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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dubin-Johnson syndrome (DJS) is a rare benign chronic disorder of bilirubin metabolism, characterized by conjugated hyperbilirubinemia, darkly pigmented liver and presence of abnormal pigment in hepatic parenchymal cells. This is a retrospective study of twenty cases of DJS highlighting their major clinical and pathological findings. Liver biopsies were available in all the cases, obtained during a fourteen-year period (January 1991 to March 2005). The patients' age ranged from 7-63 years (median 21 years). These twenty cases comprised 13 males and 7 females. Major clinical manifestations were recurrent or persistent jaundice, abdominal pain and fever. Duration of illness ranged from 9 months to 58 years (median 10 years). All of them had conjugated hyberbilirubinemia and total serum bilirubin levels ranged between 1.4-13 mg/dl (mean 4.4 mg/dl). Liver biopsies revealed presence of coarse granular brown pigment in the cytoplasm of hepatocytes more concentrated in the pericanalicular region and more prominent in centrilobular hepatocytes. Associated findings were presence of hepatitis B virus related chronic hepatitis (1), history of tubercular lymphadenitis (1), chronic cholecystitis in (2), coronary heart disease (1) and exacerbation during pregnancy (1).
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PMID:Dubin-Johnson syndrome--a clinicopathologic study of twenty cases. 1718 37

A 24-year old patient with severe haemophilia A and chronic hepatitis C developed two weeks after transjugular liver biopsy (TJLB) haemobilia with colicky upper abdominal pain, coffee ground emesis, melaena and anaemia. Abdominal ultrasound and endoscopic retrograde cholangiogram confirmed the diagnosis. After adequate factor VIII substitution and revision with a balloon catheter the patient became asymptomatic. Haemobilia is a uncommon complication after liver biopsy. This complication should be kept in mind even if the occurrence is delayed after intervention. TJLB is an established and safe method to obtain liver specimen in patients with coagulation disorders.
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PMID:[Delayed upper abdominal pain and tarry stool after transjugular liver biopsy. A 24-old man with hemophilia]. 1743

We present the case of a patient with chronic hepatitis B who developed an extensive intrahepatic hematoma, associated with a 30-fold elevation in serum alanine aminotransferase levels, following percutaneous liver biopsy. The patient was hypertensive but without hemorrhagic diathesis by routing tests done before biopsy. There was no concomitant intraperitoneal hemorrhage and no blood transfusions were required, despite a 9% drop in hematocrit. The complication was associated with short-lived, mild-to-moderate abdominal pain, easily relieved by paracetamol analgesics. The intrahepatic hematoma, as followed by computed tomography, resolved within 8 months. This case indicates that extensive intrahepatic hematoma and associated ischemic injury may infrequently complicate a liver biopsy and that hypertension may be a predisposing factor.
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PMID:Acute ischemic injury due to a giant intrahepatic hematoma: A complication of percutaneous liver biopsy. 1757 14

A 57-year old woman received interferon alfa-2b and ribavirin combination treatment for chronic hepatitis C. High fever and lower abdominal pain developed 10 months after the start of treatment. Antibiotic drugs were not effective. After two weeks, colonoscopic findings revealed a periappendiceal abscess. After colonoscopy study, fever decreased. We have to suspect abscess formation too as appearing a high fever during interferon and ribavirin combination treatment.
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PMID:[A periappendiceal abscess during combination interferon and ribavirin treatment for chronic hepatitis C]. 1798 12

Interferon therapy is indicated for the treatment of chronic hepatitis C and prevention of hepatocellular carcinoma. We describe the case of a 66-year-old Italian woman who received pegylated interferon alpha-2a plus ribavirin combined therapy for HCV-related chronic liver disease. Preliminary hematochemical, ultrasound and bioptic investigations did not show liver cirrhosis or hepatocarcinoma. After 24 weeks of treatment transaminase serum levels were in the normal range and circulating HCVRNA was undetectable by PCR qualitative assay. On week 46 a serious adverse event occurred, with rapid transaminase increase, severe hyperpyrexia, and abdominal pain, leading to interruption of interferon and ribavirin. Liver biopsy was repeated and it revealed poorly differentiated hepatocellular carcinoma. Only palliative care could be performed and the patient died of liver failure within 2 months. The present case underlines that hepatocellular carcinoma can be misdiagnosed in spite of laboratory and instrumental follow-up. More sensitive tools are needed for tumor detection, to avoid IFN impairment of the liver, even though it eradicates HCV.
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PMID:Occurrence of diffuse, poorly differentiated hepatocellular carcinoma during pegylated interferon plus ribavirin combination therapy for chronic hepatitis C. 1860 96

