Результаты поиска

Treatment of chronic hepatitis C.

Chronic hepatitis C entails a life-long risk of developing cirrhosis and hepatocellular carcinoma and eradication of the hepatitis C virus (HCV) is the only realistic approach for lowering the risk of disease progression. Treatment is indicated for patients with high transaminases and histologic signs of chronic hepatitis: 6-12 month therapy with 3-6MU interferon alfa thrice weekly combined with 1-1.2 grams ribavirin yielded up to 30% sustained virological responses (SVR). SVR raised up to 50% with pegylated interferons combined with ribavirin. Favourable predictors of response to the former t…

Animal models of autoimmune hepatitis.

Autoimmune hepatitis (AIH) is difficult to study in humans because of the late diagnosis, the heterogenic genetic background and the lack of tissue specimens. Therefore, animal models have been used for more than 90 years to study liver-specific immune regulation. This article summarizes how early studies of experimental AIH established the importance of T cells for causing the liver injury and how regulatory pathways were detected. Studies in transgenic models demonstrated that T cells can be tolerant to liver antigens by ignorance, deletion, anergy, and receptor downregulation. They furtherm…

Emerging treatments for autoimmune hepatitis.

Prednisone alone or a lower dose of prednisone in combination with azathioprine induces remission and enhances survival in autoimmune hepatitis. Treatment failure, incomplete response, drug-induced side effects, and relapse after drug withdrawal are unsatisfactory outcomes that justify the search for new therapies. Potent new drugs promise greater blanket immunosuppression than current regimens, and insights into the pathogenic mechanisms of the disease make site-specific interventions possible. Cyclosporine and tacrolimus are calcineurin inhibitors that impair the transcription of interleukin…

Autoimmune hepatitis and overlap syndromes.

Autoimmune hepatitis (AIH) is an immune-mediated, autodestructive liver disease with hepatocytes as target cells, mostly affecting young women. Primary biliary cirrhosis (PBC) is also regarded as an autoimmune liver disease with bile duct epithelia as the target cells, resulting in a continuous loss of bile ducts. Both diseases may occur simultaneously in their full manifestations in about 10% to 20% of cases, thus constituting an overlap syndrome with PBC directing the course of the disease. AIH may also occur simultaneously with primary sclerosing cholangitis (PSC), with a frequency of betwe…

Hepatitis C and the skin.

Hepatitis C is an important and common cause of chronic hepatitis and cirrhosis. Cutaneous manifestations are often the first signs of infection. Dermatologists must be aware of these manifestations, because early diagnosis is the best treatment. HCV Ab by ELISA should be ordered in patients with LCV-urticarial vasculitis, cryoglobulinemia, lichen planus, Sjögren's syndrome, unexplained pruritus, PCT, PAN, chronic urticaria, patients starting methotrexate, unexplained pruritus, and any patient initiating therapy with a potentially hepatotoxic drug.

[Severe alcoholic hepatitis in Japan].

Multiple organ failures are frequently observed in patients with severe alcoholic hepatitis. Most of the patients have a poor prognosis similar to fluminant hepatitis. Since alcohol intake has been recently increasing in Japan, severe alcoholic hepatitis is expected to be increased. The objective of this study was to determine whether there was any factor by which prognosis of severe alcoholic hepatitis was determined. We carried out nationwide survey by asking the hospitals that are approved by the Japanese Society of Gastroenterology for current incidence of alcoholic liver disease including…

Hepatitis associated with Chinese herbs.

Traditional Chinese herbal medicines are widely available in Western society and are popular as a form of 'natural' alternative medicine. Their use is increasing, as they are perceived to be free of side effects, but they remain largely unregulated. We describe two patients who suffered severe hepatitis, one of whom died, after taking Chinese herbal remedies for minor complaints. We also review the English-language literature on hepatitis associated with Chinese herbs. Two products appear to be implicated frequently: Jin bu huan was taken by 11 patients, and Dictamnus dasycarpus was taken by s…

Ischaemic hepatitis in the elderly.

BACKGROUND: Ischaemic hepatitis is centrilobular necrosis which is usually associated with an acute cardiovascular event and in a general hospital setting has been considered to be a rare condition. It is though thought to be frequently unrecognized, which is important as it has implications for both investigations and drug therapy. Previous reports have not focused on the elderly. OBJECTIVES: (1) To determine the incidence of ischaemic hepatitis in elderly patients admitted to a Department of Geriatric Medicine and (2) to assess both the clinical and biochemical features of the condition. M…

Extrahepatic manifestations of viral hepatitis.

