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Case Reports in Hepatology

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https://www.readbyqxmd.com/read/29862098/acute-liver-failure-among-patients-on-efavirenz-based-antiretroviral-therapy
#1
Innocent Lule Segamwenge, Miriam Kaunanele Bernard
Objectives: To describe the clinical characteristics of patients presenting with fulminant liver failure after varying periods of exposure to Efavirenz containing antiretroviral medications. Methods: We report a series of 4 patients with human immunodeficiency virus (HIV) infection who were admitted with acute liver failure (ALF) over a 6-month period. All these patients had been treated with a range of Efavirenz containing antiretroviral regimens and were negative for hepatitis A, B, and C infections as well as other opportunistic infections, all were negative for autoimmune hepatitis, and none had evidence of chronic liver disease or use of alcohol or herbal medications...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29854501/refractory-hepatic-hydrothorax-a-rare-complication-of-systemic-sclerosis-and-presinusoidal-portal-hypertension
#2
Gary A Abrams, Robert Chapman, Samuel R W Horton
We report on a rare case of refractory hepatic hydrothorax in an individual with Scleroderma/CREST syndrome and noncirrhotic portal hypertension. Portal pressure measurements revealed a normal transjugular hepatic venous portal pressure gradient, mild pulmonary hypertension, and an unremarkable liver biopsy except for mild sinusoidal dilation. Pulmonary hypertension, cardiac diastolic dysfunction, and chronic kidney disease were determined to be the causes of his refractory pleural effusions and ascites. Over the year, he underwent 50 thoracenteses and 20 paracenteses averaging 10-12 liters/week...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29854500/incidental-metastatic-meningioma-presenting-as-a-large-liver-mass
#3
Ifeyinwa E Obiorah, Metin Ozdemirli
Meningiomas are slow growing neoplasms of the central nervous system (CNS). Most of the tumors are benign and distant metastasis from a benign meningioma is rare. Metastasis to the liver, although rare, usually presents with hypoglycemia or occurs in conjunction with a clinical history of an intracranial meningioma or following the resection of a prior CNS meningioma, thus making clinical diagnosis relatively easy. Here we present an unusual case of metastatic meningioma to the liver in a 54-year-old female who presented with an incidental liver mass by ultrasound...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29850300/young-man-with-hepatomegaly-a-case-of-glycogenic-hepatopathy
#4
Walid Abboud, Saif Abdulla, Mohammed Al Zaabi, Ramzi Moufarrej
Glycogenic hepatopathy is a rare but potentially reversible condition characterized by hepatomegaly and elevated liver enzymes occurring in poorly controlled type 1 diabetes mellitus patients and often requires a liver biopsy to confirm the diagnosis. We present the case of a young man who was admitted with diabetic ketoacidosis in the setting of poorly controlled diabetes mellitus type 1 and was noted to have significantly elevated transaminases that continued to worsen despite appropriate treatment of the diabetic ketoacidosis...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29805823/tubulocystic-carcinoma-of-the-bile-duct
#5
Masahiro Takeuchi, Yoshitaka Sakamoto, Hirotsugu Noguchi, Sohsuke Yamada, Keiji Hirata
Tubulocystic carcinoma of the bile duct is extremely rare and has not been reported in the literature. We reported a case of cystic neoplasm of the liver with distinct histopathological features that could not be clearly classified as of either mucinous or intraductal papillary neoplasm. A 68-year-old Japanese patient had a multicystic biliary tumor within the liver. This tumor was detected on follow-up of polymyalgia rheumatica. The exophytic, multicystic, 35 × 50 mm mass was composed of complex tubulocystic structures...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29796326/castleman-s-disease-and-posttransplant-lymphoproliferative-disorder-after-liver-transplant-3-year-follow-up
#6
Lokesh K Jha, Laura L Ulmer, Marco A Olivera-Martinez, Timothy M McCashland, Kai Fu, Fedja A Rochling
