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)

We describe a 47-year-old woman with severe aplastic anemia with genital bleeding who developed acute severe hepatitis after the administration of danazol while she was receiving cyclosporin. She had been diagnosed with severe aplastic anemia 1 year previously and, while hospitalized, had received methyl prednisolone pulse therapy, which was not successful. She was then referred to our hospital. She was treated with antithymocyte globulin, cyclosporin, granulocyte colony-stimulating factor, and methyl prednisolone; a good response was achieved after 3 months of this therapy. Subsequently, oral administration of cyclosporin was continued, but she was readmitted to our hospital when pancytopenia gradually developed and the genital bleeding recurred. Danazol was administered for pancytopenia and endometriosis. Four days after the first administration of danazol, epigastric pain occurred, and the danazol was stopped. Eighteen days after the first danazol administration, very severe hepatic injury occurred abruptly. The patient died of hepatic failure. Postmortem examination revealed centrilobular massive necrosis of the liver. Danazol was implicated as the agent responsible for causing the hepatic failure. Drug interactions between danazol and cyclosporin may cause adverse effects.
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PMID:Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia. 1175 52

Acute liver disease was diagnosed in three pregnant patients: two 30-year-old women had a 'haemolysis, elevated liver enzymes, low platelets' (HELLP) syndrome and acute fatty liver of pregnancy, respectively, and a 20-year-old woman had acute liver failure due to acute hepatitis B. The first two patients had a caesarean section, the third one delivered her child, which died spontaneously shortly after birth at a gestational age of 23 weeks. She was then treated by liver transplantation. All three patients left the hospital in good condition. Liver diseases in pregnancy may be pregnancy-related, e.g. the HELLP syndrome and acute fatty liver of pregnancy, but they may also be coincidental phenomena, e.g. viral hepatitis. The HELLP syndrome is often associated with pre-eclampsia, and presents with epigastric pain and thrombocytopenia with haemolysis. Acute fatty liver disease and acute liver failure due to hepatitis present with liver insufficiency characterised by anorexia, nausea, coagulopathy, hypoglycaemia and elevated serum ammonia levels. Management depends on the diagnosis and the gestational age; pregnancy complicated by acute fatty liver disease should be terminated while pregnancy complicated by the HELLP syndrome early in pregnancy may be maintained to improve the outcome of the foetus. In acute liver failure due to viral hepatitis, termination of pregnancy alone does not affect the disease.
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PMID:[The pregnant patient with acute liver disease]. 1253 8

Saw palmetto is a frequently used botanical agent in benign prostatic enlargement (BPH). Although it has been reported to cause cholestatic hepatitis and many medical conditions, Saw palmetto has not been implicated in acute pancreatitis. We report a case of a probable Saw palmetto induced acute hepatitis and pancreatitis. A 55-year-old reformed alcoholic, sober for greater than 15 years, presented with severe non-radiating epigastric pain associated with nausea and vomiting. His only significant comorbidity is BPH for which he intermittently took Saw palmetto for about four years. Physical examination revealed normal vital signs, tender epigastrium without guarding or rebound tenderness. Cullen and Gray Turner signs were negative. Complete blood count and basic metabolic profile were normal. Additional laboratory values include a serum amylase: 2,152 mmol/L, lipase: 39,346 mmol/L, serum triglyceride: 38 mmol/L, AST: 1265, ALT: 1232 and alkaline phosphatase was 185. Abdominal ultrasound and magnetic resonance cholangiography revealed sludge without stones. A hepatic indole diacetic acid scan was negative. Patient responded clinically and biochemically to withdrawal of Saw palmetto. Two similar episodes of improvements followed by recurrence were noted with discontinuations and reinstitution of Saw Palmetto. Simultaneous and sustained response of hepatitis and pancreatitis to Saw palmetto abstinence with reoccurrence on reinstitution strongly favors drug effect. "Natural" medicinal preparations are therefore not necessarily safe and the importance of detailed medication history (including "supplements") cannot be over emphasized.
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PMID:Saw palmetto-induced pancreatitis. 1680 Apr 17

Anticonvulsant hypersensitivity syndrome (AHS) is a rare complication associated with the use of anti-epileptic medications. The syndrome's main symptoms are cutaneous eruptions, fever, hepatitis, and lymphadenopathy. We describe a 23-year-old woman who developed AHS 2 months after starting phenytoin therapy. She presented with fever, orofacial edema, skin rash, and lymphadenopathy. Four days after admission, she developed agonizing epigastric pain with diffuse epigastric tenderness. An abdominal CT scan demonstrated splenomegaly with a large, hypodense area involving the upper half of the spleen, consistent with splenic rupture. She was managed medically in an effort to avoid splenectomy. There are no other documented cases of spleen rupture linked to AHS. A possible mechanism is the alteration of lymphocytic function due to the accumulation of cytotoxic metabolites and infiltration of the spleen with lymphocytic cells, distending the capsule and predisposing it for rupture. We believe that the case presented here should increase awareness of the potentially life-threatening complications associated with AHS.
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PMID:Spleen rupture secondary to anticonvulsant hypersensitivity syndrome. 1709 1

