Familial cirrhosis with hepatoma

Clustering of hepatocellular carcinoma in Alaska Native families

Alaska Natives have a high incidence of hepatocellular carcinoma (HCC), with regional, ethnic, village, and familial clustering. During 1969-1988, 15 of the 45 incident cases of HCC in Alaska Natives occurred in 5 families. This report presents epidemiologic, virologic, and immunogenetic data on these 5 families. The results of hepatitis B virus (HBV) serologic testing indicates that HBV infection was an important factor in 4 of the 5 families. Human lymphocyte antigen (HLA) testing was performed in 3 families. The HLA results are reviewed in relationship to the familial clustering of HCC.

Factors determining the development of hepatocellular carcinoma in hepatitis B surface antigen carriers. A comparison between families with clusters and solitary cases

This article documents five families with clusters of hepatocellular carcinoma (HCC), including one in which three successive generations were involved. All the 12 patients in these five families and 96.3% of the patients in 54 families with solitary cases of HCC seen during the same period were hepatitis B surface antigen (HBsAg)-positive. The prevalence of HBsAg in families with clusters and solitary cases of HCC was compared. The clustering of HCC in the five families reported could not be accounted for by a higher HBsAg carrier rate or an earlier age of onset of the hepatitis B virus infection. An attempt was made to identify the factors that determine the development of HCC in HBsAg carriers.

Maternal transmission of hepatocellular carcinoma

A family in which four members have died of hepatocellular carcinoma is presented. Hepatitis B surface antigen was present in both cases in which it was sought and also present in nine of ten surviving siblings in the second generation. Maternal transmission of hepatitis B surface antigen and susceptibility to hepatocellular carcinoma is postulated.

Renal tubular transport of proline, hydroxyproline, and glycine. 3. Genetic basis for more than one mode of transport in human kidney

Impaired renal tubular transport of proline, hydroxyproline, and glycine was inherited as an autosomal recessive trait in two Ashkenazi-Jewish pedigrees and one French-Canadian family; the heterozygotes for the trait exhibited hyperglycinuria only. Intestinal transport of imino acids and glycine was not impaired in homozygotes. It is possible that more than one mutant allele may occur at a locus controlling tubular transport of the imino acids and glycine, since one subject with the imino-glycinuric phenotype had one parent who was not hyperglycinuric. More than 60% of the specific tubular transport function is still available in homozygotes for absorption of imino acids and glycine at endogenous substrate concentrations; however, this persistent transport is already saturated at these concentrations in contrast to the large capacity available in normal subjects. Furthermore, the glycine portion of this persistent transport is noninhibitable by imino acids in contrast to the normal situation. The imino acids can inhibit each other's uptake in mutant and normal phenotypes. Two modes of transport for the imino acids and glycine are proposed to explain these observations: (1) a common system with high capacity, and (2) two additional systems, each with low capacity (one-tenth or less of the common system). One of these systems is apparently shared by proline and hydroxyproline. The mutant allele(s) observed in this investigation occur at the locus for the common system.