Аутоиммунный гепатит на фоне описторхозной инвазии (клинический случай)

2020 ◽  
pp. 68-73
Keyword(s):  
Differential Diagnosis ◽  
Liver Cirrhosis ◽  
Early Diagnosis ◽  
Autoimmune Diseases ◽  
Disease Progression ◽  
Liver Diseases ◽  
Autoimmune Liver Diseases

The article describes the case of liver cirrhosis of autoimmune origin on the background of opisthorchiasis. The relevancy of the problem is justified by complexity of early diagnosis of autoimmune liver diseases on the background of opisthorchiasis, lack of data on the characteristics of the course of the combined pathology, and probable comorbidity of these diseases. These and many other questions still need to be addressed in future researches. The article shows the difficulty of differential diagnosis of autoimmune diseases of the liver and hepatitis of parasitic etiology, which leads to untimely, inadequate treatment and disease progression.

scholarly journals The risk of liver cancer in autoimmune liver diseases

2019 ◽  
Vol 11 ◽  
pp. 175883591986191 ◽  
Author(s):  
Ana Lleo ◽  
Ynto S. de Boer ◽  
Rodrigo Liberal ◽  
Massimo Colombo
Keyword(s):  
Early Diagnosis ◽  
Liver Diseases ◽  
Close Association ◽  
Fatal Outcome ◽  
Primary Biliary Cholangitis ◽  
Primary Malignancy ◽  
Abdominal Ultrasonography ◽  
Systematic Analysis ◽  
Acid Therapy ◽  
Autoimmune Liver Diseases

Hepatocellular carcinoma (HCC), the dominant primary malignancy of the liver, has almost invariably a fatal outcome that can be averted only by early diagnosis and treatment. While the close association of HCC with chronic viral hepatitis and alcohol abuse has impacted favourably on screening and treatment of this deadly tumour, at the same time it has long obscured the etiologic role of autoimmune liver diseases. Recently, a systematic analysis of 25 published cohorts disclosed a 3.1 × 1000 patients/year incidence of HCC in autoimmune hepatitis patients that tripled in those with cirrhosis. HCC is also a sequela of primary biliary cholangitis, where the incidence is more relevant in males, those with advanced liver disease and nonresponders to ursodeoxycholic acid therapy. Cholangiocarcinoma (CCA), the second ranking primary cancer of the liver, is also on the rise with its intrahepatic pattern, in part reflecting an association with chronic liver diseases of diverse aetiology. In the USA and northern Europe, perihilar CCA is a frequent complication of primary sclerosing cholangitis, a cholestatic disorder thought to be immune mediated. International Guidelines clearly recommend HCC screening with abdominal ultrasonography every 6 months in autoimmune cirrhotic patients. While surveillance of patients with autoimmune liver disorders who are at risk of HCC affects both early diagnosis and radical therapy of this tumour, this is not the case for CCA, where early diagnosis is challenged by the lack of sensitive and accurate tests for screening.

scholarly journals Extrahepatic Autoimmune Diseases in Patients with Autoimmune Liver Diseases: A Phenomenon Neglected by Gastroenterologists

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Liping Guo ◽  
Lu Zhou ◽  
Na Zhang ◽  
Baoru Deng ◽  
Bangmao Wang
Keyword(s):  
Autoimmune Diseases ◽  
Thyroid Disease ◽  
Genetic Background ◽  
Liver Diseases ◽  
Autoimmune Thyroid Disease ◽  
Clinical Impact ◽  
Current View ◽  
Autoimmune Thyroid ◽  
Autoimmune Liver Diseases ◽  
Prompt Diagnosis

Autoimmune liver diseases (AILDs) often coexist with other extrahepatic autoimmune diseases (EHAIDs). The spectrum of EHAIDs in patients with AILDs is similar, whereas the incidence is different. Notably, autoimmune thyroid disease and Sjogren’s syndrome are the most common EHAIDs. Associated extrahepatic diseases may predate the appearance of AILDs or coincide with their onset. More frequently, they may appear during the course and even occur years after the diagnosis of AILDs. Importantly, associated EHAIDs may influence the natural course and prognosis of AILDs. To date, a definite pathophysiological pathway which contributes to the coexistence of AILDs and EHAIDs is still lacking. The current view of autoimmunity clustering involves a common susceptibility genetic background which applies to related pathologies. Herein, we review the current published researches regarding EHAIDs in patients with AILDs, particularly in relation to their clinical impact and pathophysiology. In managing patients with AILDs, gastroenterologists should be aware of the possibly associated EHAIDs to ensure a prompt diagnosis and better outcome.

scholarly journals ALGORITHM OF DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF CHRONIC DIFFUSE LIVER DISEASES (CHRONIC HEPATITIS AND LIVER CIRRHOSIS) IN DIFFICULT CLINICAL SITUATIONS, BASED ON DETERMINATION OF ENZYMATIC ACTIVITIES OF BLOOD SERUM

2020 ◽  
Vol 8 (4) ◽  
pp. 566-573
Author(s):  
H.I. Yupatov ◽  
◽  
V.A. Pryshchepenko ◽  
Keyword(s):  
Differential Diagnosis ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Blood Serum ◽  
Liver Diseases ◽  
Laboratory Research ◽  
Control Group ◽  
Diagnostic Measures ◽  
Diffuse Liver Diseases

