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Case Reports in Hepatology

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https://www.readbyqxmd.com/read/29441209/retrospective-identification-of-herpes-simplex-2-virus-associated-acute-liver-failure-in-an-immunocompetent-patient-detected-using-whole-transcriptome-shotgun-sequencing
#1
Atsushi Ono, C Nelson Hayes, Sakura Akamatsu, Michio Imamura, Hiroshi Aikata, Kazuaki Chayama
Acute liver failure (ALF) is a severe condition in which liver function rapidly deteriorates in individuals without prior history of liver disease. While most cases result from acetaminophen overdose or viral hepatitis, in up to a third of patients, no clear cause can be identified. Liver transplantation has greatly reduced mortality among these patients, but 40% of patients recover without liver transplantation. Therefore, there is an urgent need for rapid determination of the etiology of acute liver failure...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29375917/safety-of-sofosbuvir-and-ribavirin-combination-therapy-in-a-patient-who-developed-anemia-due-to-ribavirin
#2
Hirokazu Suii, Itaru Ozeki, Ryoji Tatsumi, Masakatsu Yamaguchi, Mutsuumi Kimura, Tomohiro Arakawa, Tomoaki Nakajima, Yasuaki Kuwata, Takumi Ohmura, Shuhei Hige, Yoshiyasu Karino, Joji Toyota
Interferon (IFN) and ribavirin (RBV) combination therapy was previously the standard of care for treatment of hepatitis C virus (HCV) genotype 2 infection. But, it often induced hemolytic anemia. In 2014, sofosbuvir (SOF) was approved for the treatment of chronic HCV genotype 2 in Japan. SOF/RBV therapy is more effective against genotype 2 than IFN/RBV therapy. We report a case of a 74-year-old woman with chronic HCV genotype 2b infection. She received five treatments including RBV and IFN therapy before SOF was approved and all of them were ineffective...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29333304/synthetic-cannabinoid-abuse-and-a-rare-alpha-1-antitrypsin-mutant-causing-acute-fulminant-hepatitis-a-case-report-and-review-of-the-literature
#3
Kurt J Knowles, Eric X Wei, Abhishek Seth, John Bienvenu, James Morris, Kenneth Manas, Paul Jordan, Moheb Boktor
Synthetic cannabinoids (SCs) abuse is on the rise because they are easily obtained over the counter; they are potent psychoactive compounds and routine drug testing does not detect them. As their abuse is on the rise, so are their detrimental side effects; however, the occurrence of acute hepatitis due to SCs abuse has been reported only once before. In this case, testing revealed that the patient was also heterozygous for alpha-1-antitrypsin (A-1-AT) with the phenotype of PI⁎EM. This mutant phenotype has never been reported as a cause of A-1-AT disease and the abuse of SCs in a patient with this phenotype has also never been reported...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29270324/early-onset-of-tenofovir-related-fanconi-syndrome-in-a-child-with-acute-hepatitis-b-a-case-report-and-systematic-review-of-literature
#4
Renato Pascale, Viola Guardigni, Lorenzo Badia, Francesca Volpato, Pierluigi Viale, Gabriella Verucchi
Tenofovir disoproxil fumarate- (TDF-) related nephropathy is known to be a long-term complication of this drug, more commonly observed in HIV-infected patients, but occurring also in hepatitis B. Cases of Fanconi Syndrome associated with TDF have been reported in adult patients, usually as a long-term complication of chronic hepatitis B treatment. We present here a case of a 12-year-old male developing a severe acute HBV hepatitis treated with TDF. The patient achieved an early virological and biochemical response, but with a subsequent onset of proximal renal tubular damage, consistent with Fanconi Syndrome...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29259831/sport-related-portal-vein-thrombosis-an-unusual-complication
#5
Igor Dumic, Nikola Tankosic, Milica Stojkovic Lalosevic, Tamara Alempijevic
Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29158927/liver-metastases-in-pancreatic-acinar-cell-carcinoma-treated-with-selective-internal-radiation-therapy-with-y-90-resin-microspheres
#6
Felipe Nasser, Joaquim Maurício Motta Leal Filho, Breno Boueri Affonso, Francisco Leonardo Galastri, Rafael Noronha Cavalcante, Diego Lima Nava Martins, Vanderlei Segatelli, Lilian Yuri Itaya Yamaga, Rene Claudio Gansl, Bernardino Tranchesi Junior, Antônio Luiz de Vasconcellos Macedo
Background: Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT. Case Report: 59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29093978/should-serum-protein-electrophoresis-be-a-surrogate-for-liver-biopsy-in-some-cases-of-alpha1-antitrypsin-deficiency
#7
Newton Key Hokama, Marcelo Padovani de Toledo Moraes, Paula de Oliveira Montandon Hokama, Fernando Gomes Romeiro
Most patients with alpha1 antitrypsin deficiency do not receive this diagnosis until developing severe complications, in particular when respiratory symptoms are absent. This is a reason for making alpha1 antitrypsin deficiency a possible diagnosis among patients with cryptogenic cirrhosis or other conditions of liver disease without a clear etiology. In this report, a case of cryptogenic cirrhosis is presented, showing the role of serum protein electrophoresis in the diagnosis, which was made before liver biopsy...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29090102/complete-remission-after-sequential-therapy-of-drug-eluting-beads-transarterial-chemoembolization-and-liver-resection-in-large-solitary-nodule-hepatocellular-carcinoma
