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Journal of Clinical and Experimental Hepatology

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https://www.readbyqxmd.com/read/28348477/rapid-onset-of-fatal-lactic-acidosis-complicating-tenofovir-therapy-in-a-diabetic-patient-with-cirrhosis-a-cautionary-tale
#1
Ramesh Kumar, Shivani Agrawal
No abstract text is available yet for this article.
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348476/unusual-presentation-of-tubercular-liver-abscess-in-an-immune-competent-adult
#2
Pramod Kumar, Sunil Taneja, Kirti Gupta, Ajay Duseja, Radha K Dhiman, Yogesh K Chawla
Isolated hepatobiliary tuberculosis (TB) has been uncommonly described with or without biliary involvement and accounts for less than 1% of all tubercular infections. Isolated hepatic TB is even rare and poses a great diagnostic challenge. We report a case of isolated tubercular liver abscess with extension into the chest wall in an immune-competent adult, which was diagnosed and managed successfully with antitubercular treatment.
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#3
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348474/malignant-hepatic-epithelioid-hemangioendothelioma-with-villaret-syndrome
#4
Hanchanale Pavan, Joy Varghese, Kavya Harika, Mukul Vij, Venkataraman Jayanthi, Mohamed Rela
Malignant hepatic epithelioid hemangioendothelioma is a rare, vascular tumor of the liver with peak incidence in the middle age with a female preponderance and of unknown etiology. Majority of the tumors are asymptomatic. The gold standard for diagnosis of the tumor is liver histology showing presence of epithelioid tumor cells on a background of a hyaline stroma. Immunohistochemical positivity for CD31, CD34, Factor VIII, and Podoplanin (D2-40) is confirmatory. The treatment of choice is liver transplantation...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348473/acute-onset-significant-muscle-weakness-in-a-patient-awaiting-liver-transplantation-look-for-statins
#5
Narendra S Choudhary, Sanjiv Saigal, Neeraj Saraf, Arvinder S Soin
Statins are commonly used drugs in patients with liver and cardiac disease. Statin-induced severe myopathy is a very uncommon presentation and rhabdomyolysis may occur in extreme cases which leads to renal failure. Patients with comorbidities like diabetes, hypothyroidism, and liver disease have higher chances of development of statin-induced myopathy. We describe a case of Child's C cirrhosis wherein the patient had acute onset significant muscle weakness and improved on statin discontinuation.
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348472/portal-inflow-in-extensive-portomesenteric-thrombosis-using-the-pericholedochal-varix-in-living-donor-liver-transplantation
#6
Kishore Gurumoorthy Subramanya Bharathy, Shridhar Vasantrao Sasturkar, Piyush Kumar Sinha, Senthil Kumar, Viniyendra Pamecha
Extensive portomesenteric thrombosis presents a technical challenge in liver transplantation. Establishing portal inflow in living donor liver transplantation (LDLT) is indispensable to ensure regeneration of the graft. The use of a pericholedochal varix for inflow has been described only in a few case reports. Described herein is one such instance in the setting of LDLT, highlighting the nuances of this procedure in the light of available literature.