An unusual staphylococcal isolate was recovered from blood cultures in a patient with chronic hepatitis B virus infection, who presented with low grade fever accompanied by increased upper abdominal pain, nausea and weakness. The isolate was identified as Staphylococcus gallinarum based on biochemical characteristics and 16S rRNA gene sequence analyses.
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PMID:Case report: Staphylococcus gallinarum bacteremia in a patient with chronic hepatitis B virus infection. 1898 36

Hepatitis C is caused by the hepatitis C virus (HCV) infection. According to World Health Organization data, 3% of the world population (approximately 170 million people) is infected with HCV; in Poland there are over 700,000. Over 70% of those infected manifest no symptoms in the acute phase of the disease, and in about 70-80% the acute phase progresses into a chronic form. Patients with symptoms in the acute phase of HCV infection most commonly present with unspecific signs and symptoms that may develop in other viral liver infections, e.g. malaise, fatigue, abdominal pain, mild hepato- and splenomegaly and arthralgia. These symptoms usually persist for 2 to 12 weeks. In the chronic phase a subset of patients complain of malaise, nausea, abdominal pain and itching. With time, chronic hepatitis C may develop into liver cirrhosis. The basic diagnostic methods in HCV infection involve determination of anti-HCV antibodies using the ELISA immunoassay and examination of HCV-RNA with the RT-PCR method. The current treatment of HCV infection involves administration of pegylated interferon a and ribavirin over a period of 48 weeks in HCV-1 genotype infection, and 24 weeks for HCV-2 and 3 genotypes. Effectiveness of therapy depends on the HCV genotype. HCV elimination can be achieved in 78% of patients with HCV-2 and 3 genotypes, and in 55% of patients with HCV-1 genotype.
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PMID:Viral hepatitis C. 1920 52

Although an estimated 1 million persons in the United States are chronically infected with hepatitis B virus, the prevalence of hepatitis B has declined since the implementation of a national vaccination program. Hepatitis B virus is transmitted in blood and secretions. Acute infection may cause nonspecific symptoms, such as fatigue, poor appetite, nausea, vomiting, abdominal pain, low-grade fever, jaundice, and dark urine; and clinical signs, such as hepatomegaly and splenomegaly. Fewer than 5 percent of adults acutely infected with hepatitis B virus progress to chronic infection. The diagnosis of hepatitis B virus infection requires the evaluation of the patient's blood for hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. The goals of treatment for chronic hepatitis B virus infection are to reduce inflammation of the liver and to prevent complications by suppressing viral replication. Treatment options include pegylated interferon alfa-2a administered subcutaneously or oral antiviral agents (nucleotide reverse transcriptase inhibitors). Persons with chronic hepatitis B virus infection should be monitored for disease activity with liver enzyme tests and hepatitis B virus DNA levels; considered for liver biopsy; and entered into a surveillance program for hepatocellular carcinoma.
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PMID:Hepatitis B: diagnosis and treatment. 2038 72

A-63-year-old man was referred to our hospital for interferon therapy to treat chronic hepatitis C. The patient complained of right upper abdominal pain 1 hour after the ultrasound-guided liver biopsy. Bleeding in the gallbladder and the common bile duct were found on emergency CT. Obstructive jaundice due to the common bile duct hematoma was diagnosed, and endoscopic retrograde cholangiopancreatography(ERCP) was performed, and a filling defect thought to be a hematoma was seen in the bile duct on cholangiography. The hematoma in the bile duct was extracted after endoscopic sphincteroyomy.
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PMID:A patient with obstructive jaundice due to bleeding in the common bile duct after ultrasound-guided liver biopsy. 2131 37

Acute porphyria is a term that encompasses a group of hereditary disorders involving defects in heme metabolism, characterized by acute episodes of abdominal pain, acute hypertension, tachycardia and neuropsychiatric disorders, sometimes leading to convulsions, ascending paralysis and coma. Misdiagnosis or delayed diagnosis can seriously worsen prognosis. We report the case of a woman with subclinical acute intermittent porphyria and chronic hepatitis incidentally diagnosed due to transaminase elevation on laboratory analysis.
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PMID:[Subclinical acute intermittent porphyria. An uncommon cause of chronic hepatitis]. 2147 89


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