Case Reports in Hepatology最新文献

{"title":"ANCA-Associated Intrahepatic Duct Injury Associated with Levamisole-Adulterated Cocaine.","authors":"Joshua K Salabei,&nbsp;Sara Khan,&nbsp;Afzal Khan,&nbsp;Zekarias T Asnake,&nbsp;Troy J Fishman,&nbsp;Jonathan D Stromas,&nbsp;Zeeshan H Ismail,&nbsp;John R Leibach","doi":"10.1155/2020/8867183","DOIUrl":"https://doi.org/10.1155/2020/8867183","url":null,"abstract":"<p><p>Damage to the liver or kidney can occur through direct toxic effects; however, damage can also be drug-induced immune-mediated. Levamisole-adulterated cocaine (LAC) is known to cause antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis and glomerulonephritis leading to acute kidney injury and end-stage renal disease. It remains unclear whether LAC is associated with hepatic duct damage. Here, we report a case with biopsy-proven evidence of intrahepatic duct damage months after being diagnosed with ANCA-associated crescentic and sclerosing glomerulonephritis caused by LAC use. This case represents the first report of LAC-induced ANCA-associated hepatic duct cholestasis in the setting of previous LAC-induced ANCA-positive glomerulonephritis.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8867183"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38803739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Brucellosis and Cirrhosis: The Triggering Event of Fatal Liver Decompensation.","authors":"Maria Kosmidou,&nbsp;Eleftherios Klouras,&nbsp;Iro Rapti,&nbsp;Sebastien Filippas-Ntekouan,&nbsp;Haralampos Milionis","doi":"10.1155/2020/8868001","DOIUrl":"https://doi.org/10.1155/2020/8868001","url":null,"abstract":"<p><p>Cirrhotic patients are known to be particularly susceptible to infectious complications that may vary according to regional endemic patterns. Brucellosis, a common zoonosis with worldwide distribution, exhibits a predilection for the reticuloendothelial system and thus resulting in hepatic involvement. We describe three cirrhotic patients in whom acute brucellosis and/or its treatment served as the triggering factor of hepatic decompensation, with deleterious effects. The patients suffered from alcoholic cirrhosis and culture-proven brucellosis. All patients came from an area endemic to brucellosis. The first patient exhibited a relapsing brucellosis course with progressive deterioration of his fragile liver function. The second patient progressed rapidly to jaundice, possibly partly attributed to antibiotic pharmacotoxicity, and died during liver transplantation. The third patient eventually succumbed to diffuse intravascular coagulation. Brucellosis can be a triggering event of fatal liver decompensation in cirrhotic patients. Enhancing health literacy of the patients, particularly in endemic areas, is of paramount importance for prevention of exposure to similar pathogens.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8868001"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38803740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Multiple Intratumoral Hemorrhage and Rupture of Hepatocellular Carcinoma after Starting Lenvatinib.","authors":"Katsutoshi Ishihara","doi":"10.1155/2020/6659388","DOIUrl":"https://doi.org/10.1155/2020/6659388","url":null,"abstract":"<p><p>A man in his 80s was administered lenvatinib to treat multiple hepatocellular carcinomas. After starting lenvatinib, he was admitted to our hospital for fever and epigastric tenderness. Conjunctival icterus and conjunctival pallor were observed. Computed tomography showed high density areas in his tumors which were suggestive of intratumoral hemorrhage and tumor rupture. As a result, the patient underwent an emergent angiography and arterial embolization.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"6659388"},"PeriodicalIF":0.0,"publicationDate":"2020-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38766593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variceal Bleed and Portal Hypertensive Gastropathy in a Noncirrhotic Patient with Isolated Splenomegaly.","authors":"S M Mahmudul Hasan,&nbsp;Meghan Dmitriew,&nbsp;Jennifer Leonard","doi":"10.1155/2020/8893713","DOIUrl":"https://doi.org/10.1155/2020/8893713","url":null,"abstract":"<p><p>Portal hypertension caused by cirrhosis is the most common etiology of esophageal varices. However, abnormalities of the splenoportal axis in the absence of liver disease may also cause portal hypertension resulting in varices. We report a rare case of esophageal variceal bleed in a noncirrhotic patient with isolated splenomegaly secondary to chronic granulocyte colony stimulating factor (G-CSF) therapy. The patient is a 26-year-old male with Cohen syndrome who required long-term G-CSF treatment for chronic neutropenia. He presented with large volume hematemesis and pancytopenia in the setting of known splenomegaly with no evidence of cirrhosis. An urgent EGD revealed active variceal bleeding and portal hypertensive gastropathy. The patient was appropriately resuscitated and underwent a successful transjugular intrahepatic portosystemic shunt and CT-guided coil placement for the bleeding varices. We are the first to report variceal bleed as a complication of long-term G-CSF use, a life-threatening consequence that requires urgent intervention.