Determination of steroid response by abdominal ultrasound in cases with autoimmune pancreatitis

The determination of aminotranferases levels is very useful in the diagnosis of hepatopathies. In recent years, an elevated serum ALT level in blood donors has been associated with an increased risk of post-transfusion hepatitis (PTH). The purpose of the study was to research the factors associated with elevated ALT levels in a cohort of voluntary blood donors and to evaluate the relationship between increased ALT levels and the development of hepatitis C (HCV) infection. 166 volunteer blood donors with elevated ALT at the time of their first donation were studied. All of the donors were questioned about previous hepatopathies, exposure to hepatitis, exposure to chemicals, use of medication or drugs, sexual behaviour, contact with blood or secretions and their intake of alcohol. Every three months, the serum levels of AST, ALT, alkaline phosphatase, gamma glutamyl transpeptidase, cholesterol, triglyceride and glycemia are assessed over a two year follow-up. The serum thyroid hormone levels as well as the presence of auto-antibodies were also measured. Abdominal ultrasound was performed in all patients with persistently elevated ALT or AST levels. A needle biopsy of liver was performed in 9 donors without definite diagnostic after medical investigation. The presence of anti-HCV antibodies in 116 donors were assayed again the first clinical evaluation. At the end of follow-up period (2 years later) 71 donors were tested again for the presence of anti-HCV antibodies. None of donors resulted positive for hepatitis B or hepatitis C markers during the follow-up. Of the 116 donors, 101 (87%) had persistently elevated ALT serum levels during the follow-up. Obesity and alcoholism were the principal conditions related to elevated ALT serum levels in 91/101 (90.1%) donors. Hypertriglyceridemia, hypercholesterolemia, hypothyroidism and diabetes mellitus also were associated with increased ALT levels. Only 1/101 (0.9%) had mild chronic active non A-G viral hepatitis and 3/101 (2.9%) had liver biopsy with non-specific reactive hepatitis. The determination of ALT levels was not useful to detect donors infected with HCV at donation in Brazil, including the initial seronegative anti-HCV phase.

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CORRELATION BETWEEN PLATELET COUNT AND BOTH LIVER FIBROSIS AND SPLEEN DIAMETER IN PATIENTS WITH SCHISTOSOMIASIS MANSONI

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000100008 ◽

2014 ◽

Vol 51 (1) ◽

pp. 34-38 ◽

Cited By ~ 4

Author(s):

Tibério B MEDEIROS ◽

Ana Lucia C DOMINGUES ◽

Carlos F LUNA ◽

Edmundo P LOPES

Keyword(s):

Platelet Count ◽

Abdominal Ultrasound ◽

Chronic Viral Hepatitis ◽

Spleen Size ◽

Periportal Fibrosis ◽

Schistosomiasis Mansoni ◽

The Mean ◽

Automated Cell Counter ◽

Cell Counter

Context Studies have described the correlation between platelet count and the stages of fibrosis in chronic viral hepatitis, but few publications have studied this correlation in Schistosomiasis mansoni. Objectives Therefore, this study aimed to correlate platelet count with both the periportal fibrosis pattern and spleen diameter evaluated by ultrasound exam in patients with Schistosomiasis mansoni. Methods Patients with Schistosomiasis mansoni were evaluated by abdominal ultrasound by a single examiner for the determination of periportal fibrosis pattern (Niamey classification) and spleen diameter. Platelet counts were performed in an automated cell counter. Results One hundred eighty-seven patients with Schistosomiasis mansoni (mean age: 50.2 years) were included in the study, 114 of whom (61%) were women. Based on the Niamey classification, the ultrasound analysis revealed that 37, 64, 64 and 22 patients exhibited patterns C, D, E and F, respectively. In these four groups, the mean number of platelets was 264, 196, 127 and 103 x 109/L and mean spleen diameter was 9.2, 11.9, 14.9 and 16.2 centimeters, respectively. A reduction in platelet count was significantly associated with both the progression of the periportal fibrosis and the increase in spleen size. Conclusions Platelet count in patients with Schistosomiasis mansoni was inversely correlated with the severity of periportal fibrosis and spleen diameter.

