Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The classification of chronic hepatitis introduced in 1968 is still current, but has been modified. The concept of bridging hepatic necrosis has been incorporated, and is recognised as an important feature of both acute and chronic aggressive (active) hepatitis (CAH). In the pathogenesis of the latter, piecemeal necrosis is, however, thought to be the more important factor. The histological picture of CAH varies widely. Several causes of CAH have been identified, including hepatitis B virus. Recognition of surface and core components of the virus in tissue sections has facilitated study of the relationship between host response and pathological lesion in chronic hepatitis. CAH and primary biliary cirrhosis share histological features, and a mixed form has been postulated. Staining for copper sometimes helps to distinguish the two lesions. A third histological category, chronic lobular hepatitis, comprises patients with histological lesions like those of acute hepatitis, but with a chronic or recurrent course.
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PMID:Liver biopsy in chronic hepatitis: 1968-78. 35 68

The classification, clinical course, etiology and treatment of chronic hepatitis are discussed. The clinical manifestations of chronic hepatitis are of limited diagnostic use. Diagnosis must be made by liver biopsy. The disease is classified as chronic persistent or chronic active hepatitis. The prognosis for chronic persistent hepatitis is excellent, and no treatment is required. Chronic active hepatitis may progress to cirrhosis and is associated with a poor prognosis if untreated. Recognized causes of chronic active hepatitis are hepatitis-B virus infection, post-transfusion hepatitis not associated with hepatitis-B virus, and certain drugs. For drug-induced hepatitis, discontinuation of the medication is indicated. For other types of chronic active hepatitis the recommended treatment is prednisone 10 mg and azathioprine 50 mg daily.
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PMID:Drug therapy reviews: chronic hepatitis. 35 29

Indirect immunoperoxidase stainings for hepatitis B core and surface antigens (HBc&s Ag) were applied to formalin-fixed paraffin sections in 113 liver specimens from 56 patients. Many cytomorphologic staining characteristics of HBc&s Ag were illustrated, and the percentages of the cellular population positive for HBc&s Ag were estimated for all specimens in order to provide the basis for general analyses. The quantitative expressions and the topographic distribution of HBc&s Ag were assessed with respect to their significance and implication in histopathologic reactions. A definitive relationship or relevance was neither established nor completely excluded due to the size of samples. However, cytomorphologically the membranous expression of HBc&s Ag was shown often in association with acute lobular hepatitis and chronic active hepatitis. This observation supports the concept that the membranous expression may be the prerequisite for immune mediated hepatitic injury in viral hepatitis. In this study we also carried out indirect immunoferritin and immunoperoxidase electron microscopy for HBc&s Ag on formalin-fixed liver specimens. The results assured the validity of the light microscopic immunohistologic procedures. The immunoelectron microscopy confirmed the presence of core antigen in the Dane particles formation that takes place in the cisternae of endoplasmic reticulum. The significance of the cytoplasmic core antigen and the possible role of immunoelectron microscopy in the elucidation of mechanisms of hepatitic injury were discussed.
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PMID:Immunohistologic demonstration of hepatitis B viral antigens in liver with reference to its significance in liver injury. 36 33

The administration of amino-3 beta hydroxy-20 beta pregnene-5, to the male Wistar rat, per os, at doses of 100 and 200 mg/kg/24 h, induce the development of a chronic active hepatitis. The ultrastructural observation shows slight changes only in perilobular hepatocytes at the beginning of treatment; then hepatocellular alterations progressively increase and may be observed in the whole lobule after 40 and 80 days of treatment; the progression of hepatocellular damage is associated with collagen increase and bile duct proliferation. The interest of this experimental hepatitis, as a model analogous to human chronic active hepatitis, is discussed.
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PMID:[Ultrastructural study of rat liver after administration of an aminated steroid (author's transl)]. 37 95

In a study of apparently normal, healthy Korean Army recruits performed in 1962, we found that 42 of 1,906 screened subjects had elevations of their serum glutamic pyruvate transaminase. Liver biopsies were obtained from 32 of these subjects and 9 of these had a "novel" antigen present, which reacted specifically with a convalescent serum from a case of serum hepatitis. We have recently tested frozen serum obtained from 8/9 of these cases and found that all 8 had HBsAg in their serum which, in some cases, persisted for at least three months. We reviewed the histological specimens from the original 32 cases using newly defined criteria: 18 were diagnosed as chronic active hepatitis and the 8 HbsAg positive cases with the "novel" antigen were in this group. In four of these cases the lesion appeared to progress to cirrhosis during a 3--4 month follow-up period. Since none of the cases had a prior history of hepatitis and no symptoms developed during the follow-up period, our findings emphasize the significance of chronic hepatitis B virus carrier state in the etiology of cryptogenic cirrhosis.
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PMID:The etiology of chronic active hepatitis in Korea. 37 25

