Intrahepatic Biliary Cystadenoma With Colonic Adenomatous Polyps in a Patient With Chronic Hepatitis B: A Case Report and Literature Review

Background: Biliary cystadenomas are rare cystic tumors of the bile duct system that are mostly benign but also have the possibility of malignant transformation. Biliary cystadenomas mostly occur in the intrahepatic bile ducts and are more common in middle-aged women. Due to non-specific radiology, preoperative diagnosis is difficult and is usually performed by postoperative pathology. Complete resection is the best treatment option, and the postoperative prognosis is good.Case Description: This study reports a case of a patient with biliary cystadenoma who was diagnosed with simultaneous chronic hepatitis B and colon (hepatic flexure) adenomatous polyps. The patient presented to the doctor because of abdominal pain, and a blood test showed hepatitis B. Computed tomography revealed both right liver and colonic lesions. Colonoscopy revealed polyps, and the postoperative pathological diagnosis was adenomatous polyps. Laparoscopic resection of the right liver tumor was performed, and it was diagnosed as hepatobiliary cystadenoma by postoperative pathological analysis combined with immunohistochemistry.Conclusion: In patients with chronic hepatitis, the shape of biliary cystadenoma may not be very typical, and it is necessary to combine this with immunohistochemistry for diagnosis. When multiple lesions are detected in the painful area, the diagnosis of each lesion and its treatment sequence are worthy of consideration. Under normal circumstances, the prognosis of biliary cystadenoma is good; however, in patients with chronic hepatitis B, more cases need to be observed for verification.

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STUDY OF PREVALENCE AND PATTERN OF HEARING LOSS IN PATIENTS OF HEPATITIS B

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i12.830 ◽

2019 ◽

Vol 3 (12) ◽

Author(s):

Kapildev Mondal ◽

Poulomi Saha

Keyword(s):

Hearing Loss ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Pure Tone ◽

Control Group ◽

Hepatitis B Infection ◽

Cellular Carcinoma ◽

The Right ◽

Hep B

Hepatitis B has been documented to cause various extra hepatic manifestations along with known hepatic complications. It has been reported that hepatitis-B patients are more susceptible to inner ear damage and hearing loss. The aim of this study is to evaluate hearing loss among patients of hepatitis B {all 6 categories Hepatitis B infection: chronic Hepatitis B infection , hepatitis B cirrhosis ,Hepatitis B virus carriers , occult chronic Hepatitis B and Hepatitis B infection with poly arthritis nodosa, hepato cellular carcinoma with hepatitis B}compared with healthy subjects. METHOD: In this case control study 100 Hepatitis B positive patients and 100 age and gender-matched healthy individuals were included over the period of 5 years. All of them were known cases of chronic hepatitis B positive for HBsAg at least for 18 months. All patients were aged 18 to 50 years to exclude presence of presbycusis. After base line investigations, they were subjected for all cases and controls were subjected otoscopic examination and hearing assessment using standard pure tone audiometry. Descriptive statistical analysis has been carried out in this study. RESULT: In patients of Hepatitis B (94 patients,6 patients had of natural death ) pure tone average (mean thresholds 250,500, 1000,2000,4000 &8000 Hz) was 28.4 dB in the right ear and 27.3 dB in the left (hearing loss).In the control group(96 patients,4 patients dropped out), PTA average was 9.9 dB in the right ear and 9.3dB in the left (normal hearing). In both groups, Speech Discrimination score (SDS) was100% in both ears. The percentage of hearing loss in the right and left ear over the total of six frequencies differed significantly in the two groups. Out of 94 patients of control group, 38 patients (40.4%) patients presented with Chronic Liver Disease (CLD), 14 patients (14.8%) patients presented with cirrhosis with Hepatitis B, 6 (6.3%) patients had Poly arthritis Nodosa with Hep-B, 18(19.1%) patients were diagnosed as carrier of Hepatitis-B , 11(11.7%) patients had occult Hepatitis-B and 7(7.4%) patients were diagnosed with hepato cellular carcinoma. Hearing loss was maximum in patients of PAN with Hep-B. Second highest mean SNHL was seen in patients of Hep-B with cirrhosis .Third highest mean hearing loss was noted in patients with HCC .Forth highest mean hearing loss was noted in patients with occult Hep-B. Fifth highest mean hearing loss was noted in carriers of Hep-B.Lowest group with SNHL was chronic liver disease. CONCLUSION: Regular audiometric tests are recommended for patients with HBV infection to assess their hearing ability and enable the earlier detection of SNHL. We also suggest that HBV presenting with the sudden onset of hearing loss should be examined for the possibility of acute exacerbation of chronic HBV infection. KEYWORDS: Mean, Sensorineural, Hearing loss, Cirrhosis.

