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[Novel treatments for hepatitis C viral infection and the hepatic fibrosis].

Hepatitis C virus (HCV) infection represents a global health problem due to its evolution to hepatic cirrhosis and hepatocellular carcinoma. The viral pathogenesis and infectious processes are not yet fully understood. The development of natural viral resistance towards the host immune system represents a mayor challenge for the design of alternative therapeutic interventions and development of viral vaccines. The molecular mechanisms of hepatic fibrosis are well described. New alternatives for the treatment of patients with HCV infection and hepatic cirrhosis are under intensive research. New…

Effect of treatment of hepatic histopathology in children and adolescents with autoimmune hepatitis.

OBJECTIVE: To evaluate the effects of treatment on liver histopathology of children and adolescents diagnosed with autoimmune hepatitis. PATIENTS AND METHODS: Histopathological evaluation of liver biopsies performed at diagnosis or early during treatment, compared with biopsies after immunosuppressive treatment of 20 children and adolescents diagnosed with autoimmune hepatitis who presented clinical and biochemical remission for at least 24 months. Liver histopathology was assessed by 2 pathologists. Agreement between their interpretations was analyzed with kappa statistics. RESULTS: The age…

A case of fulminant hepatic failure caused by hepatitis E virus.

Recent studies reported finding hepatitis E virus (HEV) in sera of domestic animals in Japan and also that HEV is a causative agent of non-A, non-B, non-C acute hepatitis and fulminant hepatitis. To clarify the incidence and severity of the disease caused by HEV in Hiroshima, Japan, we studied 97 patients with acute sporadic hepatitis. Stored serum samples were analysed for markers of hepatitis viruses. Only one patient, who developed fulminant hepatitis that was indistinguishable from acute exacerbation of autoimmune hepatitis (AIH), and died of liver failure, was positive for IgM and IgG ant…

[Diagnosis and prophylaxis of latent hepatic failure at patients with hepatic echinococcosis].

Morphological and biochemical (NAD, NADF, xanthine oxidase, lipid peroxidation products) disorders at liver tissue samplings were studied at 60 patients with hepatic echinococcosis. It is demonstrated that hydatid cysts of both lobe of liver are associated with high level of lipid peroxidation products and low level of respiratory coenzymes at liver tissue. It is concluded that morphological and biochemical examinations of liver tissue samplings are the main methods for early diagnosis of hepatic failure at patients with hepatic echinococcosis.

[Hepatic angiomyolipoma in two patients infected with hepatitis C virus].

AIM: The aim of this study is to present our experience with two cases of hepatic angiomyolioma in hepatitis C virus (HCV) positive patients, and to up-date the clinical manage, diagnostic and treatment of this entity. CLINICAL OBSERVATIONS: Both cases were presented in women in their 4-5th decade of life. Clinical presentation was with symptoms in one but incidental in the other. Both were HCV positive. Values of alpha-fetoprotein were normal. Radiological imaging was not diagnostic. Histopathological examination and immunohistochemical findings gave the diagnosis of angiomyolipoma. At time …

A case of herpes simplex hepatitis with hepatic nodules in an immunocompetent patient.

Herpes simplex hepatitis is a rare cause of acute hepatitis in immunocompetent patients. Herpes hepatitis presents with nonspecific symptoms like fever, loss of appetite, vomiting, nausea and abdominal pain. Elevated transaminase values with leukopenia, relatively low bilirubin level and mucosal herpetic lesions often provide clues to the diagnosis. We describe an immunocompetent woman with herpes simplex hepatitis presenting with multiple hypodense lesions in the liver and mucocutaneous herpetic lesions.

Critical roles of TRAIL in hepatic cell death and hepatic inflammation.

The TNF-related apoptosis-inducing ligand (TRAIL) induces apoptosis of tumor cells but not most normal cells. Its role in hepatic cell death and hepatic diseases is not clear. In vitro studies suggest that murine hepatocytes are not sensitive to TRAIL-induced apoptosis, indicating that TRAIL may not mediate hepatic cell death. Using two experimental models of hepatitis, we found that hepatic cell death in vivo was dramatically reduced in TRAIL-deficient mice and mice treated with a blocking TRAIL receptor. Although both TRAIL and its death receptor 5 were constitutively expressed in the liver,…

Unusual presentation of hepatic vascular tumors as fulminant hepatic failure.

Epithelioid hemangioendothelioma and angiosarcoma of the liver are rare neoplasms of vascular origin. They can present with nonspecific symptoms such as malaise and weight loss, as well as with liver-related symptoms such as abdominal pain, tender hepatomegaly and jaundice. Portal hypertension and rarely liver failure can occur. We hereby report two cases of fulminant hepatic failure that were eventually diagnosed with epithelioid hemangioendothelioma and angiosarcoma of the liver.

[Relationship between hepatitis G virus infection and hepatic failure].

OBJECTIVE: To study the pathogenic effect of hepatitis G virus (HGV) infection on hepatic failure. METHODS: Using the RT-PCR and EIA techniques to detect HGV RNA and anti-HGV in sera of hepatic failure patients and compare them with their liver function and mortality rates. RESULTS: There was no significant difference about the positive rates of HGV among acute hepatic failure, subacute hepatic failure and chronic hepatic failure groups (X(2)=2.54, P>0.05). The level of ALT in HGV-positive group was slightly lower than that in HGV-negative group. The concentration of bilirubin and globulin w…

Lupus-like syndrome with submassive hepatic necrosis associated with hepatitis A.

