1/408. Acute transient radiation hepatitis following whole abdominal irradiation.Sporadic cases or radiation hepatitis have been reported following doses above 3500 rad delivered in 3-4 weeks to the liver. The authors report their experience of radiation hepatitis in two out of 117 consecutive lymphoma cases treated with total abdominal irradiation. These two patients developed clinically overt manifestations which lasted for a short period of time and fully recovered. The dose delivered to the whole liver was 3000 rad in six weeks, but in one an additional 1000 rad in five fractions were delivered to the left lobe in an attempt to boost the dose to the central axis lymphatic system up to 4000 rad. The low incidence of radiation hepatitis and its reversible course, when 3000 rad in six weeks are delivered to the whole liver, is emphasised.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
2/408. Hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis.A case of hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis is described. The patient was admitted with symptoms of hepatitis with cholestatic jaundice. Antibody tests for hepatitis B and C and human immunodeficiency virus were negative. The patient continued to deteriorate clinically. Eventually, the patient succumbed to hepatic failure. autopsy disclosed systemic cryptococcosis that caused extensive necrosis of the liver. In review of the literature, only nine cases of cryptococcal infection presenting as hepatitis, cholangitis, and cholecystitis as initial manifestation were reported. Four of these patients had been subjected to exploratory laparotomy for clinical suspicion of acute abdomen. One patient developed cirrhosis as a result of cryptococcal hepatitis. Two patients succumbed to hepatic failure. cryptococcosis is known to occur commonly in immunocompromised patients, yet only two reported cases presenting as hepatitis were associated with immunocompromised status.- - - - - - - - - - ranking = 0.14285714285714keywords = liver (Clic here for more details about this article) |
3/408. Acute pseudohepatitis in a chronic substance abuser secondary to occult seat belt injury.Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis c seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.- - - - - - - - - - ranking = 0.42857142857143keywords = liver (Clic here for more details about this article) |
4/408. Disseminated bartonella infection with granulomatous hepatitis in a liver transplant recipient.Disseminated infection with bartonella spp with granulomatous hepatitis was diagnosed in a liver transplant recipient presenting with fever of unknown origin. Pathological findings on liver biopsy were atypical, with scant granulomas seen only after a second biopsy. The patient responded promptly to antibiotic therapy. Infections caused by bartonella spp should be considered in transplant recipients with fever of unknown origin.- - - - - - - - - - ranking = 0.85714285714286keywords = liver (Clic here for more details about this article) |
5/408. 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 = 0.28571428571429keywords = liver (Clic here for more details about this article) |
6/408. Fulminant hepatitis is significantly increased in hepatitis B carriers after allogeneic bone marrow transplantation.BACKGROUND: bone marrow transplantation (BMT) is effective treatment for many hematologic disease, but performed in a population with a high endemic hepatitis B virus carrier rate, the incidence of liver function impairment and fulminant hepatitis (FH) is expected to be raised. methods: Forty-three hepatitis b virus carriers received high-dose chemotherapy and BMT, 32 patients received an allogeneic graft, and 11 patients autologous marrow. Acute graft-versus-host disease prophylaxis consisted of methotrexate on day 1, 3, 6, and 11 and cyclosporine for 6 months. RESULTS: After a median follow-up period of 68 months (range: 1-11.5 years), 26 (81.3%) allogeneic BMT patients developed impaired liver function (LF), 5 progressed to FH on day 93, 169, 170, 180, and 468, respectively, and died after an average of 13.8 days (range: 1-45 days). Whereas only 4 (36.4%) autologous BMT patients developed impaired LF, and none FH. Impaired LF (P=0.026, chi-square), and FH (odds ratio=12.86, P=0.009 for coefficient) were significantly related to an allogeneic marrow graft, and the timing of liver function impairment coincided with cyclosporine withdrawal. Hepatitis B surface antigen (HbsAg) disappeared from the serum in 4/14 (28.6%) patients receiving a marrow graft from an HbsAg donor. HbsAg was not detected in the serum after BMT in 2/11 (18.2%) autologous BMT patients. CONCLUSIONS: hepatitis b virus carriers receiving a marrow graft from an HbsAg donor have a significantly increased risk of FH.- - - - - - - - - - ranking = 0.42857142857143keywords = liver (Clic here for more details about this article) |
