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

A 47-year-old man with acute myeloblastic leukemia (AML) developed angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) 4 months after induction chemotherapy for AML. During a leukopenic period, the patient suffered from pericarditis with massive pericardial effusion in which human herpesvirus 6 (HHV-6) DNA was detected. Although complete remission of AML was achieved, fever persisted and atypical skin rash followed by generalized lymphadenopathy along with polyclonal hypergammaglobulinemia appeared. A diagnosis of AILD was made on a biopsy specimen of the inguinal lymph node. The patient died of fulminant hepatitis and the autopsy showed lymphomatous infiltrates involving the liver, bone marrow, lungs, spleen, kidneys and heart. HHV-6 DNA sequences were identified in the biopsy specimen of the lymph node and in the involved organ tissues. HHV-6 in this patient was variant B. It is known that HHV-6 can be reactivated in immunocompromised patients and causes severe complications. This unusual clinical course suggests that the immunosuppression associated with AML and the additional iatrogenic immunosuppression following cytopenia-inducing chemotherapy predisposed the patient to reactivated HHV-6 infection. The sequential detection of this virus before and after manifestation of AILD may support the evidence that HHV-6 infection could directly or indirectly trigger AILD. This is the first time that such a sequence of events has been reported to our knowledge. The possibility of HHV-6 infection should be considered when unexplained fever and generalized lymphadenopathy are seen in patients with leukemia, and administration of antiviral agents should be considered for the diagnostic evaluation.
 ...
PMID:Angioimmunoblastic lymphadenopathy with disseminated human herpesvirus 6 infection in a patient with acute myeloblastic leukemia. 917 44

Descriptive reports of liver histologic features in celiac disease (CD) are sparse, and the effect of a gluten-free diet (GFD) on the course of liver injury is poorly understood. We reviewed liver biopsy specimens in 30 patients with CD and performed immunostains for IgG, IgG4, IgM, and IgA. Subsequent liver biochemical tests and compliance with the GFD were recorded. Of the patients, 19 had autoimmune-mediated liver disease (AILD; autoimmune hepatitis, 9; primary sclerosing cholangitis, 7; and primary biliary cirrhosis, 3). The remaining 11 patients had cryptogenic hepatitis (5), hepatitis C (2), steatohepatitis (2), sarcoidosis (1), and T-cell lymphoma (1). The liver disease diagnosis preceded the CD diagnosis in all groups except steatohepatitis. Although 82% of patients without AILD had symptomatic CD, only 26% of patients with AILD had such symptoms. The pathology of the specific liver disease was not atypical in histologic features or IgG/IgM ratios. While GFD improved cryptogenic hepatitis, it did not seem to affect AILD. We propose that AILD and cryptogenic hepatitis in patients with CD represent distinct clinical, histologic, and immunohistochemical entities rather than 2 ends of a spectrum of liver injury.
 ...
PMID:The liver in celiac disease: clinical manifestations, histologic features, and response to gluten-free diet in 30 patients. 2168 40