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Autoimmune hepatitis Histopathologic and clinical diagnosis

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https://www.readbyqxmd.com/read/29782306/urticarial-lesions-in-a-pregnant-woman
#1
Sergio Santos-Alarcón, Cesar Benavente-Villegas, Isabel García-Briz, Magdalena Moneva-Léniz, Celia Sanchis-Sánchez, Almudena Mateu-Puchades
Dear Editor, Gestational pemphigoid (GP) is a rare autoimmune bullous dermatosis in pregnancy. GP usually occurs during the second or third month of pregnancy. It clinically manifests as the development of either early-onset urticarial lesions or late-onset subepidermal blisters that may linger for weeks or even months. Herein we report the case of a 45-year-old woman with the distinctive clinical onset of GP. A forty-five-year-old woman, gravida I, para 0, at 27 weeks gestation, was referred for evaluation to our Department with an extensive pruritic eruption that had developed over the previous 7 days...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29743801/acute-exacerbation-to-autoimmune-hepatitis-mimicking-acute-viral-hepatitis-a-case-series-and-review-of-literature
#2
Sunil Taneja, Pramod Kumar, Suvradeep Mitra, Ajay Duseja, Ranjana Minz, Ashim Das, Radha K Dhiman, Yogesh Chawla
Background: Acute exacerbation of Autoimmune Hepatitis (AIH) poses a significant challenge for diagnosis as it can mimic acute viral hepatitis especially in absence of autoantibodies and hypergammaglobulinemia. Aim: To determine the clinical, laboratory, histopathological characteristics and response to treatment in AIH patients with acute exacerbation. Methods: A retrospective analysis of 16 patients with acute exacerbation of AIH diagnosed over a period of eight years (2008-2016)...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29697415/an-update-on-the-clinicopathologic-features-and-pathologic-diagnosis-of-hepatitis-e-in-liver-specimens
#3
Daniela Lenggenhager, Achim Weber
Infection with the hepatitis E virus (HEV) is globally seen a leading cause of hepatitis. Now increasingly recognized also in industrialized countries, hepatitis E constitutes a significant health problem worldwide. The patient's immune status determines the clinical course and histopathology of hepatitis E. In immunocompetent patients, hepatitis E usually follows an asymptomatic or subclinical course, but may also present with acute hepatitis. In contrast, immunocompromised patients may develop chronic hepatitis, and patients with preexisting liver diseases are at risk for liver decompensation with potentially fatal outcome...
April 24, 2018: Advances in Anatomic Pathology
https://www.readbyqxmd.com/read/29446799/autoimmune-hepatitis-in-children
#4
Saumya Pathak, Deepak Kamat
Autoimmune hepatitis (AIH) is an immune-mediated, inflammatory liver disease. Clinical presentation of AIH in children is highly variable. It can present acutely, chronically, or silently. There are two main types of AIH-type 1 and type 2, which are differentiated and defined by the presence of specific autoantibodies. AIH eventually progresses to cirrhosis when left untreated, and occasionally even with treatment. AIH must be suspected and excluded in all children presenting with signs of acute, prolonged, or severe liver disease...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29188475/current-perspectives-on-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#5
REVIEW
Marianne Lerch, Carlo Mainetti, Benedetta Terziroli Beretta-Piccoli, Thomas Harr
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a delayed-type hypersensitivity reaction to drugs. They represent true medical emergencies and an early recognition and appropriate management is decisive for the survival. SJS/TEN manifest with an "influenza-like" prodromal phase (malaise, fever), followed by painful cutaneous and mucous membrane (ocular, oral, and genital) lesions, and other systemic symptoms. The difference between SJS, SJS/TEN overlap, and TEN is defined by the degree of skin detachment: SJS is defined as skin involvement of < 10%, TEN is defined as skin involvement of > 30%, and SJS/TEN overlap as 10-30% skin involvement...