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Steroid Therapy and Steroid Response in Autoimmune Pancreatitis

International Journal of Molecular Sciences ◽

10.3390/ijms21010257 ◽

2019 ◽

Vol 21 (1) ◽

pp. 257 ◽

Cited By ~ 2

Author(s):

Hiroyuki Matsubayashi ◽

Hirotoshi Ishiwatari ◽

Kenichiro Imai ◽

Yoshihiro Kishida ◽

Sayo Ito ◽

...

Keyword(s):

Autoimmune Pancreatitis ◽

Critical Role ◽

Steroid Treatment ◽

Clinical Images ◽

Corticosteroid Administration ◽

Steroid Response ◽

Sclerosing Pancreatitis

Autoimmune pancreatitis (AIP), a unique subtype of pancreatitis, is often accompanied by systemic inflammatory disorders. AIP is classified into two distinct subtypes on the basis of the histological subtype: immunoglobulin G4 (IgG4)-related lymphoplasmacytic sclerosing pancreatitis (type 1) and idiopathic duct-centric pancreatitis (type 2). Type 1 AIP is often accompanied by systemic lesions, biliary strictures, hepatic inflammatory pseudotumors, interstitial pneumonia and nephritis, dacryoadenitis, and sialadenitis. Type 2 AIP is associated with inflammatory bowel diseases in approximately 30% of cases. Standard therapy for AIP is oral corticosteroid administration. Steroid treatment is generally indicated for symptomatic cases and is exceptionally applied for cases with diagnostic difficulty (diagnostic steroid trial) after a negative workup for malignancy. More than 90% of patients respond to steroid treatment within 1 month, and most within 2 weeks. The steroid response can be confirmed on clinical images (computed tomography, ultrasonography, endoscopic ultrasonography, magnetic resonance imaging, and 18F-fluorodeoxyglucose-positron emission tomography). Hence, the steroid response is included as an optional diagnostic item of AIP. Steroid treatment results in normalization of serological markers, including IgG4. Short- and long-term corticosteroid treatment may induce adverse events, including chronic glycometabolism, obesity, an immunocompromised status against infection, cataracts, glaucoma, osteoporosis, and myopathy. AIP is common in old age and is often associated with diabetes mellitus (33–78%). Thus, there is an argument for corticosteroid therapy in diabetes patients with no symptoms. With low-dose steroid treatment or treatment withdrawal, there is a high incidence of AIP recurrence (24–52%). Therefore, there is a need for long-term steroid maintenance therapy and/or steroid-sparing agents (immunomodulators and rituximab). Corticosteroids play a critical role in the diagnosis and treatment of AIP.

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Determination of the duration of glucocorticoid therapy in type 1 autoimmune pancreatitis: A systematic review and meta-analysis

Pancreatology ◽

10.1016/j.pan.2021.05.303 ◽

2021 ◽

Author(s):

Seung Bae Yoon ◽

Sung-Hoon Moon ◽

Jong Hyeok Kim ◽

Ji Won Park ◽

Sung Eun Kim ◽

...

Keyword(s):

Systematic Review ◽

Autoimmune Pancreatitis ◽

Meta Analysis ◽

Glucocorticoid Therapy ◽

Type 1 Autoimmune Pancreatitis

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Pancreatic cancer or autoimmune pancreatitis: endosonography as a diagnostic reviser

Orvosi Hetilap ◽

10.1556/oh.2013.29513 ◽

2013 ◽

Vol 154 (2) ◽

pp. 62-68 ◽

Cited By ~ 1

Author(s):

Zoltán Szepes ◽

Mariann Dobra ◽

Csaba Góg ◽

Edit Zábrák ◽

Éva Makula ◽

...