UNLABELLED: Viral hepatitis has been shown to be associated with various extrahepatic manifestations. These can be seen in both acute and chronic liver disease, may precede or follow overt liver disease. AIMS AND OBJECTS: To study the prevalence of extrahepatic manifestations of viral hepatitis and follow the course of the disease in response to antiviral therapy whenever indicated. METHODS: Prospectively 448 patients of viral hepatitis were evaluated for extrahepatic manifestations and patients of glomerulonephritis (GN), polyarteritis nodosa (PAN) and cryoglobulinemia were tested for viral …

Liver transplantation and hepatitis C.

End-stage liver disease caused by chronic hepatitis C viral infection is one of the major indications for liver transplantation. However, evidence for ongoing viral replication can already be found days after surgery and may lead sequentially to lobular hepatitis, chronic active hepatitis, fibrosis and liver cirrhosis. In some patients, this evolution is remarkably fast, most probably enhanced by the immunosuppressive therapy. A minority of patients develop a clinical picture of progressive cholestatic liver disease with histological signs of chronic rejection, which may necessitate retranspla…

Interferon for acute hepatitis C.

BACKGROUND: Acute hepatitis C virus (HCV) infection progresses to chronicity in the majority of patients. In order to prevent the progression to chronic disease, several studies have assessed interferon in patients with acute hepatitis C. OBJECTIVES: The aim of this review was to assess the efficacy of interferon in acute HCV infection. SEARCH STRATEGY: We searched MEDLINE, the Cochrane Controlled Trials Register, and the abstracts of the American Association for the Study of Liver Diseases (June 2001). We also contacted pharmaceutical companies to obtain unpublished trials. SELECTION CRITE…

Лечение острого гепатита С.

Острый гепатит С имеет высокую склонность к тому, чтобы стать хроническим, что дает основания для лечения пациентов с острыми заболеваниями, пытающихся предотвратить хроническое заболевание. Почти все опубликованные исследования по лечению острого гепатита С были небольшими по размеру, неконтролируемыми и весьма разнородными в том, что касается характеристик пациентов, дозы и продолжительности лечения, последующей оценки и критериев, используемых для определения эффективности и безопасности. В опубликованных исследованиях по лечению острого гепатита С используется стандартная монотерапия альфа

Совпадение в аннотации оригинала
Acute hepatitis C has a high propensity to become chronic, which provides the rationale for treating patients with acute disease attempting to prevent chronicity. Almost all published studies on therapy of acute hepatitis C have been small in size, uncontrolled, and highly heterogeneous as to patient features, dose and duration of treatment, follow-up evalua…

Autoimmune hepatitis in the elderly.

OBJECTIVES: Autoimmune hepatitis (AIH) is widely believed to be a disease of young women and menopause. Little is known about the frequency and clinical characteristics in patients aged > or =65 yr. METHODS: We reviewed charts of 120 consecutive outpatients with known AIH to identify patients who were diagnosed at the age of 65 or older. These 20 patients (median age, 69 yr) were compared to the same number of younger patients (median age, 24 yr) with well-documented AIH from the same cohort. RESULTS: Seventeen percent (20/120) of our patients were > or =65 yr at the time of diagnosis. In th…

[Asymptomatic hepatitis induced by propylthiouracil].

Propylthiouracil (PTU) is widely used to treat patients with hyperthyroidism. In rare cases this drug has been found to have toxic effects o … which represents a very unusual laboratory constellation in this kind of patient. The serology for hepatitis A, B, C and for EBV and CMV was negative. After stopping PTU, methimazole (MMI) was started and the liver enzymes normalised within two weeks. After 12 months of MMI therapy, the patient is assymptomatic, with normal liver enzyme levels and normal t …

[Thyrotoxicosis hepatitis: a case report].

Abnormal liver function in thyroid disorders may be secondary to thyrotoxicosis or to autoimmune injury to the liver. We report the case of … howed normal bile ducts; echocardiography ruled out heart failure; viral and autoimmune markers for hepatitis and cirrhosis were negative. Percutaneous liver biopsy showed moderate intrahepatic steatosis, anisokaryosis, lymphocyte infiltration in the portal areas, and Kupffer cell hyperplasia. Outcome was favorable after seven months of iodine therapy, conf …

Severe hepatitis due to Atrium.

(1) Atrium, a combination of difebarbamate, febarbamate and phenobarbital first marketed in France more than 30 years ago, carries a risk of hepatitis. (2) Despite restrictions on its indications and treatment duration introduced in 1997, cases of severe liver damage have continued to be notified in France. (3) Benzodiazepines are the reference drugs for alcohol withdrawal. Carbamates and barbiturates are no more effective than benzodiazepines, and carry a higher risk of adverse effects. (4) The recent decision to withdraw Atrium from the market was long awaited.