In a representative population sample of 905 persons we examined the prevalence of raised levels of liver-derived enzymes and its possible association with self-reported alcohol consumption adjusted for smoking and BMI applying logistic regression analyses. A large proportion of 12% (women 8%; men 16%) presented raised liver-derived enzymes. Below 21 units per week (one unit equals 12 grams of alcohol) there was no association with self-reported alcohol consumption. However, the risk of abnormal liver enzymes increased with higher consumption for both sexes; if the intake was above 28 units per week, the odds ratio for raised liver enzymes increased dramatically. Whether this subclinical biochemical liver condition is an early marker of alcohol-related liver damage remains to be seen, but the long-term consequences of the reported alcohol consumption and the frequency of raised liver enzymes require follow-up.
Captopril, the competitive inhibitor of angiotensin-converting enzyme, has proved efficient in the treatment of arterial hypertension and heart failure. Its use is generally associated with low incidence of adverse reactions and hepatic injury has not been emphasized as an important adverse reaction in Denmark. However worldwide, several cases of hepatic injury have been reported. We report one case of Captopril-induced hepatic injury. Despite discontinuation of Captopril a hepatorenal syndrome developed and the patient died five weeks after admission. This report emphasizes the need to be aware of the possibility of hepatic injury in patients receiving Captopril.
Carcinoma of the breast is the most common type of cancer among women in Denmark (3,000 new cases a year). About half of the patients will at some time develop metastases. Treatment of extended disease is controversial. Public discussion has focused on whether it is desirable to treat these patients with chemotherapy or not. This case story describes four cases with long term survival (nine, ten, 14, 19 years after début of metastases). This underlines that it is possible within the existing types of treatment to achieve both extended survival and acceptable life quality. The doctor's dilemma is that he does not know whom treatment helps. We conclude that treatment should be offered to all patients. This will be of benefit to the whole group.
Comment In: Ugeskr Laeger. 1995 Jan 16;157(3):3017846781