February 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29108197/-advances-in-clinical-differentiation-between-immunological-and-drug-induced-liver-injury
#6
Y Wang, Y N Li, J Zhang, B M Wang, L Zhou
The differentiation between autoimmune hepatitis (AIH) and drug-induced liver injury (DILI) is a difficult task in clinical practice. Some AIH patients had a medication history before disease onset, and some DILI patients may have positive serum antibody. In addition, these two groups of patients have similar clinical symptoms, serological examination results, and liver histopathology, which lead to the difficulties in differentiation. However, correct differential diagnosis is of great significance in making clinical treatment decisions and preventing liver cirrhosis...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29040982/clinicopathological-study-of-autoimmune-hepatitis-cases-that-were-difficult-to-differentiate-from-drug-induced-liver-injury
#7
Akemi Tsutsui, Kenichi Harada, Koichi Tsuneyama, Tomonori Senoh, Takuya Nagano, Koichi Takaguchi, Midori Ando, Satoko Nakamura, Koichi Mizobuchi, Masatoshi Kudo
AIM: Acute-onset autoimmune hepatitis (AIH) histopathologically presents with features of acute hepatitis and lacks a specific diagnostic method. Also, AIH is often difficult to differentiate from drug-induced liver injury (DILI). We aimed to investigate the final clinical diagnosis of these cases, and compare the clinical, biochemical, and histological characteristics of AIH vs. DILI. METHODS: We examined the Digestive Disease Week Japan 2004 (DDW-J) scale scores, AIH scores, clinical data, and pathological findings in 20 patients in whom it was difficult to differentiate autoimmune liver disease from DILI...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/29035910/new-predictive-factors-of-poor-response-to-therapy-in-autoimmune-hepatitis-role-of-mean-platelet-volume
#8
Ahmed Abdel-Razik, Nasser Mousa, Sahar Zakaria, Rania Elhelaly, Rasha Elzehery, Khaled Zalata, Mahmoud Awad, Ahmed A Eldeeb, Mostafa Abdelsalam
BACKGROUND AND OBJECTIVES: The response to immunosuppressive therapy in autoimmune hepatitis (AIH) is a matter of debate. The aim of this work is to identify the histological, biochemical, and clinical predictive factors of incomplete response/treatment failure to the standard treatment (prednisone with or without azathioprine) in a well-characterized series of AIH Egyptian patients. PATIENTS AND METHODS: Of 49 AIH patients, only 36 patients completed this retrospective cohort study...
October 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28794251/clinicopathologic-features-of-myositis-patients-with-cd8-mhc-1-complex-pathology
#9
Chiseko Ikenaga, Akatsuki Kubota, Masato Kadoya, Kenichiro Taira, Naohiro Uchio, Ayumi Hida, Meiko Hashimoto Maeda, Yu Nagashima, Hiroyuki Ishiura, Kenichi Kaida, Jun Goto, Shoji Tsuji, Jun Shimizu
OBJECTIVE: To determine the clinical features of myositis patients with the histopathologic finding of CD8-positive T cells invading non-necrotic muscle fibers expressing major histocompatibility complex class 1 (CD8-MHC-1 complex), which is shared by polymyositis (PM) and inclusion body myositis (IBM), in relation to the p62 immunostaining pattern of muscle fibers. METHODS: All 93 myositis patients with CD8-MHC-1 complex who were referred to our hospital from 1993 to 2015 were classified on the basis of the European Neuromuscular Center (ENMC) diagnostic criteria for IBM (Rose, 2013) or PM (Hoogendijk, 2004) and analyzed...
