ABSTRACT
Endoscopic ultrasound (EUS)-guided liver biopsy is gaining popularity for liver parenchymal sampling due to its detailed visualization of liver anatomy, precision in sampling, and the ability to combine liver biopsy with other endoscopic goals. In this study, we present a case involving an anatomically complex, immunocompromised patient who underwent EUS-guided liver biopsy. While the samples were sufficient and progressed the management of her autoimmune hepatitis, her course was complicated by a multiloculated liver abscess. EUS liver biopsy has an excellent safety profile, but a small risk of infection remains, especially in immunocompromised patients or those with preexisting biliary obstruction.
ABSTRACT
Sex disparities in cardiac homeostasis and heart disease are well documented, with differences attributed to actions of sex hormones. However, studies have indicated sex chromosomes act outside of the gonads to function without mediation by gonadal hormones. Here, we performed transcriptional and proteomics profiling to define differences between male and female mouse hearts. We demonstrate, contrary to current dogma, cardiac sex disparities are controlled not only by sex hormones but also through a sex-chromosome mechanism. Using Turner syndrome (XO) and Klinefelter (XXY) models, we find the sex-chromosome pathway is established by X-linked gene dosage. We demonstrate cardiac sex disparities occur at the earliest stages of heart formation, a period before gonad formation. Using these datasets, we identify and define a role for alpha-1B-glycoprotein (A1BG), showing loss of A1BG leads to cardiac defects in females, but not males. These studies provide resources for studying sex-biased cardiac disease states.