#8
Juferdy Kurniawan, Andri Sanityoso Sulaiman, Sahat Basana Romanti Ezer Matondang, Toar Jean Maurice Lalisang, Ening Krisnuhoni, Steven Zulkifly
Hepatocellular carcinoma (HCC) is the fifth most prevalent and the second highest cause of death among cancer. The treatment of large solitary nodule HCC is still challenging. Transarterial chemoembolization (TACE) and liver resection are two modalities of therapy in HCC management. However, recurrence rate from each therapy is relatively high. We report a case of 46-year-old man diagnosed with large solitary nodule HCC, who was treated with drug eluting bead TACE (DEB-TACE) prior to liver resection. Studies about this combination are still limited and showed various results...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28840045/hemoperitoneum-secondary-to-spontaneous-rupture-of-a-retroperitoneal-varix
#9
Derrick D Eichele
Hemoperitoneum due to a ruptured retroperitoneal varix is an exceedingly rare condition and a poor prognostic sign with catastrophic and life-threatening complication of portal hypertension. We present a unique case of a 56-year-old female with cirrhosis secondary to primary sclerosing cholangitis who presented with acute abdominal pain and hypovolemic shock prior to a cardiac arrest following a ruptured retroperitoneal varix without prior esophageal varices and a newly identified intrahepatic cholangiocarcinoma...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28835860/herpes-simplex-virus-hepatitis-a-presentation-of-multi-institutional-cases-to-promote-early-diagnosis-and-management-of-the-disease
#10
Ashwinee Natu, Guiseppe Iuppa, Clifford D Packer
OBJECTIVE: To compare three cases of Herpes simplex virus (HSV) hepatitis to increase early diagnosis of the disease. Case  1. A 23-year-old man with Crohn's disease and oral HSV. HSV hepatitis was diagnosed clinically and he improved with acyclovir. Case  2. An 18-year-old G1P0 woman with transaminitis. Despite early empiric acyclovir therapy, she died due to fulminant liver failure. Case  3. A 65-year-old woman who developed transaminitis after liver transplant. Diagnosis was confirmed by biopsy and she had resolution of acute liver failure with acyclovir...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28785493/intractable-fasting-hypoglycemia-as-a-manifestation-of-hepatocellular-carcinoma
#11
Justin J Forde, Ofor Ewelukwa, Tony Brar, Roniel Cabrera
Non-islet cell tumor hypoglycemia (NICTH) is a rare and serious paraneoplastic complication of both malignant and benign tumors to consider when evaluating fasting hypoglycemia, especially in the setting of liver diseases. We present a case of NICTH in a 54-year-old male with hepatocellular carcinoma (HCC) who presented with symptomatic intractable hypoglycemia (IH) after bowel preparation and fasting for screening upper endoscopy and colonoscopy.
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28761769/tacrolimus-induced-type-iv-renal-tubular-acidosis-following-liver-transplantation
#12
Christopher Schmoyer, Suraj Mishra, Frank Fulco
Calcineurin inhibitors remain an integral component of immunosuppressive therapy regimens following solid organ transplantation. Although nephrotoxicity associated with these agents is well documented, type IV renal tubular acidosis is a rare and potentially underreported complication following liver transplantation. Hepatologists must be able to recognize this adverse effect as it can lead to fatal hyperkalemia. We describe a case of tacrolimus-induced hyperkalemic type IV renal tubular acidosis in a patient following an orthotopic liver transplant for alcoholic cirrhosis...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28529811/glycogenic-hepatopathy-resolution-with-minimal-glucose-control
#13
Abhimanyu Chandel, Brittany Scarpato, Jeanette Camacho, Miles McFarland, Shaffer Mok
We describe a presentation of glycogenic hepatopathy in a poorly controlled type I diabetic patient. As patients with glycogenic hepatopathy often have nonspecific complaints, diagnosis tends to be delayed and laboratory and imaging data are often indistinguishable from nonalcoholic fatty liver disease. Our patient's diagnosis of glycogenic hepatopathy required a liver biopsy, which demonstrated the characteristic pathology. Her symptoms resolved with minimal alteration to her insulin regimen and only slightly improved glucose control...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28512588/severe-aplastic-anemia-following-parvovirus-b19-associated-acute-hepatitis
#14
Masanori Furukawa, Kosuke Kaji, Hiroyuki Masuda, Kuniaki Ozaki, Shohei Asada, Aritoshi Koizumi, Takuya Kubo, Norihisa Nishimura, Yasuhiko Sawada, Kosuke Takeda, Tsuyoshi Mashitani, Masayuki Kubo, Itsuto Amano, Tomoyuki Ootani, Chiho Ohbayashi, Koji Murata, Tatsuichi Ann, Akira Mitoro, Hitoshi Yoshiji
