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Pigment gallstone composition in patients with hemolysis or infection/stasis

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Abstract

The effect of hemolysis and infection/stasis on pigment gallstones was assessed by comparing the composition of stones from (1) U.S. patients without hemolysis or cirrhosis, (2) U.S. patients with sickle cell disease, and (3) Japanese patients with biliary infections. Gallstone composition was quantitated by infrared spectroscopy and chemical analyses. Gallstones from patients with sickle cell anemia contained more pigment, carbonate, calcium, and measured components than stones from U.S. patients without hemolysis (P<0.05). However, the similar types of calcium salts in black stones from patients with and without sickle cell anemia suggested that intermittent hemolysis may be a potential mechanism in the formation of black stones found in the general population. In Japanese patients with brown pigment stones, there was an absence of calcium carbonate, low levels of calcium phosphate, and the presence of calcium salts of fatty acids (P<0.05). Thus, the accompanying stasis and/or infection in this latter group was associated with the formation of a distinctive stone type and was not involved in the formation of the black stones. The similarly small proportion of cholesterol in each of these groups suggested that it was present due to coprecipitation rather than to cholesterol supersaturation.

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Author notes

  1. Willis C. Maddrey MD

    Present address: Department of Medicine, Jefferson University, 19107, Philadelphia, Pennsylvania

Authors and Affiliations

  1. Gastrointestinal Section, Department of Medicine, University of Pennsylvania School of Medicine, 3400 Spruce Street, 19104, Philadelphia, Pennsylvania

    Roger D. Soloway MD, Bruce W. Trotman MD,  Willis C. Maddrey MD & Fumio Nakayama MD

  2. Liver Unit, Department of Medicine, Johns Hopkins University School of Medicine, 21205, Baltimore, Maryland

    Roger D. Soloway MD, Bruce W. Trotman MD,  Willis C. Maddrey MD & Fumio Nakayama MD

  3. Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka 812, Japan

    Roger D. Soloway MD, Bruce W. Trotman MD,  Willis C. Maddrey MD & Fumio Nakayama MD

Authors
  1. Roger D. Soloway MD
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  2. Bruce W. Trotman MD
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  3. Willis C. Maddrey MD
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  4. Fumio Nakayama MD
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Additional information

This work was supported in part by a grant from the National Institutes of Health, AM-16549.

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Soloway, R.D., Trotman, B.W., Maddrey, W.C. et al. Pigment gallstone composition in patients with hemolysis or infection/stasis. Digest Dis Sci 31, 454–460 (1986). https://doi.org/10.1007/BF01320307

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  • DOI: https://doi.org/10.1007/BF01320307

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