1/25. Appearance of severe jaundice after radiometabolical treatment of thyrotoxicosis.The appearance of moderate jaundice with mildly raised levels of plasma bilirubin is an uncommon complication of thyrotoxicosis and is usually accompanied by signs of right heart failure. Some described cases were actually related, at least in part, to autoimmune chronic hepatitis. In this paper we describe a case of thyrotoxicosis accompanied by deep jaundice with very high levels of bilirubin occuring in the absence of cardiac failure and with no signs of hepatitis. jaundice disappeared shortly after the start of thyrostatic drug treatment, supporting a possible detrimental effect of hyperthyroidism on the hepatic bilirubin metabolism.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/25. Long-term extracorporeal bilirubin elimination: A case report on cascade resin plasmaperfusion.Acute hepatic failure develops as a disease entity of rather diverse origin. With disease progression, toxic bilirubin levels may cause severe complications which include AV-nodal blockage, cardiac arrhythmia, impaired consciousness, generalized seizures, and status epilepticus. Treatment choices to prevent clinical deterioration comprise of costly and limited available orthotopic liver transplantation, utilization of extracorporeal bioartificial liver support devices and haemoperfusion/plasmaperfusion treatment with activated charcoal/anion exchange filters. Here, we present a patient with acute drug-induced cholestatic hepatitis. Excessively elevated bilirubin levels were accompanied by cardiac and cerebral complications. Extracorporeal resin perfusion treatment (Plasorba, BR-350) was successfully performed over a 50-day period without activation of the coagulation system or side effects. Bilirubin levels were lowered to a minimum of 225 micromol/l, with concurrent clinical improvement. In conclusion, extracorporeal anion exchange plasmaperfusion may be a viable long-term treatment for hyperbilirubinaemic side effects in overt cholestatic hepatitis.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
3/25. Orthotopic liver transplantation in a patient with severe haemophilia A and with advanced liver cirrhosis.A patient with severe haemophilia A underwent orthotopic liver transplantation because of changes correlated to end-stage liver cirrhosis due to hepatitis b, C and D infection. Replacement therapy was carried out for 4 days and the clinical course was uneventful. At the time of reporting the patient has a normal working life. FVIII plasma concentration is normal. The indirect hyperbilirubinaemia may be related to the Gilbert's anomaly of the donor.- - - - - - - - - - ranking = 0.5keywords = hepatitis (Clic here for more details about this article) |
4/25. Severe hemolysis and renal failure in glucose-6-phosphate dehydrogenase deficient patients with hepatitis e.Hemolytic anemia as a complication of acute hepatitis is not uncommon in patients with glucose-6-phosphate dehydrogenase deficiency. However, severe hemolysis in these patients is rare. We report a cohort of five patients with acute viral hepatitis e who developed severe intravascular hemolysis and unusually high levels of bilirubin. All five patients had severe, complicated, protracted courses of illness. Four patients developed acute renal failure, and two of these required hemodialysis. To the best of our knowledge this is the first report of a cohort of patients with glucose-6-phosphate dehydrogenase deficiency and acute viral hepatitis e with severe intravascular hemolysis. We emphasize the fact that intravascular hemolysis should be suspected in patients with acute viral hepatitis e with marked bilirubinemia and anemia. Measures to prevent renal failure should be taken in such cases.- - - - - - - - - - ranking = 4keywords = hepatitis (Clic here for more details about this article) |
5/25. Intravascular haemolysis: a potential missed diagnosis.Raised serum bilirubin is a common finding as part of a routine "liver function test" profile. This case describes a patient with a raised serum bilirubin that was eventually found to be caused by intravascular haemolysis. The tests that confirmed the cause were instigated by clinical biochemistry staff but not before the patient had undergone unnecessary invasive procedures and had the diagnosis delayed by some time. The case is a reminder to biochemistry and haematology laboratories and clinical staff to investigate the possibility of haemolysis as well as hepatitis and Gilbert's disease as a cause of an isolated raised bilirubin.- - - - - - - - - - ranking = 0.5keywords = hepatitis (Clic here for more details about this article) |
