Cases reported "Hepatitis, Viral, Human"

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11/318. Analysis of immune cells in a patient with post-transfusion hepatitis caused by human cytomegalovirus.

    Cellular immune responses are associated with the pathogenesis of human cytomegalovirus (HCMV) hepatitis. We investigated a patient with post-transfusion HCMV hepatitis. A 9 year-old girl was involved in a traffic accident and suffered from traumatic damage to the left kidney and diaphragm and received a pelvic bone fracture. At emergency surgery she was transfused with 1200 ml of fresh whole donor blood. Abnormal liver function was observed in the 10 days after surgery. Titers of serum anti-HCMV IgG and IgM antibodies were elevated at 11, 17 and 25 weeks after operation. We analyzed the surface markers of peripheral blood mononuclear cells obtained 21 weeks after surgery. The CD4/CD8 ratio and the number of CD16 CD56 decreased. We detected HCMV immediate early (IE) dna in the fractionated peripheral blood cells (polymorphonuclear leukocytes, CD2 , CD4 and CD8 T lymphocytes) by polymerase chain reaction. The histology of liver biopsy at 23 weeks after operation showed the findings of acute hepatitis and the absence of HCMV IE antigen. It was considered that the immunosuppressive condition associated with the trauma, operation or transfusion itself induced the reactivation of HCMV or that transfused blood cells infected with HCMV caused reinfection. It was also speculated that HCMV hepatitis was not only due to the direct damage of hepatic cells by HCMV, but also due to the cellular immune responses associated with HCMV infection.
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ranking = 1
keywords = b, hepatitis
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12/318. Acute jaundice in pregnancy: acute fatty liver or acute viral hepatitis?

    In this case, the difficulty in differential diagnosis between acute viral hepatitis and acute fatty liver of pregnancy was analyzed. These 2 conditions often raise controversal question regarding the decision making on emergency anesthesia for cesarean section to avert complications and optimize management. The dilemma in which an anesthesiologist is put is whether to promise the anesthesia straightaway in the face of a demonstrable acute jaundice in pregnancy to advise a postponement of surgery until a turn for the better. In this embarrassing situation, the authors suggest that a postpronement of surgery is rational to observe the development during which both the mother and the fetus should be closely monitored. Once the necessity of a cesarean section outweighs the benefit of transitional conservative treatment, it should be performed immediately.
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ranking = 0.50336572873175
keywords = b, hepatitis
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13/318. budd-chiari syndrome complicated by hepatocellular carcinoma with no evidence of infection with hepatitis virus: a case report.

    Hepatocellular carcinoma occurs in patients with budd-chiari syndrome. However, the etiology of hepatocellular carcinoma accompanied with budd-chiari syndrome has not been elucidated. We report a case of budd-chiari syndrome with membranous obstruction of the inferior vena cava complicated by hepatocellular carcinoma in an 80 year-old man. There was no evidence of co-infection with hepatitis a, B, C, D, E, and G virus. Histologically, the non-cancerous liver tissue showed chronic venous congestion with no evidence of hepatitis virus-associated liver cirrhosis. This case suggests that chronic venous congestion of the liver may be one of the pathologic conditions that occurs in hepatocellular carcinoma.
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ranking = 0.52788524377102
keywords = b, hepatitis
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14/318. Indirect evidence of TTV replication in bone marrow cells, but not in hepatocytes, of a subacute hepatitis/aplastic anemia patient.

    The presence of a new dna virus (TTV) has been reported in sera from patients with posttransfusion hepatitis of unknown etiology. The precise replication site of TTV, however, has not been established. In this study, the presence of TTV in liver autopsy material, and in bone marrow biopsy and autopsy samples taken from a subacute hepatitis/aplastic anemia patient was determined by PCR and Southern blot analyses. Liver cells were found to contain only TTV dna and not mRNA. Bone marrow material, especially that taken at biopsy, contained high levels of TTV dna. It is suggested that the TTV replication site was in the bone marrow rather than in the liver, and that TTV infection was the cause of this patient's aplastic anemia. The precise etiological association of TTV with hepatitis remains to be established.
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ranking = 1.1870183480359
keywords = b, hepatitis
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15/318. Bone marrow hypoplasia associated with acute viral hepatitis in four children.

    Four cases of children, aged 2 to 11 years, with acute viral hepatitis and bone marrow hypoplasia are reported. Three patients presented only jaundice and hepatomegaly; one also had liver failure. All the four patients underwent bone marrow aspiration which showed bone marrow aplasia. In two of the four patients a liver biopsy revealed patchy necrosis with inflammatory mononuclear cell infiltrate. Half of the patients received a bone marrow transplantation; the remaining patients were treated by intravenous infusion of immunoglobulins, growth factors and steroids. The main epidemiological and etiological features of such association are also reported.
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ranking = 0.41875058350166
keywords = b, hepatitis
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16/318. Insignificant role of hepatitis G virus infection in patients with liver enzyme elevations of unknown etiology.

