Cases reported "Liver Cirrhosis"

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1/4. Juvenile hemochromatosis associated with B-thalassemia treated by phlebotomy and recombinant human erythropoietin.

    Juvenile hemochromatosis is a rare genetic disorder that causes iron overload. Clinical complications, which include liver cirrhosis, heart failure, hypogonadotropic hypogonadism and diabetes, appear earlier and are more severe than in HFE-related hemochromatosis. This disorder, therefore, requires an aggressive therapeutic approach to achieve iron depletion. We report here the case of a young Italian female with juvenile hemochromatosis who was unable to tolerate frequent phlebotomy because of coexistent ss-thalassemia trait. The patient was successfully iron-depleted by combining phlebotomy with recombinant human erythropoietin.
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keywords = phlebotomy
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2/4. Primary hepatocellular carcinoma in idiopathic hemochromatosis after reversal of cirrhosis.

    Previous reports have emphasized the association of primary hepatocellular carcinoma in patients with idiopathic hemochromatosis with cirrhosis. In contrast, patients with idiopathic hemochromatosis without cirrhosis have no increased risk of hepatocellular carcinoma. phlebotomy therapy, by preventing the accumulation of parenchymal iron and subsequent cirrhosis, is believed to prevent hepatocellular carcinoma in the precirrhotic stage of the disease. We report the case of a 67-yr-old man with a 32-yr history of idiopathic hemochromatosis complicated by cirrhosis, who had reversal of cirrhosis with phlebotomy therapy, yet developed hepatocellular carcinoma. There was no serologic or tissue evidence of hepatitis b infection.
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keywords = phlebotomy
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3/4. Massive hydrothorax complicating occult cirrhosis.

    This case emphasizes that absence of ascites does not rule out cirrhosis as the cause of a massive pleural effusion. Consideration of hemochromatosis as a cause of cirrhosis is worthwhile both for the patient and his family, as the course of the cirrhosis may be benefited by periodic phlebotomy to reduce the iron overload, and disease may be prevented in asymptomatic relatives.
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keywords = phlebotomy
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4/4. Medicinal iron-induced hepatic cirrhosis: reversal by phlebotomy: studies on pathogenesis.

    A patient with no underlying hematologic or iron metabolic disorder developed iron induced hepatic cirrhosis as a consequence of long term medicinal iron ingestion. Marked improvement in liver histology followed removal of 28 grams of iron by phlebotomy. Radioautographic studies in rats showed a periportal hepatocyte concentration of radioiron absorbed from the intestine while plasma transferrin was saturated. Based on these and other observations an hypothesis is proposed to explain liver damage in disorders of iron overload.
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keywords = phlebotomy
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