBAR1 protein, human ; Hypolipidemic Agents ; Immunosuppressive Agents ; Janus Kinase Inhibitors ; Methylamines ; PPAR alpha ; PPAR delta ; PPAR gamma ; Peroxisome Proliferator-Activated Receptors ; Propionates ; Receptors, Cytoplasmic and Nuclear ; Receptors, G-Protein-Coupled ; Thiazepines ; Triazoles ; obeticholic acid (0462Z4S4OZ) ; farnesoid X-activated receptor (0C5V0MRU6P) ; Chenodeoxycholic Acid (0GEI24LG0J) ; CD40 Ligand (147205-72-9) ; Fibroblast Growth Factors (62031-54-3) ; Abatacept (7D0YB67S97) ; Ustekinumab (FU77B4U5Z0) ; Fenofibrate (U202363UOS) ; Bezafibrate (Y9449Q51XH)
Language	English
Publishing date	2018-05-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1472315-3
ISSN	1557-8224 ; 1089-3261
ISSN (online)	1557-8224
ISSN	1089-3261
DOI	10.1016/j.cld.2018.03.004
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