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8893713"},"PeriodicalIF":0.0,"publicationDate":"2020-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38766594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Course Changes of Serum Keratin Concentrations after Liver Transplantation: Contrasting Results of Keratin-18 and Keratin-19 Fragments.","authors":"Cristina Macía,&nbsp;Jose Loureiro,&nbsp;Isabel Campos-Varela,&nbsp;Ihab Abdulkader,&nbsp;Esteban Otero,&nbsp;Evaristo Varo,&nbsp;Santiago Tomé,&nbsp;Arturo Gonzalez-Quintela","doi":"10.1155/2020/8895435","DOIUrl":"https://doi.org/10.1155/2020/8895435","url":null,"abstract":"<p><strong>Objective: </strong>Under normal conditions, adult hepatocytes express only keratin-8 (K8) and keratin-18 (K18), whereas cholangiocytes also express K19. In this study, we delineate the pattern of normal time-course changes in serum K19 and K18 levels after liver transplantation. <i>Patients and Methods.</i> Serum levels of the K19 fragment CYFRA 21-1 and the K18 fragments tissue polypeptide specific antigen (TPS) and M30 (a neoepitope that is generated after caspase cleavage during apoptosis) were measured at baseline and at regular intervals (up to 6 months) after liver transplantation in 11 adult patients.</p><p><strong>Results: </strong>There was a gradual decrease in serum K19 concentrations from baseline values after transplantation, following a time-course pattern similar to that of serum bilirubin. In contrast, serum concentrations of K18 fragments increased markedly shortly after transplantation and gradually decreased thereafter, following a time-course pattern similar to that of serum transaminases. The increase in TPS tended to occur earlier than that in M30, suggesting an initial predominance of hepatocyte necrosis followed by a predominance of apoptosis in the first days after transplantation. Five patients presented posttransplant complications (acute rejection in three cases and HCV recurrence in two cases). An early increase in serum K19 concentrations was observed in all cases. An increase in serum concentrations of K18 fragments (M30 and TPS) was observed in the two cases with HCV recurrence and was more variable in the three cases with acute rejection.</p><p><strong>Conclusions: </strong>Serum concentrations of K19 and K18 fragments follow a dissimilar pattern of time-course changes after liver transplantation. The diagnostic value of variations in these normal patterns should be addressed in future studies.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8895435"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8895435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Cryptococcus</i>: A Rare Cause of Parotid Abscess in Liver Cirrhosis.","authors":"Takeshi Okamoto,&nbsp;Katsuyuki Fukuda","doi":"10.1155/2020/8849448","DOIUrl":"https://doi.org/10.1155/2020/8849448","url":null,"abstract":"<p><p>A 61-year-old man with decompensated liver cirrhosis presented with a parotid mass. Fine-needle aspiration of the parotid gland revealed <i>Cryptococcus neoformans</i>. Lumbar puncture confirmed cryptococcal meningitis. Multiple splenic lesions with radiographic features consistent with cryptococcal splenic abscesses were also seen. Despite antifungal therapy, the patient died 17 days after infection was confirmed. This is the first report of a cryptococcal parotid abscess in a patient with liver cirrhosis.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8849448"},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8849448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38341023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Hepatocellular Carcinoma in a Patient with Chronic Hepatitis C 21 Years after Achieving a Sustained Virological Response to Interferon Therapy.","authors":"Tasuku Hara,&nbsp;Tomoya Ohara,&nbsp;Masashi Taniguchi,&nbsp;Toshiaki Sakai,&nbsp;Kohei Oka,&nbsp;Naoto Iwai,&nbsp;Toshifumi Tsuji,&nbsp;Takashi Okuda,&nbsp;Toshiyuki Komaki,&nbsp;Junichi Sakagami,&nbsp;Keizo Kagawa","doi":"10.1155/2020/8824974","DOIUrl":"https://doi.org/10.1155/2020/8824974","url":null,"abstract":"<p><p>A 77-year-old man with chronic hepatitis C (CH-C) infection, who achieved a sustained virological response (SVR) to interferon (IFN) therapy, was followed up regularly. Before IFN therapy, he did not have metabolic diseases, and the histological diagnosis of his chronic hepatitis was stage-3 fibrosis. After achieving SVR, the fibrosis-4 (FIB-4) index level dropped once but gradually increased. 