The favorable effect of glucocorticoids on the development of the chronic active hepatitis is statistically proved on the basis of the amelioration of the survival rate in controlled studies. The so-called lupoid hepatitis is significantly better influenced than the HBs-Ag positive chronic hepatitis. By additional therapy with azathioprine it is possible to reduce the dose of glucocorticoids. Therefore it is better to combine glucocorticoids and azathioprine in some cases, especially in those with a high dosed glucocorticoid therapy. Further prospective studies are necessary to check more precisely the therapeutic effect of the different remedies. The effect of D-penicillamine is vague. A treatment with chloroquine is indicated in cases with contraindications again glucocorticoids and azathioprine.
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PMID:[Therapy of chronic hepatitis (author's transl)]. 37 53

Drug-induced active hepatitis is rare. The three main drugs incriminated are oxyphenisatine, alphamethyldopa and isoniazid. Despite the histological appearance suggestive of chronic active hepatitis, such forms of hepatitis, and in particular those due to alphamethyldopa and isonizid, follow an acute rather than a chronic course. The course is usually rapidly favourable when the responsible drug is stopped, provided the histological lesions are not those of multilobar necrosis or cirrhosis.
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PMID:[Drug-induced active hepatitis (author's transl)]. 38 56

It is a clinically and experimentally well supported working hypothesis that infection with hepatitis B virus may result in chronic active hepatitis in patients with suspected immune deficiencies. On this basis, a pilot study was performed in order to evaluate the effect of "specific" transfer factor (TF) in the treatment of HBS-Ag-positive chronic active hepatitis. From the leukocytes of 500 ml venous blood each of 40 volunteers that had completely recovered from acute virus hepatitis B within the last 6 months, a unique TF pool (40 units of TF) was prepared according to the method of Lawrence. Preexaminations indicated that this preparation was able to enhance cellular immune reactions in vitro. Thirteen patients with HBS-antigenemia and chronic active hepatitis (i.e., two liver biopsies within the last 6 or more months with the histological criteria of chronic aggressive hepatitis according to de Groote, elevated serum levels of bilirubin, alkaline phosphatase, transaminase activities, and/or gamma-globulines) were randomized: Seven received s.c. injections of two units of TF each on days 1 and 15, the other six saline. Conversion of skin reactions to some ubiquitous antigens occurred in the TF group, but no significant and constant drop of HBS-Ag serum titers was observed. Although some of the biochemical parameters seemed to ameliorate in the TF group, the differences versus the control group did not prove to be significant within the limited number of patients under observation. The in vitro reactivity of patients' lymphocytes to HBS-Ag, tested by means of the 3H-thymidine uptake, was never found enhanced after TF application. In the used doses, "specific" TF was not effective in the treatment of HBS-Ag-positive chronic active hepatitis; unfavorable side-effects were not observed.
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PMID:[Transfer factor (TF) treatment of patients with HBs-Ag-positive chronic active hepatitis. A prospective, controlled study (author's transl)]. 38 53

Twelve patients with liver disease related to methyldopa were seen between 1967 and 1977. Illness occurred within 1--9 weeks of commencement of therapy in 9 patients, the remaining 3 patients having received the drug for 13 months, 15 months and 7 years before experiencing symptoms. Jaundice with tender hepatomegaly, usually preceded by symptoms of malaise, anorexia, nausea and vomiting, and associated with upper abdominal pain, was an invariable finding in all patients. Biochemical liver function tests indicated hepatocellular necrosis and correlated with histopathological evidence of hepatic injury, the spectrum of which ranged from fatty change and focal hepatocellular necrosis to massive hepatic necrosis. Most patients showed moderate to severe acute hepatitis or chronic active hepatitis with associated cholestasis. The drug was withdrawn on presentation to hospital in 11 patients, with rapid clinical improvement in 9. One patient died, having presented in hepatic failure, and another, who had been taking methyldopa for 7 years, showed slower clinical and biochemical resolution over a period of several months. The remaining patient in the series developed fulminant hepatitis when the drug was accidentally recommenced 1 year after a prior episode of methyldopa-induced hepatitis. In this latter patient, and in 2 others, the causal relationship between methyldopa and hepatic dysfunction was proved with the recurrence of hepatitis within 2 weeks of re-exposure to the drug.
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PMID:Patterns of hepatic injury induced by methyldopa. 42 37

Two hundred four volunteer blood donors with hepatitis B surface antigen found in their blood were followed for 3 to 44 months. The annual clearance rate of this antigen was 1.7%. Liver enzyme levels (aminotransferase) were elevated in 45 (22.1%) on at least one occasion, in 26 (12.7%) for one month or more, and in 13 for more than six months. Liver biopsies were performed on 17 chronic carriers with normal enzymes and nonspecific histologic abnormalities were found in 14 and mild diffuse hepatitis in three. Seventeen carriers with abnormal enzymes were biopsied, and specimens revealed chronic active hepatitis (CAH) in seven, including two with bridging necrosis and three with cirrhosis. CAH was found in 7 of 26 (26.9%) carriers with abnormal liver enzymes persisting for at least one month and 4 of 13 (30.8%) with abnormal liver enzymes for more than six months.
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PMID:The liver histology and frequency of clearance of the hepatitis B surface antigen (HBsAg) in chronic carriers. 42 95


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