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)

Systemic lupus erythematosus (SLE) and primary biliary cirrhosis (PBC) are distinct clinical disorders which rarely occur in the same patient. We report on a 65-year-old woman with coexistence of both conditions. Diagnosis of SLE was ascertained by the presence of seven ACR criteria (cutaneous lesions, photosensitivity, antinuclear and anti-double-stranded-DNA antibodies, pancytopenia, arthritis, oral lesions). PBC was disclosed by clinical investigation, liver histology and highly positive antimitochondrial M2 antibodies. The most important differential diagnoses of lupus hepatitis are PBC and autoimmune hepatitis. Diagnostic criteria for these conditions are discussed, and previous reports on overlap between SLE and PBC are reviewed.
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PMID:Unusual coexistence of systemic lupus erythematosus and primary biliary cirrhosis. 819 7

HCV-infection is an important infectious disease in rheumatology. It is the cause of mixed cryoglobulinemia and other rheumatic manifestations develop frequently during HCV-infection. These comprise: Sicca-syndrome, thromboembolic events associated with anti-cardiolipin antibodies and fibromyalgia. Also associated with HCV-infection is a non-erosive polyarthritis. This synovitis often fulfills the ACR-criteria for rheumatoid arthritis, but the disease course is different with frequent remissions and non-erosive joint involvement. The following autoantibodies are associated with HCV-infection: Cryoglobulins, rheumatoid factor, antinuclear antibodies (ANA), antismooth muscle antibodies (SMA), anti-phospholipid-antibodies and anti-thyroid-antibodies. In HCV-associated sicca-syndrom, antibodies against Ro (SSA) and La (SSB) are not detected. The course of HCV-infection is often occult, without elevation of liver enzymes. We summarize the clinical and serological signs and symptoms when HCV-infection should be suspected and when HCV-testing should be performed in a rheumatological setting. The identification of HCV-infection in rheumatic patients is important to minimize the risk of aggravating hepatitis by prescription of hepatotoxic drugs and because of the availability of alpha-interferon as a potential virus eradicating agent.
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PMID:[Hepatitis C virus in rheumatic diseases]. 946 81

MCs are important effector cells in a broad range of immune responses. Their role in liver allograft rejection is not clear. Twenty-one liver transplant recipients (mean age +/- s.d.; 10.2 +/- 4.1 yr) who experienced a rejection episode are included in this study. Biopsy specimens from normal livers (allograft biopsy with normal histopathology n = 5 and naive livers n = 6), transplanted livers with CR (n = 5), and transplanted livers with ACR (n = 26) were studied. The total number of PT in each biopsy specimen was documented, and the number of PT that contained MCs was expressed as a percentage of the total number of PT. MCs, percentage of PT containing MCs and the average number of MCs/PT was significantly higher in rejection specimens than in control biopsy samples. All parameters were significantly higher in CR group than AR groups. Increasing grades of rejection was also associated with progressively more MCs and MC/PT (r = 0.68 p = 0.000; r = 0.58 p = 0.002). Only serum bilirubin level was related to the MCs in AR group. Only MC/PT was detected as an independent predictor of graft survival (p = 0.011, RR 2.87 95% CI 1.3-6.5). Despite the fact that the role of MCs in liver allograft rejection is still unknown; they exist in inflammatory infiltrates during pediatric liver allograft rejection. MC-rich portal infiltrates may distinguish chronic liver rejection from other inflammatory states such as AR, hepatitis and biliary obstruction.
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PMID:Association of mast cells and liver allograft rejection. 1843 10

