alcohol and parenteral heroin abuse . association with adolescent onset of Hepatic cirrhosis in young adults :

Hepatic cirrhosis is infrequently diagnosed in young adults. In a hospital for addictive diseases in New York City, we found cirrhosis in 53 patients under age 35 within just 40 months. The cirrhosis was biopsy-proven in 37 patients (group I) and diagnosed clinically in 16 patients with severe liver disease (group II). Alcohol abuse was found in 51 patients (96%), and parenteral heroin abuse was seen in 52 (98%). The duration of alcohol abuse was seven or fewer years in 24 patients (45%) and 10 or fewer in 39 (74%). In 44 (83%), the substance abuse began in adolescence. Comparison of group I cirrhotic patients with 65 non-cirrhotic biopsied patients showed that cirrhosis was significantly associated with abuse of both alcohol and parenteral heroin (p<OOO1). The distribution of 66 HLA antigens from A, B, C, and DR loci showed no differences when 42 patients were compared with 42 ethnically-matched control substance abusers. The early development of cirrhosis in these young patients may be related to multiple hepatic injuries induced by alcohol and parenteral heroin abuse and to the onset of addictive diseases during adolescence or early adult life.

[1]  W. Bodmer,et al.  HL-A antigens and disease. Statistical and genetical considerations. , 2008, Tissue antigens.

[2]  R. Millman,et al.  Alcohol use in youthful methadone-maintained former heroin addicts: liver impairment and treatment outcome. , 1983, Alcoholism, clinical and experimental research.

[3]  M. Goldman,et al.  Development of alcohol-related expectancies in adolescents: separating pharmacological from social-learning influences. , 1982, Journal of consulting and clinical psychology.

[4]  C. Barbatis,et al.  Heterozygous MZ alpha 1-antitrypsin deficiency in adults with chronic active hepatitis and cryptogenic cirrhosis. , 1981, The New England journal of medicine.

[5]  M. Kreek,et al.  Hepatitis B serologic studies in narcotic users with chronic liver disease. , 1981, The American journal of gastroenterology.

[6]  H. Ishii,et al.  HLA antigens as immunogenetic markers of alcoholism and alcoholic liver disease , 1980, Pharmacology Biochemistry and Behavior.

[7]  Jerold A. Cohen,et al.  The SGOT/SGPT ratio—An indicator of alcoholic liver disease , 1979, Digestive Diseases and Sciences.

[8]  T C Chalmers,et al.  The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 "negative" trials. , 1978, The New England journal of medicine.

[9]  B. Stimmel,et al.  ALCOHOLISM AND POLYDRUG ABUSE IN PERSONS OF METHADONE MAINTENANCE * , 1978, Annals of the New York Academy of Sciences.

[10]  P. Terasaki,et al.  Microdroplet testing for HLA-A, -B, -C, and -D antigens. The Phillip Levine Award Lecture. , 1978, American journal of clinical pathology.

[11]  R. Purcell,et al.  The natural history of liver disease in former drug users , 1976, The American journal of the medical sciences.

[12]  E. Schiff,et al.  Hepatic disease in asymptomatic parenteral narcotic drug abusers: a Veterans Administration collaborative study. , 1975, The American journal of the medical sciences.

[13]  E. Gunderson,et al.  Deaths among young alcoholics in the U.S. Naval Service. , 1974, Quarterly journal of studies on alcohol.

[14]  M. Kreek,et al.  Long-term methadone maintenance therapy: effects on liver function. , 1972, Annals of internal medicine.

[15]  I. Litt,et al.  Liver disease in the drug-using adolescent. , 1972, The Journal of pediatrics.

[16]  A. Prince,et al.  Chronic liver disease in asymptomatic narcotic addicts. , 1972, Annals of internal medicine.

[17]  J. Ball,et al.  Causes of death among institutionalized narcotic addicts. , 1970, Journal of chronic diseases.

[18]  L. Kuller,et al.  The increasing mortality attributed to cirrhosis and fatty liver, in Baltimore (1957-1966). , 1968, Annals of internal medicine.

[19]  W. Creutzfeldt,et al.  Cirrhosis of the liver. On the aetiology, pathogenesis, results of treatment and period of survival in an unselected series of 560 patients. , 1966, German medical monthly.

[20]  E. Henrikson.  CIRRHOSIS OF THE LIVER: WITH SPECIAL REFERENCE TO THE SURGICAL ASPECTS , 1936 .

[21]  M. DehesaViolante.  The delta agent , 1985 .

[22]  M. Davis,et al.  Histocompatibility antigens in alcoholic liver disease. , 1982, British medical bulletin.

[23]  I. Mackay,et al.  HLA and alcoholic cirrhosis. , 1982, Tissue antigens.

[24]  I. Mackay,et al.  HLA associations with autoimmune-type chronic active hepatitis: identification of B8-DRw3 haplotype by family studies. , 1980, Gastroenterology.

[25]  B. Stimmel,et al.  Mortality rates of persons entering methadone maintenance: a seven-year study. , 1979, The American journal of drug and alcohol abuse.

[26]  O. Anand,et al.  Quantitative and temporal relationships of alcohol use in narcotic addicts and methadone maintenance patients undergoing alcohol detoxification. , 1978, The American journal of drug and alcohol abuse.

[27]  W. Stone,et al.  The natural history of cirrhosis. Experience with an unselected group of patients. , 1968, The Quarterly journal of medicine.

[28]  T. Koizumi,et al.  Cirrhosis of the liver in Japan. , 1965, Acta hepato-splenologica.