Hepatitis A is a common self-limited liver disease. However, 15% of patients may have some complications. Autoimmune hepatitis that is triggered by viral hepatitis has been reported. We hereby describe an unrecognized association of hepatitis A with a full blown lupus-like syndrome manifested by the appearance of arthralgia, exudative pleural effusion with the presence of lupus erythematosus cells and autoantibodies. All these findings disappeared after a short course of steroid treatment. The case is presented and the literature is reviewed.

[Autoimmune hepatitis in children. Initial presentation as fulminant hepatic failure].

UNLABELLED: There are few cases reported of autoimmune hepatitis (AIH) type 2 presenting as fulminant hepatic failure (FHF) in children. The purpose of this study was to report three girls with AIH type 2 that presented as FHF. METHODS: Over a period of 12 years, 123 patients with AIH diagnosed based on international criteria, 9 (7%) were type 2.3 of them presented as FHF. Other etiologies (viral, metabolic and toxic) were ruled out. The treatment was started with prednisone (2 mg-kg-day) and azathioprine (2 mg-kg-day). EVOLUTION: Patients 1 and 3 died while waiting for liver transplant (LT)…

[Clinical evaluation of hepatic bruit audible in patients with alcoholic hepatitis].

It is well accepted that many patients with alcoholic hepatitis have an audible bruit over the liver (hepatic bruit) in western countries. However, this sign has not been discussed in Japan. The aim of this study was to assess the significance of the hepatic bruit in Japanese patients with alcoholic hepatitis. Hepatic bruit was specifically searched for on auscultation by two physician in consecutive patients (6 alcoholic hepatitis, 58 other alcoholic liver disease, 128 nonalcoholic liver disease including 16 hepatocellular carcinoma). Hepatic bruit was detected in 5 of 6 (83%) patients with a…

[Chronic hepatic porphyria and hepatitis B and C virus infections].

BACKGROUND: It is known that in patients with porphyria cutanea tarda (PCT) there is an increased prevalence of the hepatitis B virus (HBV) and the hepatitis C virus (HCV). The incidence of anti-HCV in PCT in our country is 21.7% in estimations by the second generation method, however, the incidence of HBV in PCT was not assessed so far. METHODS AND RESULTS: In 60 patients with PCT antigens and antibodies against HBV and HCV were assessed (by the anti-HCV third generation ELISA method) and in subjects with signs of HBV or HCV. HBV DNA and HCV RNA were assessed by the method of the polymerase …

Idiopathic neonatal hepatitis presenting as neonatal hepatic siderosis and steatosis.

Idiopathic neonatal hepatitis (INH) is a heterogeneous disease of undetermined cause. We report a retrospective histologic reevaluation of INH. Sixty patients with INH were reviewed along with 32 biliary atresia (BA) patients. Histologic findings, iron and fat deposits, giant cell transformation, portal fibrosis, and bile duct proliferation were semiquantitatively graded from 0 to 4+. Significant histologic findings were defined as > or =2+. Frequencies of patients with significant histologic findings in the INH group were compared with those of the BA group. Among the patients with significan…

Immunohistochemical characterization of hepatic lymphocytes in acute hepatitis A, B, and C.

The distinctive histologic findings in acute hepatitis A, B, and C suggest that different immunological mechanisms are involved in the pathogenesis of these diseases. This study was undertaken to define the immune response in each type of acute hepatitis by identification of the intrahepatic lymphocyte subsets. Thirty paraffin-embedded liver biopsy specimens from 10 patients with acute hepatitis A, 10 patients with acute hepatitis B, and 10 patients with acute hepatitis C were evaluated. Immunohistochemical staining was performed by the indirect immunoperoxidase technique using the following m…

Fulminant hepatic failure with massive necrosis as a result of hepatitis A infection.

Fulminant hepatic failure as a result of hepatitis A is a rarely diagnosed complication entity in developed countries. With the advent of specific serologic markers for acute hepatitis A virus infection, the incidence and pathology of fulminant hepatitis A can be more clearly defined. We describe four patients (one adult, three children; two males and two females, ages 2 1/2-58 years) referred to our institution for orthotopic liver transplantation subsequent to fulminant hepatic failure following hepatitis A infection. All of these patients had a history of residence in or travel to hepatitis…

Striking variability of hepatic copper levels in fulminant hepatic failure.

Two cases of acute hepatic failure are reported in which the diagnosis of Wilson's disease was considered because of low serum ceruloplasmin, low serum copper levels and high 24 h urinary copper. Case 1 had Kayser-Fleischer rings, haemolysis and a high 24 h urinary copper, and so Wilson's disease was confidently diagnosed. Case 2 had high urinary copper excretion, but [64Cu] study indicated a 24:2 h ratio of 0.7 and made the diagnosis of Wilson's disease uncertain. Both patients underwent orthotopic hepatic transplantation, and multiple biopsies were taken from the resected specimen in order t

Смертельный массивный некроз печени от варицелла-зостерного гепатита.

Сообщается о необычайном случае гепатита варицелла-зостера, который привел к смертельному массовому некрозу печени у 64-летней белой женщины. У пациента была ветрянка за 30 лет до смерти, но никогда не было каучуконосных зостеров. Печень показала типичные эозинофильные внутриядерное включение, а герпесвирусные вироны были продемонстрированы электронной микроскопией. Косвенные иммунофлюоресцентные сероологические исследования подтвердили удалённую и недавнюю инфекцию вирусом варицелла-зостер. Обсуждается потенциальное значение случайной селелектомии, проведенной за 14 месяцев до смерти, и общая

Совпадение в аннотации оригинала
An unusual case of varicella-zoster hepatitis is reported which resulted in fatal massive hepatic necrosis in a 64-year old white female. The patient had had chickenpox 30 years prior to death but no cutaneous zoster at any time. The liver showed typical eosinophilic intranuclear inclusions and herpesvirus virions were demonstrated by electron microscopy. In…