    Hepatitis G virus (HGV) may cause acute and chronic infection in humans but its role in parenchymal liver injury and chronic hepatitis is obscure. In this study, the importance of HGV was investigated in patients with elevated aminotransferases alanine transaminase/aspartate transaminase (ALT/AST) levels of unknown etiology. We included 56 patients with elevated ALT/ AST levels of unknown etiology and 81 healthy controls in the study. HGV rna was investigated by the reverse transcription polymerase chain reaction. The other possible causes of transaminase elevation were excluded with detailed biochemical and serologic tests. Liver biopsy was performed on 47 patients for histologic examination. HGV rna was detected in only two patients (3.3%) and in one control (1.2%). There was no statistical difference between the groups. Liver biopsy revealed minimal inflammatory changes and steatosis in HGV rna-positive patients. These observations indicated that HGV prevalence is not different from that of the general population in patients with liver transaminases elevation of unknown etiology. The role of this novel virus in the pathogenesis of chronic liver injury of unknown etiology appears insignificant in our geographic area.
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ranking = 47.196877837034
keywords = chronic hepatitis, b, hepatitis
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17/318. Hepatitis related to cytomegalovirus infection in two patients with Crohn's disease treated with azathioprine.

    azathioprine-related side-effects occur in about 15% of treated patients. Liver toxicity is a rare complication of this drug, but is considered, in most cases, a contraindication to the continuation of treatment. However, abnormal liver tests may occur in patients under azathioprine treatment also due to infections. The distinction between toxic and infective causes of abnormal liver tests is important in order to identify patients that can be rechallenged with the drug. cytomegalovirus infection is common in immunosuppressed transplant recipients, while the incidence is lower in patients with inflammatory bowel disease treated with immunosuppressive drugs. To our knowledge, only 2 cases of cytomegalovirus hepatitis occurring during azathioprine treatment for Crohn's disease had been reported so far. Here, we describe two patients who experienced mild hepatitis associated with the onset of cytomegalovirus infection during azathioprine treatment. The infection was documented by the appearance of IgM anti cytomegalovirus. Both cases were self-limiting. In one of the 2 patients, azathioprine was given again after resolution of the hepatitis with good control of Crohn's disease and without other complications. We also retrospectively evaluated the incidence of liver abnormalities assessed by blood tests in 58 consecutive patients with Crohn's disease treated with azathioprine at our institution. Abnormal results were obtained in 8 out of these 58 patients, requiring discontinuation of the drug in 3 patients, two of whom were the cytomegalovirus cases described above.
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ranking = 0.79278727957356
keywords = b, hepatitis
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18/318. Hepatitis-associated aplastic anemia and transfusion-transmitted virus infection.

    A 17-year-old man was admitted to our hospital because of severe acute hepatitis. Serologic studies were negative for A, B, C and G hepatitis viruses. Later, he was found to be positive for transfusion-transmitted virus (TTV) dna. He was discharged after normalization of liver function tests. Four months after the onset of hepatitis, he was re-admitted because of pancytopenia. Bone marrow findings were consistent with aplastic anemia. The anemia responded to steroid therapy. In this case, TTV was probably involved in the development of aplastic anemia.
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ranking = 0.28509640819303
keywords = b, hepatitis
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19/318. Detection of HGV rna in digestive organs.

    The organ where the GB virus (GBV)-C/hepatitis G virus (HGV) localizes and proliferates is not known. We examined the digestive organs for HGV rna to determine the localization of the HGV. Two cases of patients with serum-positive HGV rna were investigated. We embedded surgically excised materials and digestive secretion materials from cases 1 and 2 in paraffin blocks. The tissue specimens investigated included lymph nodes No. 201 and 202, ascending colon (nontumor and tumor area), ileocecum, appendix, liver (nontumor and tumor area) and gall bladder. We made cDNA after extraction of total rna from thin tissue sections and detected HGV rna with a reverse transcription polymerase chain reaction method. No HGV rna was detected in liver, colon and gall bladder tissues. HGV rna was only detected in the appendix tissue. Comparison of nucleotide sequences of PCR products from serum and appendix was almost the same. Homology between US type (PNF2161) and the serum and appendix PCR products was 92.6 and 93.6%, respectively. These results suggest that HGV proliferates in the appendix and is carried by the portal blood flow to the liver, and may cause a hepatitis reaction in the liver.
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ranking = 0.34519203838385
keywords = b, hepatitis
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20/318. Virus-like particles in a case of acute hepatitis with human GB virus-C viraemia.

    BACKGROUND/AIMS: It is still controversial whether the human GB virus-C can cause liver injury, as in situ demonstration of the virus is still inconclusive. methods: Here we describe the case report of a patient with two episodes of severe acute hepatitis, who had a meticulous clinical, immunological and microbiological work-up, including human GB virus-C rna detection by in situ hybridization and electron microscopy. RESULTS: Human GB virus-C viraemia was found as the only potential cause of hepatitis in this patient. Furthermore, virus-like particles could be demonstrated in the cytoplasm of single hepatocytes by electron microscopy and human GB virus-C rna was detected in the liver by in situ hybridization. CONCLUSION: The presence of human GB virus-C rna in serum together with the demonstration of human GB virus-C rna in the liver, favour acute human GB virus-C infection as the cause of liver injury in this patient. Thus virus-like particles and hepatic human GB virus-C rna should be specifically looked for by electron microscopy and in situ hybridization, especially during the diagnostic work-up of patients with unexplained hepatitis.
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ranking = 0.63701990404038
keywords = b, hepatitis
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