September 5, 2017: Neurology
https://www.readbyqxmd.com/read/28523968/gastrointestinal-system-involvement-in-systemic-lupus-erythematosus
#10
Z Li, D Xu, Z Wang, Y Wang, S Zhang, M Li, X Zeng
Systemic lupus erythematosus (SLE) is a multisystem disorder which can affect the gastrointestinal (GI) system. Although GI symptoms can manifest in 50% of patients with SLE, these have barely been reviewed due to difficulty in identifying different causes. This study aims to clarify clinical characteristics, diagnosis and treatment of the four major SLE-related GI system complications: protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), hepatic involvement and pancreatitis. It is a systematic review using MEDLINE and EMBASE databases and the major search terms were SLE, PLE, IPO, hepatitis and pancreatitis...
October 2017: Lupus
https://www.readbyqxmd.com/read/28457528/disease-associations-with-isolated-elevations-of-each-of-the-four-igg-subclasses
#11
Sarah Engelhart, Robert J Glynn, Peter H Schur
PURPOSE: Immunoglobulin G4-related disease (IgG4-RD) is a relatively newly defined disease entity that refers to a group of immune-mediated disorders that have certain histopathologic, serologic, and clinical features in common. IgG4-RD is often associated with elevated serum IgG4. The discovery of IgG4-RD highlights the scarcity of literature examining elevations in other IgG subclasses and their potential associations to disease. In this retrospective chart review study, we aim to address that gap, by exploring disease associations in patients with isolated IgG subclass elevations...
October 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27957241/recent-advances-in-the-diagnosis-and-treatment-of-primary-biliary-cholangitis
#12
REVIEW
Ying-Qiu Huang
Primary biliary cholangitis (PBC), formerly referred to as primary biliary cirrhosis, is an infrequent progressive intrahepatic cholestatic autoimmune illness that can evolve into hepatic fibrosis, hepatic cirrhosis, hepatic failure, and, in some cases, hepatocellular carcinoma. The disease itself is characterized by T-lymphocyte-mediated chronic non-suppurative destructive cholangitis and elevated serum levels of extremely specific anti-mitochondrial autoantibodies (AMAs). In this article, we will not only review epidemiology, risk factors, natural history, predictive scores, radiologic approaches (e...
November 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/26824512/-biliary-diseases-with-pancreatic-counterparts-cross-sectional-imaging-findings
#13
REVIEW
Venkata S Katabathina, Erin M Flaherty, Anil K Dasyam, Christine O Menias, Nicole D Riddle, Narayan Lath, Kazuto Kozaka, Osamu Matsui, Yasuni Nakanuma, Srinivasa R Prasad
On the basis of the similarities in the histopathologic findings and the clinical-biologic behaviors of select biliary and pancreatic conditions, a new disease concept, "biliary diseases with pancreatic counterparts," has been proposed. Both nonneoplastic and neoplastic pathologic conditions of the biliary tract have their counterparts in the pancreas. Immunoglobulin G4 (IgG4)-related sclerosing cholangitis is the biliary manifestation of IgG4-related sclerosing disease, and type 1 autoimmune pancreatitis is its pancreatic counterpart...
March 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/26642062/role-of-histopathology-in-autoimmune-hepatitis
#14
REVIEW
Dina G Tiniakos, John G Brain, Yvonne A Bury
The diagnosis of autoimmune hepatitis (AIH) is based on a combination of biochemical, immunological and histological features and exclusion of other causes of liver disease. Typical histological features include a chronic hepatitis pattern of injury with portal inflammation and interface activity, predominance of plasma cells in the portal infiltrate, emperipolesis, and hepatocellular rosette formation. Centrilobular injury with prominent hepatocellular necrosis and mononuclear inflammation is now recognised in the histological spectrum of AIH and may represent an early stage of the disease...
2015: Digestive Diseases
https://www.readbyqxmd.com/read/26585107/-recurrence-of-primary-diseases-after-liver-transplantation
#15
Víta Žampachová, Eva Honsová
A majority of primary diseases for which orthotopic liver transplantation is carried out may recur in the liver allograft, mostly in adults. As the indication criteria, transplantation surgery and post-transplantation care improve, the patients survival lengthens as well, leading to concurrently increasing incidence as well as an increase in the relevance of recurrent diseases, which are the most significant cause of late liver graft dysfunction. The frequency, clinical consequences and therapeutic options of different disease recurrence vary considerably...