A 59-year-old male with a history of hepatitis C cirrhosis and history of hepatitis B exposure presented 8 months after orthotopic liver transplant (LT) with fever, fatigue, myalgia, night sweats, nonproductive cough, and shortness of breath. Bone marrow biopsy for pancytopenia was positive for Epstein-Barr virus (EBV) DNA. Lymph node biopsy for lymphadenopathy on imaging showed human herpes virus 8 (HHV8) associated Castleman's disease. Treatment included valganciclovir, rituximab, and prednisone taper with eventual discontinuation...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29721342/hepatotoxicity-associated-with-use-of-the-weight-loss-supplement-garcinia-cambogia-a-case-report-and-review-of-the-literature
#7
Jiten P Kothadia, Monica Kaminski, Hrishikesh Samant, Marco Olivera-Martinez
The use of herbal and dietary supplements for weight loss is becoming increasingly common as obesity is becoming major health problem in the United States. Despite the popularity of these natural supplements, there are no guidelines for their therapeutic doses and their safety is always a concern. Garcinia cambogia extract with its active ingredient "hydroxycitric acid" is a component of many weight loss regimens. It suppresses fatty acid biosynthesis and decreases appetite. However, its prolonged use in weight maintenance is unknown...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29713554/postinfantile-giant-cell-hepatitis-with-features-of-acute-severe-autoimmune-hepatitis-probably-triggered-by-diclofenac-in-a-patient-with-primary-myelofibrosis
#8
Pinelopi Arvaniti, Kalliopi Zachou, George K Koukoulis, George N Dalekos
Giant cell hepatitis (GCH) is commonly reported in neonatal and infantile liver diseases but rarely in adults where the term postinfantile GCH (PIGCH) is used. PIGCH is associated with many diseases, including drugs toxicity, viruses, and autoimmune liver diseases, with autoimmune hepatitis (AIH) being the most prevalent. We present a case of PIGCH in a 76-year-old female without known history of liver disease who suffered from an acute severe episode of hepatitis. After careful exclusion of other hepatitis causes by imaging, virological, immunological, and microbiological investigations, a diagnosis of acute severe AIH (AS-AIH) was established...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29682369/intrahepatic-cholangiocarcinoma-masquerading-as-acute-fatty-liver-of-pregnancy-a-case-report-and-review-of-the-literature
#9
Ayman Qasrawi, Omar Abughanimeh, Mouhanna Abu Ghanimeh, Simran Arora-Elder, Osama Yousef, Tarek Tamimi
Cholangiocarcinoma (CCA) is an uncommon cancer and accounts only for 3% of all gastrointestinal malignancies. In this report, we present a case of an intrahepatic cholangiocarcinoma masquerading as acute fatty liver of pregnancy (AFLP). A 38-year-old female who is 36-week pregnant presented with a 1-week history of headache, nausea, vomiting, and right upper abdominal pain, along with hepatomegaly. Laboratory investigations were remarkable for mild leukocytosis, hyperbilirubinemia, proteinuria, and elevated transaminases and prothrombin time...
2018: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29623226/acute-isolated-hyperbilirubinemia-as-a-presentation-of-alcoholic-liver-disease-a-case-report-and-literature-review
#10
Muhammad Rajib Hossain, Ramesh Kumar Pandey, Mohammad Faridul Islam, Praveen Datar, Vijay Gayam, Pradeep Puri, Thwin Malar
Isolated hyperbilirubinemia as a manifestation of alcoholic liver disease without significant liver abnormalities is seen very rarely. We report such a case where a patient with chronic alcoholism presented to the ER with acute jaundice with bilirubin of 24.8 mg/dl, predominantly conjugated in nature along with mild elevation of AST (76 IU/L). There were no other abnormalities of the liver function. The patient underwent extensive laboratory and imaging tests that excluded extrahepatic cholestasis, viral and autoimmune hepatitis, ischemic hepatitis, and so forth...
2018: Case Reports in Hepatology
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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-alpha-1-antitrypsin-deficiency
#17
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
#18
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
#19
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
#20
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
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