1/40. Acute eosinophilic interstitial nephritis and uveitis (TINU syndrome) associated with granulomatous hepatitis.A 23-year-old male presented with renal failure, cholestatic liver enzyme elevation and uveitis. Percutaneous renal biopsy revealed marked eosinophilic infiltration of the renal interstitium, which made the diagnosis of TINU syndrome (Tubulo-Interstitial nephritis and uveitis). Percutaneous liver biopsy showed granulomatous hepatitis, which was not described as a part of TINU syndrome. The diagnostic dilemma and the literature are discussed.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/40. Hepatic capillariasis in children: report of 3 cases in brazil.capillaria hepatica is a helminth that may cause an extremely rare condition of parasitic hepatitis. Only 29 cases have been published, 2 of them in brazil. We report here 3 cases of children in brazil with massive hepatic capillariasis who presented the characteristic triad of this type of infection, i.e., persistent fever, hepatomegaly, and eosinophilia. The diagnosis was made by liver biopsy. All children responded well after treatment with thiabendazole (case 1), albendazole (case 3), and albendazole in combination with a corticoid (case 2). Case 1 has been followed-up for 24 years, an event not previously reported in the literature.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
3/40. Eosinophilic enteritis observed during alpha-interferon therapy for chronic hepatitis c.We report a patient with chronic hepatitis c who developed eosinophilic enteritis while being treated with recombinant interferon alpha-2b. He had no history of either allergic disorders or recurring episodes of abdominal cramps, nausea, or diarrhea. He also had had a normal eosinophil count prior to the interferon treatment. After a 12-week course of interferon alpha-2b, he began to complain of severe abdominal pain, diarrhea, and abdominal fullness. His peripheral eosinophil count increased to 45% (absolute count, of 7,610/microl). Abdominal ultrasonography and computed tomography revealed diffuse thickness of the intestinal wall with gross ascites that contained numerous eosinophils. An upper gastrointestinal barium study with small bowel follow-through showed an edematous mucosal layer of the jejunum and ileum. There was a spectacular relief of the patient's subjective symptoms after the administration of prednisolone. follow-up studies revealed resolution of the ascites and the mucosal layer edema and normalization of the peripheral eosinophil count. prednisolone was tapered off, but the eosinophilic enteritis did not recur. As there had been no evident exposure to common causative factors for eosinophilic enteritis, we suggest that interferon alpha-2b could thus have played a role in the triggering of the eosinophilic enteritis.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
4/40. A case report of olanzapine-induced hypersensitivity syndrome.hypersensitivity syndrome is defined as a drug-induced complex of symptoms consisting of fever, rash, and internal organ involvement. The hypersensitivity syndrome is well recognized as being caused by anticonvulsants. Olanzapine is an atypical antipsychotic agent whose side effects include sedation, weight gain, and increased creatinine kinase and transaminase levels. To date, there have been no reports of hypersensitivity syndrome related to this drug. A 34-year-old man developed a severe generalized pruritic skin eruption, fever, eosinophilia, and toxic hepatitis 60 days after ingestion of olanzapine. After termination of olanzapine treatment, the fever resolved, the skin rash was reduced, eosinophil count was reduced to normal, and the transaminase levels were markedly reduced. Clinical features and the results of skin and liver biopsies indicated that the patient developed hypersensitivity syndrome caused by olanzapine.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
5/40. Is it Crohn's disease? A severe systemic granulomatous reaction to sulfasalazine in patient with rheumatoid arthritis.BACKGROUND: sulfasalazine is a widely used anti-inflammatory agent in the treatment of inflammatory bowel disease and several rheumatological disorders. Although as many as 20% of treated patients may experience reversible, dose-dependent side effects, less frequent but potentially severe, systemic reactions have also been reported. CASE PRESENTATION: A severe systemic reaction to sulfasalazine developed in a 21-year old female with rheumatoid arthritis characterized by eosinophilia, granulomatous enteritis and myelotoxicity, cholestatic hepatitis, and seizures. The clinical course and management of this patient are presented as well as a review of the incidence and outcome of severe systemic reactions to sulfasalazine. CONCLUSIONS: Granulomatous myelotoxicity and enteritis developed in a 21 year old female within 3 weeks of initiating sulfasalazine for rheumatoid arthritis. Following a short course of corticosteroids, the patient had resolution of her cholestatic hepatitis, rash, eosinophilia, and gastrointestinal symptoms with no residual manifestations at 7 months follow-up. Although severe reactions to sulfasalazine are rare and unpredictable, practicing physicians should be aware of unusual clinical presentations of toxicity when prescribing sulfasalazine.- - - - - - - - - - ranking = 0.4keywords = hepatitis (Clic here for more details about this article) |