21 years after SVR, hepatocellular carcinoma (HCC) was diagnosed by dynamic computed tomography. The HCC was 12 mm in diameter. The HCC was treated with radiofrequency ablation. CH-C patients with advanced fibrosis require long-term follow-up, even after achieving SVR.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8824974"},"PeriodicalIF":0.0,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8824974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38545077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Severe Case of Drug-Induced Liver Injury after Gemcitabine Administration: A Highly Probable Causality Grading as Assessed by the Updated RUCAM Diagnostic Scoring System.","authors":"Ilenia Mascherona,&nbsp;Caterina Maggioli,&nbsp;Maira Biggiogero,&nbsp;Oreste Mora,&nbsp;Lucia Marelli","doi":"10.1155/2020/8812983","DOIUrl":"https://doi.org/10.1155/2020/8812983","url":null,"abstract":"<p><p>Gemcitabine is an antineoplastic drug used in several forms of advanced pancreatic, lung, breast, ovarian, and bladder cancer. Common side effects include bone marrow suppression, fatigue, diarrhea, nausea, gastrointestinal upset, rash, alopecia, and stomatitis. Transient serum enzyme elevations could be observed during therapy, but clinically significant acute liver injury has been rarely associated with its use. Few cases of acute liver injury have been reported in the literature. We reported the clinical case of a 73--year-old man who developed clinically significant acute hepatic injury after using gemcitabine. Possible causes, clinical presentation, and treatments are discussed. According to the updated RUCAM score, the case was rated 10 points and became a suspected drug-induced liver injury. Moreover, on the liver biopsy, there were histological findings of mild-to-moderate portal hepatitis, eosinophilia, bile duct injury, and mild perisinusoidal fibrosis, suggesting drug damage.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8812983"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8812983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38516937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured Subcapsular Liver Hematoma: A Rare Complication of HELLP Syndrome.","authors":"Pratishtha Singh,&nbsp;Kayle Warren,&nbsp;Victor Collier","doi":"10.1155/2020/8836329","DOIUrl":"https://doi.org/10.1155/2020/8836329","url":null,"abstract":"<p><p>Subcapsular liver hematoma (SLH) is a rare complication of HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. We report a previously healthy 16-year-old female presenting with pre-eclampsia requiring emergent C-section, who developed immediate postoperative bleeding and abdominal distention. Abdominal computed tomography angiography (CTA) revealed a large encapsulated liver hematoma with active extravasation. The patient was successfully treated with a multidisciplinary approach with medical and surgical management.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8836329"},"PeriodicalIF":0.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8836329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38455535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disulfiram-Induced Acute Liver Injury.","authors":"Lucas Ramer,&nbsp;Matthieu Tihy,&nbsp;Nicolas Goossens,&nbsp;Jean-Louis Frossard,&nbsp;Laura Rubbia-Brandt,&nbsp;Laurent Spahr","doi":"10.1155/2020/8835647","DOIUrl":"https://doi.org/10.1155/2020/8835647","url":null,"abstract":"<p><p>Disulfiram is a drug used to treat alcohol dependence since many years. It interferes with the metabolism of alcohol, may be associated with neurological and dermatological symptoms, and can be hepatotoxic. Due to the frequent coexistent liver test alterations due to alcohol, the true incidence of disulfiram-associated liver injury is unclear and severity of injury may vary from mildly elevated liver enzymes to fulminant hepatitis leading to death. There are several reported cases of disulfiram hepatitis in the literature. Liver histology, when available, demonstrates some degree of portal inflammation with eosinophils and hepatocyte necrosis. We present here a well-documented case of acute hepatitis due to disulfiram with typical histological lesions, favorable outcome following drug withdrawal, and a brief steroid course. The risk of hepatotoxicity should be kept in mind when prescribing disulfiram.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2020 ","pages":"8835647"},"PeriodicalIF":0.0,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8835647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38506001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}