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348471/role-of-allopurinol-in-optimizing-thiopurine-therapy-in-patients-with-autoimmune-hepatitis-a-review
#7
REVIEW
Shivani Deswal, Anshu Srivastava
Autoimmune hepatitis (AIH) is a chronic immune mediated liver disease characterized by elevated transaminases, hyper gammaglobulinemia, presence of autoantibodies and interface hepatitis in the absence of a known etiology of liver disease. Thiopurines (azathioprine [AZA]/6-mercaptopurine [6MP]) and steroids remain the first line of treatment of AIH in both children and adults. However, a small proportion of AIH patients are either non-responders or develop side effects with AZA. The metabolism of AZA is complex and mediated by multiple enzymes...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348470/potential-liver-transplant-recipients-with-hepatitis-c-should-they-be-treated-before-or-after-transplantation
#8
REVIEW
Anil C Anand
Treatment of hepatitis C virus (HCV) with newer directly acting antivirals (DAAs) and lead to sustained viral response (SVR) in majority of patients and SVR has been documented to be associated with reversal of liver cirrhosis. The improved SVR rates and safety profiles of DAAs have led to the treatment of patients with decompensated cirrhosis awaiting liver transplantation (LT). Several clinical trials of DAAs in decompensated HCV patients have recently demonstrated SVR rates above 80%, which have been associated with significant improvements, in the Child-Pugh-Turcotte scores/or model for end-stage liver disease scores in a proportion of patients...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348469/the-preliminary-study-on-procurement-biliary-convergence-from-donors-with-complicated-bile-duct-variant-in-emergency-right-lobe-living-donor-liver-transplantation
#9
Sheng Ye, Jia-Hong Dong, Wei-Dong Duan, Wen-Bing Ji, Yu-Rong Liang
BACKGROUND: The incidence of biliary complications after living donor adult liver transplantation (LDALT) is still high due to the bile duct variation and necessity reconstruction of multiple small bile ducts. The current surgical management of the biliary variants is unsatisfactory. We evaluated the role of a new surgical approach in a complicated hilar bile duct variant (Nakamura type IV and Nakamura type II) under emergent right lobe LDALT for high model for end-stage liver disease score patients...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348468/early-acute-severe-hcv-recurrence-after-transplantation-from-universal-mortality-to-cure
#10
Manav Wadhawan, Vivek Vij, Kausar Makki, Nalini Bansal, Ajay Kumar
Acute severe recurrence of hepatitis C virus (HCV) after solid organ transplant is associated with high mortality. Pegylated interferon and ribavirin are suboptimal in treatment of this severe form of recurrence. We report 4 cases of acute severe HCV recurrence (within 6 months after transplant), including 3 cases with fibrosing cholestatic hepatitis treated with sofosbuvir and ribavirin. All four patients achieved a rapid suppression of HCV RNA with a normalization of liver function tests within 4 weeks of starting therapy...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348467/2d-shear-wave-elastography-of-liver-in-patients-with-primary-extrahepatic-portal-vein-obstruction
#11
Kumble S Madhusudhan, Raju Sharma, Ragini Kilambi, Sudhin Shylendran, Shalimar, Peush Sahni, Arun K Gupta
AIMS: To evaluate liver stiffness (LS) in patients of primary extrahepatic portal vein obstruction (EHPVO) using 2D shear wave elastography (SWE) and compare it with healthy volunteers. METHODS: Fifty patients (mean age: 22.4 years) of EHPVO and 25 healthy volunteers were included in the study. Liver function tests and viral markers were done in both groups and endoscopy in EHPVO group, followed by ultrasonography and SWE of liver. Liver elastography was done with patients/volunteers in supine position through right intercostal space...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348466/handgrip-strength-as-an-important-bed-side-tool-to-assess-malnutrition-in-patient-with-liver-disease
#12
Praveen Sharma, Abdul Rauf, Abdul Matin, Rachit Agarwal, Pankaj Tyagi, Anil Arora
BACKGROUND: Malnutrition is frequently present in patients with cirrhosis. Anthropometric measures such as body mass index (BMI), mid arm muscle circumference (MAMC), triceps skin fold thickness (TST) and subjective global assessment (SGA) have some limitations in assessment of malnutrition. This study aims to determine the prevalence of malnutrition in non-hospitalized cirrhotic and chronic hepatitis patients and to assess handgrip (HG) strength as a tool for identifying malnutrition...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348465/impact-of-hepatic-and-extrahepatic-insults-on-the-outcome-of-acute-on-chronic-liver-failure
#13
Tarana Gupta, Radha K Dhiman, Sahaj Rathi, Swastik Agrawal, Ajay Duseja, Sunil Taneja, Yogesh Chawla
BACKGROUND: To study the differences in outcome and predictors of mortality in acute-on-chronic liver failure (ACLF) precipitated by hepatic or extrahepatic insults. METHODS: Consecutive patients of cirrhosis with acute decompensation were prospectively included and followed up for 90 days from admission. ACLF was defined based on chronic liver failure (CLIF) acute-on-chronic liver failure in cirrhosis (CANONIC study) criteria. Acute worsening due to acute viral hepatitis A and E, hepatitis B flare, alcoholic hepatitis, autoimmune hepatitis flare, or drug-induced liver injury were categorized as hepatic ACLF and that due to bacterial infection, upper gastrointestinal bleed or surgery as extrahepatic ACLF...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28348464/liver-function-tests-abnormalities-and-hepatitis-b-virus-hepatitis-c-virus-co-infection-in-human-immunodeficiency-virus-hiv-infected-patients-in-india
#14
P Puri, P K Sharma, A Lolusare, V K Sashindran, S Shrivastava, A K Nagpal
BACKGROUND: While highly active anti-retroviral therapy (HAART) has improved survival of HIV-infected patients, there is increasing liver disease and progressive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) related liver disease. AIMS: To study the liver function tests (LFT) and HBV and HCV co-infection in HIV-infected patients. MATERIAL AND METHODS: All HIV-positive patients presenting to a tertiary level hospital from April 2009 to April 2011 were evaluated...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003728/looking-beyond-sorafenib-to-treat-advanced-hepatocellular-carcinoma
#15
Swastik Agrawal
No abstract text is available yet for this article.
