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Case Reports in Hepatology

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https://www.readbyqxmd.com/read/28840045/hemoperitoneum-secondary-to-spontaneous-rupture-of-a-retroperitoneal-varix
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27818806/fulminant-hepatic-failure-in-a-patient-with-crohn-s-disease-on-infliximab-possibly-related-to-reactivation-of-herpes-simplex-virus-2-infection
#13
Gary Golds, Lawrence Worobetz
HSV hepatitis is a rare but often fatal cause of liver failure which tends to affect immunocompromised individuals. Early treatment with Acyclovir has been shown to reduce mortality in HSV hepatitis making recognition of the condition critically important. Here, we present a case of HSV hepatitis in a young woman with Crohn's disease on Prednisone, Azathioprine, and Infliximab. We discuss the clinical presentation of HSV hepatitis as well as the possible causes of hepatitis in a patient on these medications...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27818805/hepatocellular-carcinoma-with-prominent-intracytoplasmic-inclusions-a-report-of-two-cases
#14
Adeline R Chelliah, Jasim M Radhi
Hepatocellular carcinoma (HCC) is the commonest primary malignant neoplasm of the liver in most countries with a notoriously poor prognosis. Variation in global incidence is well-recognized and the occurrence of HCC is linked to several established environmental, dietary, and lifestyle factors. HCC demonstrates morphological heterogeneity both within the same tumor and from patient to patient. Differing architectural patterns and cytological variants may be seen. Inclusion bodies are believed to represent organized structures of proteins which contribute to their pathogenesis and share several constituents like chaperones, p62, ubiquitin, and Valosin containing protein...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27812395/progression-of-hepatic-adenoma-to-carcinoma-in-the-setting-of-hepatoportal-sclerosis-in-hiv-patient-case-report-and-review-of-the-literature
#15
M I Montenovo, F G Jalikis, M Yeh, J D Reyes
We report a case of hepatic adenoma progression to carcinoma in the setting of hepatoportal sclerosis in an HIV+ patient and provide a review of the scarce literature regarding hepatoportal sclerosis in HIV patients. We describe the clinical presentation, diagnostic workup, and management. This is the first case report in the literature of progression of hepatic adenoma to carcinoma in hepatoportal sclerosis in an HIV patient. This case also highlights the broad differential diagnosis that should always be included in the study of any liver disease in this patient population, including the performance of invasive and aggressive tests to arrive at the final diagnosis...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27595025/enteroscopic-management-of-ectopic-varices-in-a-patient-with-liver-cirrhosis-and-portal-hypertension
#16
G A Watson, A Abu-Shanab, R L O'Donohoe, M Iqbal
Portal hypertension and liver cirrhosis may predispose patients to varices, which have a propensity to bleed and cause significant morbidity and mortality. These varices are most commonly located in the gastroesophageal area; however, rarely ectopic varices may develop in unusual locations outside of this region. Haemorrhage from these sites can be massive and difficult to control; thus early detection and management may be lifesaving. We present a case of occult gastrointestinal bleeding in a patient with underlying alcoholic liver disease where an ectopic varix was ultimately detected with push enteroscopy...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27579192/tumor-regression-in-hcc-patient-with-portal-vein-tumor-thrombosis-after-intraportal-radiofrequency-thermal-ablation
#17
Malkhaz Mizandari, Tamta Azrumelashvili, Natela Paksashvili, Nino Kikodze, Ia Pantsulaia, Nona Janikashvili, Tinatin Chikovani
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Portal vein tumor thrombosis (PVTT) is a frequent entity in HCC, which strictly limits the gold standard treatment options such as surgical resection and transarterial chemoembolization. Therefore, the prognosis of patients with PVTT is extremely poor and an emergence of seeking an alternative option for intervention is inevitable. We present a case of a 60-year-old male patient with HCC induced PVTT who was subjected to the intraportal RFA and stenting-VesOpen procedure...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27529039/melioidosis-a-rare-cause-of-liver-abscess
#18
Peter Franz M San Martin, Catherine S C Teh, Ma Amornetta J Casupang
Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth of Burkholderia pseudomallei in which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27525135/budd-chiari-syndrome-in-a-patient-with-hepatitis-c
#19
Joseph Frankl, Charles Hennemeyer, Michael S Flores, Archita P Desai
Chronic Budd-Chiari syndrome can present with cirrhosis and signs and symptoms similar to those of other chronic liver diseases. We present a case of Budd-Chiari syndrome discovered during attempted transjugular intrahepatic portosystemic shunting in a patient with decompensated cirrhosis believed to be secondary to hepatitis C. Although the patient had hepatocellular carcinoma, the Budd-Chiari syndrome was a primary disease due to hepatic venous webs. Angioplasty was performed in this case, which resolved the patient's symptoms related to portal hypertension...
2016: Case Reports in Hepatology
https://www.readbyqxmd.com/read/27525134/angiomyolipoma-in-a-patient-with-situs-inversus-totalis-managing-two-rare-diseases
#20
Jonathan Mayes, Nigel Heaton
Hepatic angiomyolipoma is an extremely rare benign hamartomatous lesion. Situs inversus totalis is a genetic condition occurring in 0.01% of the population. Following the kidney, the liver is the second most common site of angiomyolipoma. No consensus on the treatment of hepatic angiomyolipoma has been reached. However, the majority of these tumours are managed conservatively. Situs inversus totalis presents difficulties for procedures and is most commonly an incidental finding. These two conditions have not previously been reported and no genetic link has been established between them...
2016: Case Reports in Hepatology
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