7/408. Presentation of T-cell-rich B-cell lymphoma mimicking acute hepatitis.liver involvement in non-Hodgkin's lymphoma is relatively frequent, being found in approximately half of the post-mortem studies. However, the clinical presentation of lymphoma mimicking primary liver disease is uncommon. A case of non-Hodgkin's lymphoma (the recently described T-cell-rich B-cell lymphoma variant) is presented, where the initial and predominant manifestations were of hepatic origin, resembling non-neoplastic acute liver disease.- - - - - - - - - - ranking = 0.28571428571429keywords = liver (Clic here for more details about this article) |
8/408. Report of a fatal case of dengue infection with hepatitis: demonstration of dengue antigens in hepatocytes and liver apoptosis.A fatal case of dengue (DEN) infection associated with a spleen rupture and with hepatitis is reported here. Microscopic studies showed numerous areas of spleen rupture with hematomas and revealed necrotic foci in liver samples obtained at autopsy. Although hepatitis was reported in several cases of DEN fever, the mechanism of liver injury remains poorly understood. In this case, immunohistochemistry showed that DEN viral antigens were mostly detected in hepatocytes surrounding the necrotic foci. By in situ detection of dna fragmentation, apoptotic hepatocytes were found to be colocated with DEN virus-infected hepatocytes. These findings suggest that hepatocytes are the major sites of DEN virus replication in the liver and that DEN virus induces apoptosis of hepatocytes in vivo.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
9/408. Severe hepatitis and pure red cell aplasia in adult Still's disease: good response to immunosuppressive therapy.adult-onset Still's disease is a systemic inflammatory disorder with a highly variable clinical course. Mild hepatitis and anemia are common manifestations. We describe a patient with adult Still's disease who developed a severe hepatitis and a life-threatening pure red cell aplasia. The hepatitis developed after treatment with NSAIDs was started. The patient was successfully treated with a combination of prednisone, cyclosporin, and methotrexate. physicians should be aware that severe hepatitis and pure red cell aplasia can occur in adult Still's disease. We recommend a careful monitoring of liver functions in patients with adult Still's disease who are being treated with NSAIDs.- - - - - - - - - - ranking = 0.14285714285714keywords = liver (Clic here for more details about this article) |
10/408. A complex case of hepatitis in a patient with systemic lupus erythematosus.liver involvement in patients with systemic lupus erythematosus (SLE) is considered rare. Previous treatment with potentially hepatotoxic drugs or viral hepatitis have usually been implicated as the main causes of liver disease in SLE patients. On the other hand, even after careful exclusion of these aetiologies, the problem remains whether to classify the patient as having a primary liver disease with associated autoimmune clinical and laboratory features resembling SLE, such as autoimmune hepatitis, or as having liver disease as a manifestation of SLE. We report the case of an elderly woman who presented with acute hepatitis, who had been diagnosed with SLE 14 years ago and who also had sjogren's syndrome and anti-phospholipid's syndrome for several years. The histology depicted chronic active hepatitis and, after drug-induced hepatitis and viral hepatitis were excluded, the serological and clinical features were shown to be typical of liver damage caused by SLE. The patient was treated with azathioprine 100 mg/d and prednisone 30 mg/d. The clinical symptoms resolved in 10 days and the laboratory values were normal at the end of the first month of therapy. prednisone was progressively reduced, during a period of 4 months, to 10 mg/d but azathioprine was kept to the same dose. One year after the diagnoses the patient is still in remission. Although uncommon, hepatic involvement is well recognised in SLE. The interest of this case lies in the differential diagnosis and recognition of this condition, which deserves an aggressive treatment.- - - - - - - - - - ranking = 0.57142857142857keywords = liver (Clic here for more details about this article) |
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