Human parvovirus (HPV) B19 is linked to a variety of clinical manifestations, such as erythema infectiosum, nonimmune hydrops fetalis, and transient aplastic anemia. Although a few cases have shown HPVB19 infection as a possible causative agent for hepatitis-associated aplastic anemia (HAAA) in immunocompetent patients, most reported cases of HAAA following transient hepatitis did not have delayed remission. Here we report a rare case of severe aplastic anemia following acute hepatitis with prolonged jaundice due to HPVB19 infection in a previously healthy young male...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28428898/severe-acute-hepatitis-b-in-hbv-vaccinated-partner-of-a-patient-with-multiple-myeloma-treated-with-cyclophosphamide-bortezomib-and-dexamethasone-and-autologous-stem-cell-transplant
#15
Majed M Almaghrabi, Kyle J Fortinsky, David Wong
Hepatitis B reactivation can occur with various forms of immunosuppression. Cyclophosphamide, Bortezomib, and Dexamethasone (CYBOR-D) chemotherapy is commonly used for the treatment of multiple myeloma and has not been noted in guidelines to be causative in HBV reactivation. Indeed, current guidelines do not recommend providing antiviral prophylaxis to patients with prior HBV infection. We present a case of HBV reactivation as a result of CYBOR-D and autologous stem cell transplant which is complicated by the patient's partner who developed acute hepatitis B...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28299213/cervical-spinal-cord-compression-a-rare-presentation-of-hepatocellular-carcinoma
#16
Puvanalingam Ayyadurai, Kanthi Rekha Badipatla, Chukwunonso Chime, Shiva Arjun, Pavithra Reddy, Masooma Niazi, Suresh Kumar Nayudu
Hepatocellular carcinoma (HCC) is the most common primary malignancy of liver. Distant metastasis to various organs is well known. Skeletal metastasis is also reported to various locations. Vertebral metastasis has been reported mostly to thoracic spine. However, cervical spinal cord involvement leading to cord compression has been reported very rarely in literature. We present a case of 58-year-old male with liver cirrhosis presenting as neck pain. Further work-up revealed metastatic HCC to cervical spinal cord resulting in acute cord compression...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28246565/diphenhydramine-as-a-cause-of-drug-induced-liver-injury
#17
Yunseok Namn, Yecheskel Schneider, Isabelle H Cui, Arun Jesudian
Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history of 13/14-chromosomal translocation presented with fevers, vomiting, and jaundice. Aspartate-aminotransferase and alanine-aminotransferase levels peaked above 20,000 IU/L and 5,000 IU/L, respectively. He developed coagulopathy but without altered mental status...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28044114/viekira-pak-induced-fatal-lactic-acidosis-a-case-report-of-an-unusual-side-effect
#18
Molham Abdulsamad, Ariyo Ihimoyan
Viekira Pak is a new direct-acting antiviral agent that has an excellent efficacy in treating patients with chronic HCV. FDA released a safety warning that Viekira Pak can cause serious liver injury mostly in patients with underlying advanced liver disease. We report the first case of fatal lactic acidosis presenting 3 days after initiating therapy with Viekira Pak. Although it is very hard to precisely determine the cause of lactic acidosis, our case highlights an unusual side effect that ensued after starting the medication...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27999693/severe-anemia-with-hemoperitoneum-as-a-first-presentation-for-multinodular-hepatocellular-carcinoma-a-rare-event-in-western-countries
#19
Thein Swe, Akari Thein Naing, Aama Baqui, Ratesh Khillan
Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma is a life-threatening and rare condition in western countries with an incidence of less than 3% because of early detection of cirrhosis and neoplasm. Here, we describe a case of a 66-year-old male patient with altered mental status with hemorrhagic shock. Computed tomography scan of abdomen revealed hemoperitoneum and mass in liver. Patient underwent resection of liver tumor and biopsy revealed multinodular hepatocellular carcinoma. A high degree of suspicion is required where severe anemia and hemoperitoneum can be a first presentation for hepatocellular carcinoma especially in patients with chronic hepatitis C infection...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27872770/herpes-simplex-virus-hepatitis-in-an-immunocompetent-host-resembling-hepatic-pyogenic-abscesses
#20
Carrie Down, Amit Mehta, Gayle Salama, Erika Hissong, Russell Rosenblatt, Michael Cantor, David Helfgott, Kristen Marks
Herpes simplex virus (HSV) hepatitis represents a rare complication of HSV infection, which can progress to acute liver failure and, in some cases, death. We describe an immunocompetent 67-year-old male who presented with one week of fever and abdominal pain. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the abdomen showed multiple bilobar hepatic lesions, some with rim enhancement, compatible with liver abscesses. Subsequent liver biopsy, however, revealed hepatocellular necrosis, HSV-type intranuclear inclusions, and immunostaining positive for herpes virus type 2 (HSV-2)...
2016: Case Reports in Hepatology
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