Central perivenulitis (CP) encompasses dropout of zone 3 hepatocytes, red blood cell extravasation, and perivenular mononuclear inflammation. In the liver transplant setting, CP can occur in isolation or it can occur in association with portal-based disease such as acute cellular rejection (PB-ACR). Some CP is also thought to be a manifestation of chronic rejection, particularly when accompanied by zone 3 fibrosis. Prior studies of CP in pediatric liver allografts have been hampered by lack of protocol biopsies and low rates of histologic follow-up. We studied 62 consecutive liver allografts from 55 pediatric patients (age: < or =18 y) who underwent transplant from the years 1995 to 2007. Forty-nine allografts (79%) had > or =1 year of histologic follow-up, 32 (52%) > or =3 years, and 24 (39%) > or =5 years. We reviewed a total of 445 allograft biopsies (mean: 7.2 per allograft) obtained at 2 days to 11 years; 213 (48%) of these were protocol biopsies. Seven explanted livers that were removed during the course of retransplantation for graft failure in this group were also reviewed. All specimens were scored for the following features: (1) CP (mild, moderate, and severe), (2) portal ACR (mild, moderate, and severe), (3) zone 3 fibrosis (mild=perivenular or severe=bridging), and (4) ductopenia. CP was present in 120 (27%) of 445 biopsies, including 73 with CP+PB-ACR, 16 with CP within 1 month of PB-ACR, 27 with isolated CP, 3 with CP+de-novo autoimmune hepatitis, and 1 with CP+Epstein-Barr virus infection. Overall, CP was observed on at least 1 occasion in 41 (66%) allografts. It was not associated with any specific liver function test abnormality or pattern of liver function test abnormalities, it was not associated with vascular compromise as judged by Doppler ultrasound examinations, and it was not related to type of immunosuppression. CP overall was equally prevalent in the early (< or =3 mo) and late (>3 mo) post-transplant periods, but isolated CP increased in the late period. On follow-up, 6 (15%) of 41 allografts with CP developed ductopenic chronic rejection (4 requiring retransplantation) and 10 (25%) developed zone 3-based fibrosis without ductopenia (2 severe, 8 mild). In contrast, none of the 21 allografts without CP developed chronic rejection (P=0.09) and none had zone 3-based fibrosis on their last biopsy (P<0.001). All patients who developed ductopenia had 1 or more episodes of CP+PB-ACR. In contrast, isolated CP [seen in 17 (27%) allografts on at least 1 occasion] was associated with zone 3-based fibrosis in 50%, but did not lead to ductopenic chronic rejection. These results underscore the high frequency of CP in pediatric liver transplantation, occurring in 27% of all allograft biopsies and 66% of allografts overall. CP is most common in conjunction with portal ACR, where it carries a significant risk for the development of zone 3 fibrosis and a trend toward the development of ductopenic chronic rejection.
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PMID:Significance of central perivenulitis in pediatric liver transplantation. 1870 42

Juvenile systemic lupus erythematosus (JSLE) and autoimmune hepatitis (AIH) are both autoimmune disorders that are rare in children and have a widespread clinical manifestation. A few case reports have shown a JSLE-AIH associated disorder. To our knowledge, this is the first study that simultaneously evaluated the prevalence of JSLE-AIH in a large JLSE and AIH population in groups of Hepatology and Rheumatology of a tertiary Paediatric University Hospital. In a 24-year period, 228 patients were diagnosed with JSLE (ACR criteria). In the same period, 252 patients were diagnosed with AIH according to the International Autoimmune Hepatitis Group. In this article, we present the demographic data, clinical features, laboratory exams and treatment of four children with both the diseases. The prevalence was 1.8% in JSLE population and was 1.6% in AIH population. The current median age was 15.5 years and three were females. In three of them, the diagnosis of AIH preceded JSLE. All of them had increased liver enzymes with a characteristic liver biopsy of AIH and responded to the combination of prednisone, azathioprine and antimalarial drugs. In conclusion, the presence of AIH-JSLE associated disorder was rarely observed. The liver biopsy could be necessary in patients with JLSE with a persistent increase of liver enzymes.
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PMID:Autoimmune hepatitis and juvenile systemic lupus erythematosus. 1950 73

Hepatitis-C is the most common indication for liver transplantation. Recurrence of HCV is universal leading to graft failure in up to 40% of all patients. The differentiation between acute rejection and recurrent hepatitis-C is crucial as rejection treatments are likely to aggravate HCV-recurrence. Histological examination of liver biopsy remains the gold standard for diagnosis of acute rejection but has failed in the past to distinguish between acute rejection and recurrent hepatitis-C. In a retrospective study we have recently reported that C4d as a marker of the activated complement cascade is detectable in a hepatic specimen in acute rejection after liver transplantation and may serve as a valuable tool in differential diagnosis between ACR and HCV-recurrence. We performed a prospective analysis by ELISA measurement of C4d concentration in cryo-preserved liver biopsies of LTX patients who had either experienced acute rejection, hepatitis-C recurrence or displayed no pathological alterations (controls). Opposed to our immunohistologically based findings in paraffinized tissue we were unable to detect significant differences of C4d concentration in ELISA of cryo-preserved liver tissue. Consequently the role and potential value of C4d as a diagnostic marker may not be determined using ELISA-based tissue evaluation.
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PMID:ELISA-based detection of C4d after liver transplantation--a helpful tool for differential diagnosis between acute rejection and HCV-recurrence? 2055 92