6/40. phenytoin hypersensitivity syndrome.phenytoin hypersensitivity syndrome (PHS) is a rare, and important entity characterized by rash, fever, lymphadenopathy, leukocytosis with atypical lymphocytes, eosinophilia and associated hepatitis. In this article, we present the clinical, laboratory and histopathologic results of 5 cases of PHS. In therapy, pheyntoin was stopped and sodium valproate (10-20 mg/kg day) was started. Additionally, prednisolone was given in two patients who had not resolved eruption with conservative therapy.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
7/40. Eosinophilic gastroenteritis and gluten-sensitive enteropathy in the same patient.We report the clinical and laboratory features of a 19-year-old man with findings of both eosinophilic gastroenteritis and gluten-sensitive enteropathy. Before the onset of clinical symptoms, the patient had received a series of hepatitis b vaccinations but had not developed a measurable antibody response or any allergic reaction. radioallergosorbent test results were positive to several foods, and the total serum immunoglobulin e (IgE) level was elevated. Adherence to a gluten-free diet caused a normalization in the endomysial antibody titer; however, the total serum IgE level continued to increase, and the total eosinophil count remained elevated. Symptoms of recurrent vomiting and abdominal pain necessitated prednisone burst therapy. The simultaneous occurrence of eosinophilic gastroenteritis and gluten-sensitive enteropathy is rare; therapy should be directed to each disorder individually.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
8/40. vasculitis induced by zafirlukast therapy.Zafirlukast is a leukotriene inhibitor that has recently been approved for the prophylaxis of asthma. Although this new product has been well accepted because of its convenient dosing and relatively few side effects, several cases of churg-strauss syndrome have been reported to be associated with its use. In this paper we describe the case of a 54-year-old white man with no history of corticosteroid therapy in whom leukocytoclastic vasculitis, hepatitis and eosinophilia developed while he was on zafirlukast therapy for mild asthma.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
9/40. Drug rash with eosinophilia and systemic symptoms syndrome and renal toxicity with a nevirapine-containing regimen in a pregnant patient with human immunodeficiency virus.BACKGROUND: Antiretroviral therapy is associated with serious adverse events. We report the case of a pregnant human immunodeficiency virus type 1-infected woman who developed drug rash with eosinophilia and systemic symptoms syndrome and renal failure shortly after initiation of a nevirapine-containing antiretroviral regimen at 27 weeks' gestation. CASE: A 26-year-old primigravida presented with a fever of 40.2C, urticarial rash, and icteric sclera 6 weeks after starting a nevirapine-containing antiretroviral regimen. eosinophils, serum creatinine, bilirubin, and liver enzymes were markedly elevated, and abnormal coagulation studies were noted on admission. serology testing was negative for viral hepatitis and microbiologic cultures were negative for growth. Abnormal laboratory findings at discharge resolved within 4 months after discontinuation of antiretroviral agents and systemic corticosteroid therapy. CONCLUSION: Our case suggests the need for close monitoring of liver and renal function after initiation of nevirapine-containing antiretroviral regimens.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
10/40. Drug-induced rash with eosinophilia and systemic symptoms syndrome with bupropion administration.BACKGROUND: Sustained-release bupropion is commonly used for the symptomatic relief of depressive illness and as an adjuvant in smoking cessation therapy. OBJECTIVE: To report a case of bupropion-induced drug rash with eosinophilia and systemic symptoms syndrome, including acute hepatitis, obstructive lung disease, and myositis. methods: After the patient discontinued use of bupropion, serologic tests, muscle biopsies, pulmonary function tests, a chest x-ray examination, venous Doppler ultrasounds, and an electrocardiogram were performed. RESULTS: On discontinuation of bupropion and prolonged systemic corticosteroid therapy, there was complete resolution of symptoms. CONCLUSIONS: To our knowledge, this is the first reported case of drug rash with eosinophilia and systemic symptoms syndrome induced by bupropion therapy. We report this case to notify clinicians of the potential serious multisystem complications that can occur with sustained-release bupropion therapy.- - - - - - - - - - ranking = 0.2keywords = hepatitis (Clic here for more details about this article) |
| | Next -> |