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003727/an-unusual-complication-of-pyogenic-liver-abscess
#16
Hemanta K Nayak, Kamlesh Kumar, Vivek A Saraswat, Gaurav Pandey, Samir Mohindra, Ankur Singh
No abstract text is available yet for this article.
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003726/enucleation-sign-a-computed-tomographic-appearance-of-ruptured-hepatocellular-carcinoma
#17
Manphool Singhal, Upasna Sinha, Naveen Kalra, Ajay Duseja, Niranjan Khandelwal
Rupture of hepatocellular carcinoma (HCC) is a catastrophic complication, which carries high mortality. We report a case of spontaneous rupture of HCC, diagnosis of which was considered on clinical presentation and confirmed on computed tomographic (CT) scan. On CT scan, characteristic 'enucleation sign' was observed on arterial phase imaging, where a hypervascular peripheral mass showing central necrosis was seen protruding from liver surface with discontinuity of hepatic parenchyma associated with high attenuation ascites...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003725/neonatal-cholestasis-as-initial-presentation-of-portosystemic-shunt-a-case-report
#18
Güzide Doğan, Fatih Düzgün, Serdar Tarhan, Yeliz Çağan Appak, Erhun Kasırga
Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003724/balloon-occluded-retrograde-transvenous-obliteration-brto-a-novel-method-of-control-of-bleeding-from-post-glue-ulcer-over-gastric-varices-report-of-two-cases-and-review-of-literature
#19
Ritesh Prajapati, Piyush Ranjan, Arun Gupta, Ajit K Yadav
Bleeding gastric varices (GV) are managed by cyanoacrylate glue injection with transjugular intrahepatic portosystemic shunt (TIPSS) as modality for treatment failure. Ulcer can form at the site of glue injection over GV and it can cause bleeding. Treatment approach for such bleed is not well described. Balloon-occluded retrograde transvenous obliteration (BRTO), TIPSS, and devascularization remain the treatment options in this scenario. BRTO is an endovascular procedure where a balloon catheter is inserted into a draining vein of GV, and the sclerosant can be injected into the varices through the catheter during balloon occlusion...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003723/multifocal-intrahepatic-artery-aneurysm-with-fdg-avid-thrombosis-simulating-metastasis-report-of-a-rare-case
#20
Xiaofei Zhang, Ashley E Stueck, Sander Florman, Swan N Thung, Sara Lewis
Hepatic artery aneurysm (HAA), although rare, represents a serious diagnostic and therapeutic challenge due to high rupture rate and associated mortality. Early detection and accurate diagnosis are essential for successful management. Here, we present an extremely rare case of multi-focal intrahepatic HAA with confined intrahepatic rupture and hypermetabolic activity at PET imaging, simulating metastasis of melanoma. A retrospective review found only two other HAA at our institution between 2000 and 2015, both of which involved the extrahepatic artery...
December 2016: Journal of Clinical and Experimental Hepatology
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