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Chronic hepatitis b associated without/with a delta agent in Kyrgyzstan (epidemiological situation, clinical features)

Russian Journal of Infection and Immunity ◽

10.15789/2220-7619-2019-3-4-577-582 ◽

2019 ◽

Vol 9 (3-4) ◽

pp. 577-582

Author(s):

K. A. Nogoibaeva ◽

S. T. Tobokalova ◽

D. S. Bekenova ◽

J. N Nazarbaeva

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Epidemiological Surveillance ◽

Kyrgyz Republic ◽

Case Definitions ◽

Hbsag Detection ◽

Significant Difference ◽

Microsoft Office ◽

The Right

Objective. To compare epidemiological, clinical and laboratory characteristics of chronic hepatitis B (ChHB) associated with/without delta agent (ChHB+DV) study.Materials and methods. The Kyrgyzstan State Reporting Form No. 12 covering 2010–2017 period was examined. For this, 133 and 130 case histories of ChHB and ChHB+DV patients, respectively, were analyzed. The data were statiastically processed by using Microsoft Office Excel software.Results and discussion. Over the 2010–2017 period, prevalence of the “HBV Carrier” (60.4 ) was higher by 20-fold than that one for ChHB [3.8 , 95% CI (2.4–4.0)] and CVHD [3.4 , 95% CI (2.2–3.4)], as the vast majority of patients were not thoroughly examined after detecting HBsAg, and the HBV Carrier was empirically diagnosed at the primary health care units. As a result, routine case definitions for such conditions were revised and an improved system of epidemiological surveillance of viral hepatitis was developed, according to the 2016 WHO recommendations approved by the Ministry of Health of the Kyrgyz Republic (Order No. 524, dated of July 20, 2018). Asthenia was observed in ~60% of patients in both groups, whereas arthralgia — in ~5–10% of patients, more often in those comorbid with ChHB+DV, and myalgia — in as low as ~3% of cases. Impaired central nervous system functions manifested as headache and restless sleep were evenly recorded in about 10–15% of patients, without significant difference between groups. In contrast, dominating dyspeptic manifestations such as poor appetite (72±3.9% vs. 20.6±3.5%, p < 0,05), nausea (23.8±3.7% vs. 7.3±2.3%, p < 0,05), vomiting (12.3±2.6% vs. 3.3±1.5%, p < 0,05) and flatulence (27±3.9% and 13±2.9%, p < 0,05) were revealed in ChHB+DV patients. Pain in the right hypochondrium was noted in 52–56% of patients, insignificantly differed between patient groups. Incidence of yellowness of the sclera and skin layers as well as skin itching were recorded by 2–3 and 8 times, respectively, more frequently in ChHB+DV patients. A more profound cytolysis and signs of altered bilirubin metabolism were also more common in HBV patients comorbid with the delta agent. Thus, a more severe ChHB+DV course requires that all patients with primary HBsAg detection were mandatorily examined for anti-HDV antibodies to ensure early diagnostics and timely organization of the secondary and tertiary preventive measures in the Kyrgyzstan.

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Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

Scientific Programming ◽

10.1155/2021/8393697 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Zhexia Zhao ◽

Xiaoyan Chen ◽

Yanxia Zhang ◽

Qian Song ◽

Jiping Xue ◽

...

Keyword(s):

Chronic Hepatitis ◽

Elastic Modulus ◽

Liver Fibrosis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Shear Wave Elastography ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Chronic Hbv ◽

The Right

To investigate the effectiveness of shear-wave elastography (SWE) based on e-health in diagnosing liver fibrosis in patients infected with hepatitis B virus (HBV) and provide theoretical basis for early diagnosis and treatment of patients with chronic HBV infection, in this study, 73 patients with chronic HBV infection who underwent e-health SWE examination were divided into chronic hepatitis B group (51 cases) and hepatitis B cirrhosis group (22 cases), and another 20 healthy volunteers were introduced as control. The contents of second liver two half-and-half, hyaluronic acid (HA) of liver fibrosis, laminin (LN), pAUVollagen III N terminal peptide (PIII NP), collage type IV (CIV), and HBV-DNA were detected. SWE was used to measure the elastic modulus in the S2 and S3 segments of the left outer lobe of the liver, S4 segment of the left inner lobe of the liver, S5 and S8 segments of the right anterior lobe of the liver, and S6 and S7 segments of the right posterior lobe of the liver. Finally, the correlations between the four examination results of liver fibrosis and the elastic modulus values were compared, and the receiver operator characteristic curve (ROC) for SWE technical diagnosis was drawn. The results showed that there was no significant difference in HBV-DNA content between the two groups ( P > 0.05 ); the contents of alanine transaminase (ALT) and aspartate aminotransferase (AST) in the blood of chronic hepatitis B group were significantly higher than those in the liver cirrhosis group ( P < 0.05 ); HA, PIII NP, and CIV contents were significantly lower than the liver cirrhosis group ( P < 0.05 ); the success rates of SWE detection in S5 and S6 segments of the two groups were 100.00%, and the elastic modulus of the hepatitis B cirrhosis group was significantly higher than that of the chronic hepatitis B group ( P < 0.05 ); correlation results showed HA, PIII NP, and CIV of two groups of patients and elastic modulus value in S5 and S6 segments showed positive correlation ( P < 0.05 ); ROC curve analysis showed that AUC (area under the curve) was 0.866, the sensitivity was 89.59%, and the specificity was 76.49%, which indicated that the liver elastic modulus value measured by e-health SWE technology can quantitatively show liver fibrosis in patients with chronic HBV infection, and its application in the diagnosis of clinical liver fibrosis was real and feasible.

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