Cases reported "Hepatitis B"

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21/835. Early detection of hepatocellular carcinoma in hepatitis-B-positive renal transplant recipients.

    Hepatocellular carcinoma (HCC) is a leading cause of malignancy after renal transplantation in asia, where hepatitis b virus infection is endemic. Early detection and resection are the key to successful treatment because the mortality rate for HCC is high. The value of alpha-fetoprotein monitoring in the early detection of HCC in renal transplant recipients has not been reported before. We describe 2 patients who had successful resection of HCC following early diagnosis by alpha-fetoprotein monitoring. The epidemiology of post-transplant HCC in various parts of the world and its pathogenesis are discussed.
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ranking = 1
keywords = hepatitis, b
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22/835. Carcinoma of the colon with synchronous hepatic metastasis in a cirrhotic liver harboring a hepatocellular carcinoma.

    Tumor metastasis to a cirrhotic liver is rare. It has been suggested that colorectal cancer does not metastasize to the cirrhotic liver. We reported a 65 year-old man, a known carrier of hepatitis B surface antigen, diagnosed to have hepatocellular carcinoma with routine screening. A partial hepatectomy with resection of segments VI and VII was performed. The hepatectomy specimen revealed a 4.5 cm diameter HCC in a cirrhotic liver. Incidentally, 0.8 cm diameter ulcer at the descending colon. Histological examination of the left hemicolectomy specimen showed a moderately differentiated adenocarcinoma.
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ranking = 0.204106869021
keywords = hepatitis, b
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23/835. laparoscopy extends the indications for liver resection in patients with cirrhosis.

    BACKGROUND: Clinical or biological evidence of liver failure is usually considered a contraindication to open liver surgery as it is associated with a prohibitive risk of postoperative death. methods: This report describes three patients who had resection of a superficial hepatocellular carcinoma suspected either to be ruptured, or at high risk of rupture, using the laparoscopic approach. All three patients had intractable ascites, in two superimposed on active hepatitis. Surgery was per- formed under continuous carbon dioxide pneumoperitoneum with intermittent clamping of the hepatic pedicle. RESULTS: Intraoperative blood loss was between 100 and 400 ml; no blood transfusion was required. The postoperative course was uneventful except for a transient leak of ascites through the trocar wounds. Duration of in-hospital stay was 6-10 days. liver function tests had returned to preoperative values within 1 month of surgery in all patients. CONCLUSION: The laparoscopic approach may enable liver resection in patients with cirrhosis and evidence of liver failure that would contraindicate open surgery.
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ranking = 0.20924045529725
keywords = hepatitis, b
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24/835. Guillain Barre syndrome during the pre-icteric phase of acute type B viral hepatitis.

    A 54-year-old man presented with the Guillain Barre syndrome (GBS) during the pre-icteric phase of acute type B viral hepatitis. This neurological syndrome has been infrequently described in the clinical course of viral hepatitis but only once previously during the prodromal period. Deposition of circulating immune complexes of the HBsAg have been implicated in the pathogenesis of arthritis, nephritis and polyarteritis associated with type B viral hepatitis. Although the relationship of GBS to type B viral hepatitis is uncertain, a similar immunopathological mechanism may be involved.
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ranking = 4.341272157822
keywords = hepatitis b, hepatitis, b
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25/835. Multi-system cytomegalovirus fetopathy by recurrent infection in a pregnant woman with hepatitis B.

    A pregnant woman with acute hepatitis b virus (HBV) infection had her second pregnancy terminated at 25 weeks' gestation because of fetal ascites and ventriculitis. meconium peritonitis was also found at autopsy. No HBV dna but cytomegalovirus (CMV) dna was detected in the fetal liver and ascitic fluid. Recurrent maternal CMV infection was demonstrated by pre-existing CMV IgG antibodies, high IgG avidity and low IgM levels. After abortion, the patient developed chronic active hepatitis. Nevertheless, having become pregnant again with a new partner, she had an uneventful third pregnancy and gave birth to a healthy boy.
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ranking = 1.2061603035315
keywords = hepatitis, b
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26/835. Outcome of lamivudine resistant hepatitis b virus infection in the liver transplant recipient.