A 24-year-old Vietnamese woman presented with a 3-month history of non-itchy erythematous plaques on the face, trunk and limbs. Borderline lepromatous leprosy was confirmed by clinical findings, acid-fast bacilli on skin biopsy specimen and skin smear and a history of exposure. Around the twentieth day of World Health Organization (WHO) multibacillary standard treatment (rifampin 600 mg per month, dapsone 100 mg per day, clofazimine 300 mg per month and 50 mg per day for 1 year), she developed fever, general malaise, blurred vision, cough, nausea, epigastric pain, and arthralgia. The skin lesions also became swollen. During hospitalization, her illness was complicated by retrobulbar optic neuritis, secondary bacterial pneumonia, pleuritis, ascites, hepatitis, antral gastritis, progressive normocytic anemia, and peripheral sensory loss. The patient recovered after receiving systemic steroid pulse therapy (prednisolone equivalent dose 1250 mg) with systemic antibiotics (cefuroxime), adjustment of her anti-lepromatous therapy, and supportive care. She resumed the WHO multibacillary regimen uneventfully. This patient presented with a diverse type 1 reaction, which is a complex immune response in leprosy. We found that the judicious use of high dose steroids followed by a slow tapering course is beneficial in managing patients with a severe type 1 reaction. At the 1-year follow up, the patient had generalized skin hyperpigmentation resulted from long-term clofazamine use and numbness on feet without other systemic sequelae.
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PMID:Corticosteroid pulse therapy for leprosy complicated by a severe type 1 reaction. 1856 21

Elevated serum transaminase levels can have many different etiologies, especially in the pregnant patient. Hypoxic hepatitis is a distinct syndrome caused by decreased hepatic blood flow that presents with a marked, but transient, increase in liver enzymes. A 28-year-old woman, gravida 3, para 2 with history of gastric bypass, presented in the second trimester with bright red blood per rectum, syncope, and epigastric pain. Laboratory studies were significant for anemia, elevated liver enzymes, and low platelets, raising concern for hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) and the need for emergent delivery. Complete evaluation included an upper endoscopy, which revealed a bleeding jejunal ulcer that was subsequently cauterized. Shortly after cauterization, the patient's laboratory values normalized and her pain resolved. Diagnosis of hypoxic hepatitis was made after exclusion of other liver-toxic entities, thus preventing delivery of a preterm infant. Hypoxic hepatitis may masquerade as other clinical syndromes, especially in the pregnant patient. Meticulous physical examination and assessment of laboratory values is essential for making a proper diagnosis and guiding management.
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PMID:Hypoxic hepatitis in a pregnant patient: a complication of gastric bypass surgery. 1875 30

Liver involvement is an unusual manifestation of Mycoplasma pneumoniae infection. Cases of cholestatic hepatitis without pulmonary involvement have been described in children with M. pneumoniae infection but only two cases of cytolytic hepatitis have been reported in adults. We report here the case of an 18-year-old woman who presented with febrile epigastric pain of short duration associated with an elevation of gamma-glutamyl transpeptidase and alkaline phosphatase levels and with a mononuclear syndrome. Serological tests for M. pneumoniae were positive for IgG and IgM. Clinical symptoms and blood test perturbations completely resolved after treatment with macrolide.
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PMID:Acute cholestatic hepatitis revealing Mycoplasma pneumoniae infection without lung involvement in an adult patient. 1921 11

Fulminant hepatic failure is a rare complication of infection by varicella zoster virus that is favored by immunosuppression. Within 1 week, a 43-year-old male heart transplant recipient who was admitted with epigastric pain successively developed a generalized vesicular rash, hepatitis, and secondary multiorganic failure involving encephalopathy, despite treatment with acyclovir (since Day 2) and varicella zoster virus immunoglobulin (since Day 6). Emergency liver transplantation was performed on Day 9, and 36 months later, his heart and liver function are normal.
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PMID:Fulminant hepatic failure due to varicella zoster in a heart transplant patient: successful liver transplant. 1978 6

A 63-year-old man with a history of hepatitis-B-related hepatocellular carcinoma (HCC) in the left lateral portion of the liver received repeated transcatheter arterial chemoembolization (TACE) and salvage radiotherapy. Two months after completing radiotherapy, he presented with dysphagia, epigastric pain, and a protruding abdominal mass. Computed tomography showed that the bulging mass was directly invading the adjacent stomach. Endoscopy revealed a fistula from the HCC invading the stomach. Although the size of the mass had decreased with the drainage through the fistula, and his symptoms had gradually improved, he died of cancer-related bleeding and hepatic failure. This represents a case in which an HCC invaded the stomach and caused a hepatogastric fistula after repeated TACE and salvage radiotherapy.
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PMID:Hepatogastric fistula caused by direct invasion of hepatocellular carcinoma after transarterial chemoembolization and radiotherapy. 2141 85

Mycoplasma pneumoniae (Mp) is a unique pathogen that causes not only pulmonary but also extrapulmonary manifestations that must be rapidly diagnosed. A 12-year-old boy, with no relevant medical history, presented with fever, severe epigastric pain, and vomiting. Laboratory findings showed fulminant and cholestatic hepatitis, hemolytic anemia, thrombocytopenia, acute kidney injury, disseminated intravascular coagulopathy, acute myocardial infarction, and rhabdomyolysis. His clinical condition rapidly deteriorated during intubation and continuous renal replacement therapy. Despite intensive treatment, he did not recover. We report a case of fulminant and fatal multiple organ failure in a previously healthy boy with Mp infection, describing the possible pathomechanisms of multiple organ failure involved in the disease.
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PMID:Fulminant and Fatal Multiple Organ Failure in a 12-Year-Old Boy With Mycoplasma pneumoniae Infection. 2221 Nov 73


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