6/25. Acute cholestatic hepatitis associated with celecoxib.OBJECTIVE: To report a case of acute cholestatic hepatitis associated with the selective cyclooxygenase-2 inhibitor celecoxib. CASE SUMMARY: A 41-year-old white man was hospitalized for jaundice after 2 doses of celecoxib 200 mg for pain associated with right-knee trauma. Laboratory workup showed hyperbilirubinemia, mildly elevated serum transaminase concentrations, and cholestasis. Abdominal imaging showed no dilation of the biliary tree. histology showed cholestasis, with bile plugs in dilated bile canaliculi and a mild portal infiltrate that are highly suggestive of drug-induced cholestasis. DISCUSSION: This is the fourth report in the English-language literature describing cholestatic hepatitis temporally related to celecoxib use, the second supported by histologic findings typical of drug-induced cholestasis, and the first in a patient who denied use of alcoholic beverages and was taking no other drugs or herbal products at the time of the reaction. The Naranjo probability scale indicated that celecoxib was a probable cause of acute cholestatic hepatitis in this patient. CONCLUSIONS: Cholestatic hepatitis is a well-recognized adverse effect of several drugs. Although celecoxib is considered to have a very low potential for hepatic toxicity, well-documented reports of adverse reactions can contribute significantly to the definition of more accurate safety profiles for new drugs introduced into clinical practice.- - - - - - - - - - ranking = 4keywords = hepatitis (Clic here for more details about this article) |
7/25. Transient relief of asthma symptoms during jaundice: a possible beneficial role of bilirubin.Bilirubin arises from enzymatic reduction by biliverdin reductase of biliverdin, a product of heme oxygenase activity. Recent literature describes that bilirubin is a major physiologic antioxidant that can protect cells from chemical oxidants such as hydrogen peroxide. Recently, it has been reported that oxidative stress may play a crucial role in the pathogenesis of asthma. We report a case of complete resolution of persistent difficult-to-control asthma in accordance with increased levels of serum bilirubin due to acute hepatitis b. The present case suggests that anti-oxidative agents might be effective for the treatment of asthma.- - - - - - - - - - ranking = 0.5keywords = hepatitis (Clic here for more details about this article) |
8/25. dapsone induced cholangitis as a part of dapsone syndrome: a case report.BACKGROUND: dapsone can rarely cause a hypersensitivity reaction called dapsone syndrome, consisting of fever, hepatitis, exfoliative dermatitis, lymphadenopathy and hemolytic anemia. dapsone syndrome is a manifestation of the DRESS (drug rash with eosinophilia and systemic symptoms) syndrome which is a serious condition that has been reported in association with various drugs. cholangitis in dapsone syndrome has not been reported so far in the world literature. CASE PRESENTATION: We report a patient who presented with fever, exfoliative dermatitis, jaundice and anemia within three weeks of starting of dapsone therapy. These features are typical of dapsone syndrome, which is due to dapsone hypersensitivity and is potentially fatal. Unlike previous reports of hepatitic or cholestatic injury in dapsone syndrome we report here a case that had cholangitic liver injury. It responded to corticosteroids. CONCLUSION: We conclude that cholangitis, though unusual, can also form a part of dapsone syndrome. physicians should be aware of this unusual picture of potentially fatal dapsone syndrome.- - - - - - - - - - ranking = 0.5keywords = hepatitis (Clic here for more details about this article) |
9/25. Clinical, biochemical and imaging-verified regression of hepatitis b-induced cirrhosis.In a 65-year-old patient with ascites, jaundice and positive hepatitis b surface antigen (HBsAg), the histological diagnosis of cirrhosis with knodell total score 13 was made in 1995. The patient was followed up for 8 years. Spontaneous seroconversion of HBsAg appeared. Except for slight hyperbilirubinemia, all pathologic, clinical laboratory data remained normal from the second year of diagnosis till 8 years of follow-up. In the last follow up, the markers of liver fibrosis were all normal. The portal vein diameter was decreased and the esophageal varices disappeared. The imaging of liver by sonography and CT-scan did not reveal any abnormality.- - - - - - - - - - ranking = 2.5keywords = hepatitis (Clic here for more details about this article) |
10/25. Green pigmentation of deciduous teeth: report of two cases.The purpose of this paper was to present 2 cases of green pigmentation in primary teeth caused by hyperbilirubinemia, from different pathologies during the neonatal period. Medical history revealed systemic problems during the neonatal period of an infectious, neurological, renal, respiratory, and cardiological nature, as well as a high amount of bilirubin in both cases and hepatitis in the first. The staining in the teeth was due to hyperbilirubinemia, caused by these systemic conditions. The clinical characteristics of teeth may help in the diagnosis of present current or past systemic diseases. The reported cases confirm the relevance of past medical history in establishing the diagnosis of the etiology of green pigmentation as a result of high levels of bilirubin serum.- - - - - - - - - - ranking = 0.5keywords = hepatitis (Clic here for more details about this article) |
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