    BACKGROUND: In many transplant centres lamivudine is an important component of prophylaxis against, and treatment of, hepatitis b virus (HBV) graft infection. Drug resistant HBV species with specific polymerase mutations may emerge during lamivudine treatment. AIMS: To examine the clinical consequences of graft infection by lamivudine resistant virus. methods: The clinical course of four liver transplant patients who developed graft infection with lamivudine resistant virus was reviewed. The response of HBV infection to reduction of immunosuppression and to manipulation of antiviral therapy was assessed. For each patient, serum viral titre was measured and the viral polymerase gene was sequenced at multiple time points. RESULTS: High serum titres were observed following emergence of the lamivudine resistant species. Wild type HBV re-emerged as the dominant serum species after lamivudine withdrawal. All patients developed liver failure, and onset of liver dysfunction was observed when resistant virus was the dominant serum species. In three patients, liver recovery was observed when immunosuppression was stopped and when alternative antivirals were given. Wild type virus appeared to respond to ganciclovir, and to reintroduction of lamivudine. For one patient, introduction of famciclovir was associated with clinical, virological, and histological response. CONCLUSIONS: Failure of lamivudine prophylaxis may identify patients at special risk for the development of severe graft infection. Treatment of graft reinfection should include reduction of immunosuppression, and systematic exposure to alternative antivirals. Viral quantitation and genetic sequencing are essential components of therapeutic monitoring.
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ranking = 0.99897328274475
keywords = hepatitis, b
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27/835. Fulminant hepatic failure resulting from lamivudine-resistant hepatitis b virus in a renal transplant recipient: durable response after orthotopic liver transplantation on adefovir dipivoxil and hepatitis B immune globulin.

    BACKGROUND: Mutations in the hepatitis b virus (HBV) genome may occur during therapy. methods: We report an asymptomatic HBV carrier who underwent transplantation for end-stage renal disease. She developed an HBV flare 6 months after transplantation and was placed on lamivudine. After initial rapid improvement, she relapsed clinically and virologically. She decompensated with jaundice, peripheral edema, ascites, encephalopathy, coagulopathy, and hepatorenal syndrome. A liver biopsy specimen revealed submassive necrosis. RESULTS: Emergency liver transplantation was performed: lamivudine was discontinued. Hepatitis B immunoglobulin and adefovir dipivoxil were initiated. Sixteen months after orthotopic liver transplantation, she is HBV dna seronegative with normal liver enzymes. Sequencing of HBV polymerase gene from preliver transplantation sera did not detect the usual lamivudine resistance mutations in the YMDD motif but instead two other mutations (F514-->L, L528-->M). lamivudine resistance was demonstrated in vitro. CONCLUSIONS: Asymptomatic HBV carriers may reactivate following renal transplantation after immunosuppression. Resistance to lamivudine may result in severe hepatic damage in immunocompromised patients.
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ranking = 1.8030801517657
keywords = hepatitis, b
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28/835. Unilateral papilloedema after hepatitis B vaccination in a migraine patient. A case report including forensic aspects.

    PURPOSE: To report on a unilateral optic nerve reaction appearing 9-10 hours after vaccination against hepatitis B. methods: To describe the case and discuss the underlying mechanisms. There was a scintillating scotoma leaving a permanent inferior notch in the visual field, but central vision was left normal and with only a slight affection of colour perception. Shortly the optic nervehead appeared engorged, then slightly ischaemic, but was hardly left with evidence of atrophy. RESULTS: Immune-based reactions could hardly be held responsible, multiple sclerosis was unlikely, and ultrasonography excluded optic nervehead drusen. An optic nerve migraine mechanism is probable, possibly with the vaccination having acted as the trigger.
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ranking = 1.004106869021
keywords = hepatitis, b
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29/835. Acute hepatitis B after autologous stem cell transplantation in a man previously infected by hepatitis b virus.

    We report a case of acute hepatitis B after autologous stem cell transplantation (ASCT) in a patient with low-grade non-Hodgkin's lymphoma. At diagnosis of the hematological disease, the patient had the characteristic serology of a previous hepatitis B infection, being Ag HBs negative, hepatitis b virus core antibody positive (anti-HBC) and hepatitis b virus surface antibody weakly positive. He developed fatal hepatitis B after autologous stem cell transplantation, suggesting reactivation consequent to immunosuppression.
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ranking = 2.5938396964685
keywords = hepatitis, b
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30/835. Fulminant hepatitis B following bone marrow transplantation in an HBsAg-negative, HBsAb-positive recipient; reactivation of dormant virus during the immunosuppressive period.

    It is widely accepted that seroconversion of HBsAg to HBsAb indicates clearance of hepatitis b virus. We describe a 50-year-old man with chronic myelocytic leukemia who developed lethal hepatitis B 22 months after allo-BMT. He had been negative for HBsAg and positive for HBsAb before BMT. hepatitis b virus latently existing in the liver cells before BMT proliferated during the immunosuppressed period causing fatal hepatitis. Recipients with positive HBsAb should be considered to have the potential for active hepatitis B to emerge after BMT. bone marrow transplantation (2000) 25, 105-108.
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ranking = 1.608213738042
keywords = hepatitis, b
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