Keyword(s):

Pancreatic Cancer ◽

Health Care Providers ◽

Computer Tomography ◽

Autoimmune Pancreatitis ◽

Imaging Techniques ◽

Tumor Staging ◽

Cost Effective ◽

Abdominal Ultrasound ◽

Care Providers ◽

Increased Risk

Conventional radiologic imaging (abdominal ultrasound, computer tomography) used in the differential diagnosis of post-hepatic jaundice can frequently provide inaccurate diagnosis. Inflammatory lesions may mimic neoplastic processes and malignancy may be accompanied by perifocal inflammation resulting in histological misdiagnosis. Furthermore, chronic and autoimmune pancreatitis are associated with an increased risk for pancreatic cancer. Radial endosonography has become a markedly important method in the imaging of the pancreas. It has a crucial role in the diagnosis and staging of pancreatic cancer. The authors present three cases where the diagnosis of pancreatic cancer determined by conventional imaging techniques (abdominal ultrasound, computer tomography, endoscopic retrograde cholangiopancreatography) was excluded or confirmed by the radial endosonography. The authors conclude that radial endosonography is an essential complementary method among imaging techniques of the pancreas and in tumor staging. Application of that may prevent unnecessary surgeries, which is obviously useful for patients and cost effective for health care providers. Orv. Hetil., 2013, 154, 62–68.

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Galactic orbits of stars

Symposium - International Astronomical Union ◽

10.1017/s0074180900105340 ◽

1966 ◽

Vol 25 ◽

pp. 93-97

Author(s):

Richard Woolley

Keyword(s):

Globular Cluster ◽

Potential Field ◽

High Velocity ◽

Velocity Vector ◽

Variable Stars ◽

The Sun ◽

Proper Motions ◽

Rr Lyrae ◽

The Galaxy

It is now possible to determine proper motions of high-velocity objects in such a way as to obtain with some accuracy the velocity vector relevant to the Sun. If a potential field of the Galaxy is assumed, one can compute an actual orbit. A determination of the velocity of the globular clusterωCentauri has recently been completed at Greenwich, and it is found that the orbit is strongly retrograde in the Galaxy. Similar calculations may be made, though with less certainty, in the case of RR Lyrae variable stars.

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Distance to SN 1987A and the LMC

Symposium - International Astronomical Union ◽

10.1017/s0074180900118959 ◽

1999 ◽

Vol 190 ◽

pp. 549-554

Author(s):

Nino Panagia

Keyword(s):

Angular Size ◽

Large Magellanic Cloud ◽

Magellanic Cloud ◽

Light Curves ◽

Distance Modulus ◽

Absolute Size ◽

Sn 1987A

Using the new reductions of the IUE light curves by Sonneborn et al. (1997) and an extensive set of HST images of SN 1987A we have repeated and improved Panagia et al. (1991) analysis to obtain a better determination of the distance to the supernova. In this way we have derived an absolute size of the ringRabs= (6.23 ± 0.08) x 1017cm and an angular sizeR″ = 808 ± 17 mas, which give a distance to the supernovad(SN1987A) = 51.4 ± 1.2 kpc and a distance modulusm–M(SN1987A) = 18.55 ± 0.05. Allowing for a displacement of SN 1987A position relative to the LMC center, the distance to the barycenter of the Large Magellanic Cloud is also estimated to bed(LMC) = 52.0±1.3 kpc, which corresponds to a distance modulus ofm–M(LMC) = 18.58±0.05.

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International determination of the total motion of the pole

Symposium - International Astronomical Union ◽

10.1017/s0074180900177824 ◽

1961 ◽

Vol 13 ◽

pp. 29-41

Author(s):

Wm. Markowitz

Keyword(s):

Secular Motion ◽

The Future

A symposium on the future of the International Latitude Service (I. L. S.) is to be held in Helsinki in July 1960. My report for the symposium consists of two parts. Part I, denoded (Mk I) was published [1] earlier in 1960 under the title “Latitude and Longitude, and the Secular Motion of the Pole”. Part II is the present paper, denoded (Mk II).

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