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  • RESEARCH 4 BUSINESS 2016, Ljubljana, 5 and 6 of May 2016

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    Progressive elevation of bilirubin levels, pruritus, or viagra directions to use sepsis in patients with sclerosing cholangitis may be successfully palliated with percutaneous transhepatic biliary drainage (260). High-grade obstruction of the common hepatic duct may extend into the left and right hepatic ducts and there are usually also multiple strictures of the intrahepatic ducts. This may cause liver test abnormalities and, in more serious cases, sclerosing cholangitis. In a recent study of 32 patients who received an average of 5.5 cycles of chemotherapy, the incidence of liver test abnormalities was 16.2% and of severe biliary sclerosis was 7.5% (246). In another recent study in which 8 patients received two cycles of FUDR plus dexamethasone, 21% had elevations viagra directions to use of AST and/or alkaline phosphatase and 5% had bilirubin elevations greater than 6 times the upper limit of normal (197).

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    High-dose daily MTX, whether given for leukemia in children or for psoriasis in adults , was associated with the development of hepatic fibrosis or cirrhosis. One impediment to assessing the true role of MTX in causing cirrhosis in adults with psoriasis had been the lack of baseline pre-MTX liver biopsies in many of the older studies. Even before MTX therapy , this was an especially important omission since it is known that liver histological abnormalities are present in psoriatic patients.

    Preexisting liver abnormalities in patients with psoriasis, mostly steatosis , may be related to the systemic dermatological condition itself and/or comorbid conditions such as alcohol excess, obesity, exposure to other hepatotoxins, hepatitis C, and so forth. High-Dose MTX The most significant long-term side effect of chronic MTX therapy is hepatic fibrosis leading to cirrhosis.

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