2015: Ceskoslovenská Patologie
https://www.readbyqxmd.com/read/26515574/immune-mediated-necrotizing-myopathy-update-on-diagnosis-and-management
#16
REVIEW
Pari Basharat, Lisa Christopher-Stine
The idiopathic inflammatory myopathies (IIMs) comprise a group of autoimmune disorders that target skeletal muscle. They are characterized by typical laboratory and clinical features including muscle weakness, elevated muscle enzymes, characteristic histopathology of muscle biopsies, as well as electromyography abnormalities. The IIMs are divided into polymyositis, dermatomyositis, inclusion body myositis, nonspecific myositis, and immune-mediated necrotizing myopathy (IMNM). IMNM is distinguished by the absence of primary inflammation on muscle biopsy...
December 2015: Current Rheumatology Reports
https://www.readbyqxmd.com/read/26393179/chronic-liver-diseases-in-children-clinical-profile-and-histology
#17
Sachin Devidas Dhole, Archana S Kher, Radha G Ghildiyal, Manjusha P Tambse
AIM: The main aim of the study is to study the clinical profile of disorders of the liver and hepatobiliary system in paediatric patients and to correlate the histopathology findings of liver biopsy in chronic liver disease. Another aim being to assess the prognosis and to know the outcome and the effects of treatment in chronic liver diseases in paediatric age group. MATERIALS AND METHODS: It was a prospective study, included the clinical profile of Chronic Liver Diseases (CLD) in children and the histopathological correlation...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26228830/superficial-morphea-of-the-lips-and-gingiva
#18
LETTER
Vanja Vučićević Boras, Dora Gabrić, Vlaho Brailo, Nada Čikeš, Danko Velimir Vrdoljak
No abstract text is available yet for this article.
2015: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/26063488/fibrillary-glomerulonephritis-an-apparent-familial-form
#19
Tracey Ying, Prue Hill, Michael Desmond, John Agar, Andrew Mallett
Fibrillary glomerulonephritis is a rare cause of glomerulonephritis characterized by non-amyloid fibrillary deposits of unknown aetiology. It is generally considered idiopathic but may be associated with secondary causes such as monoclonal gammopathy, hepatitis B and C infections, autoimmune diseases and malignancies. We report two Australian families with apparent familial fibrillary glomerulonephritis inherited in an autosomal dominant pattern, and postulate the existence of a primary familial entity. Family 1 consists of an affected father and daughter; the daughter progressed to end-stage renal failure within 18 months of diagnosis, despite immunosuppressive therapy...
July 2015: Nephrology
https://www.readbyqxmd.com/read/25926402/clinical-and-histological-features-of-idiosyncratic-liver-injury-dilemma-in-diagnosis-of-autoimmune-hepatitis
#20
Ufuk Bariş Kuzu, Erkin Öztaş, Nesrin Turhan, Fatih Saygili, Nuretdin Suna, Hakan Yildiz, Mustafa Kaplan, Muhammet Yener Akpinar, Meral Akdoğan, Sabite Kaçar, Zeki Mesut Yalin Kiliç, Aydin Şeref Köksal, Bülent Ödemiş, Ertuğrul Kayaçetin
AIM: Drug-induced liver injury (DILI) is becoming a worldwide problem with its still unexplained properties. METHODS: The data of patients who were diagnosed with DILI between January 2008 and December 2013 were assessed. RESULTS: Five patients had been diagnosed with intrinsic and 82 patients with idiosyncratic DILI. The most common causative agents were antimicrobial drugs. The most common injury pattern was hepatocellular. When patients with bilirubin levels of more than 5 mg/dL were divided into two groups according to receiving steroid therapy (n = 11) or not (n = 40), there was not any significant difference according to their clinical results (P > 0...
April 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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