Background. The search for non-invasive criteria for differential diagnosis of chronic hepatitis and liver cirrhosis is one of the urgent tasks of hepatology. Aim. Development of an algorithm for the diagnosis and differential diagnosis of chronic diffuse liver diseases (chronic hepatitis and liver cirrhosis) in difficult clinical situations, namely in patients with questionable results of routine laboratory research. Materials and Methods. 55 patients were examined who had a characteristic clinical picture of chronic diffuse liver diseases, however, the levels of AST and ALT were close to normal values. Chronic hepatitis was confirmed in 14 patients (mean age 55.0±11.2 years), liver cirrhosis in 40 patients (mean age 55.0±9.9 years). The control group included 43 practically healthy individuals (mean age – 52.8±4.2 years). All patients underwent determination of the levels of hyaluronidase, elastase, trypsin-like and deoxyribonuclease serum activities, as well as levels of alpha-1-defensin and interleukin-13 in blood serum. Results. An algorithm for the differential diagnosis of chronic hepatitis and cirrhosis of the liver was developed, which makes it possible to identify liver disease with odds ratio of 988.0 [CI95%=31.3-31207.7]. Conclusion. The algorithm allows to optimize diagnostic measures in difficult clinical situations.

Strontium 87m Scanning of Pelvic Bones

1968 ◽  
Vol 07 (01) ◽  
pp. 28-36 ◽  
Author(s):  
Władysław Jasiński ◽  
Janina Malinowska ◽  
Henryk Mackiewicz ◽  
Henryk Siwicki ◽  
Krystyna Lukawska
Keyword(s):  
Body Weight ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Femoral Neck ◽  
Early Period ◽  
Early Recurrence ◽  
Physical Activities ◽  
External Irradiation ◽  
Pelvic Bones ◽  
Strontium 87M

SummaryThe purpose of this investigation was to study the accumulation of 87mSr in the proximal parts of the femoral bones of patients treated previously by external irradiation due to cancer of the uterine cervix. It was assumed that this method may be used in the future for the early diagnosis of postirradiation changes of bone (osteoradionecrosis).The incidence of postirradiation changes of the femoral neck among 5735 patients treated between 1950 and 1961 at the Department of Gynaecology of the Institute, was 0.8%. In the early period of postirradiation changes the patients complain only of pain and limitation of physical activities. If radiological and gynaecological findings were negative, the differential diagnosis between early recurrence and early osteoradionecrosis became impossible.49 selected patients were scanned after intravenous injection of 10—115 μCi of 87mSr per kg of body weight (0.5 up to 6.0 mCi). Illustrative cases of normal pelvic bones as well as postirradiation changes are presented and discussed. The authors conclude that the findings justify further systematic studies on the morphology of accumulation of 87mSr in the bones.

Enhanced immune responses, PI3K/AKT and JAK/STAT signaling pathways following hepatitis C virus eradication by direct-acting antiviral therapy among Egyptian patients: a case control study

2021 ◽  
Author(s):  
Haidi Karam-Allah Ramadan ◽  
Gamal Badr ◽  
Nancy K Ramadan ◽  
Aml Sayed
Keyword(s):  
Immune Response ◽  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Immune Responses ◽  
Signaling Pathways ◽  
Liver Diseases ◽  
Stat Signaling ◽  
Chronic Hcv ◽  
Direct Acting

Abstract The use of direct-acting antivirals (DAAs) therapy for the treatment of hepatitis C virus (HCV) results in a high sustained virological response (SVR) and subsequently alters liver immunologic environment. However, hepatocellular carcinoma (HCC) may occur after DAAs treatment. We aimed to clarify changes of immune responses, PI3K/AKT and JAK/STAT signaling pathways in HCV-induced liver diseases and HCC following DAAs treatment. Four cohorts are classified as chronic HCV patients, HCV-related cirrhosis without HCC, HCV-related cirrhosis and HCC, and healthy control group. The patient groups were further divided into treated or untreated with DAAs with SVR12. Increased percentages of CD3, CD8 and CD4, decreased CD4/FoxP3/CD25, CD8/PD-1 and CD19/PDL-1 were found in DAAs-treated patients in the three HCV groups. Following DAAs therapy, the levels of ROS, IL-1β, IL-6, IL-8 and TNF-α were significantly decreased in the three HCV groups. Treated HCV patients showed up regulation of p-AKT and p-STAT5 and down regulation of p-STAT3, HIF-1α and COX-2. In conclusion, DAAs enhance the immune response in chronic HCV and liver cirrhosis, hence our study is the first to show change in PI3K/AKT and JAK/STAT signaling pathways in different HCV-induced liver diseases after DAAs. In chronic HCV, DAAs have better impact on the immune response while in liver cirrhosis not all immune changes were prominent.

scholarly journals Current Trends and Characteristics of Hepatocellular Carcinoma in Patients with Autoimmune Liver Diseases

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1023
Author(s):  
Eirini I. Rigopoulou ◽  
George N. Dalekos
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Diseases ◽  
Treatment Modalities ◽  
Primary Biliary Cholangitis ◽  
Autoimmune Liver Diseases ◽  
Increased Risk ◽  
Liver Cancers ◽  
Medium Risk ◽  
Causes Of Mortality

Hepatocellular carcinoma (HCC), the commonest among liver cancers, is one of the leading causes of mortality among malignancies worldwide. Several reports demonstrate autoimmune liver diseases (AILDs), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) to confer increased risk of hepatobiliary malignancies, albeit at lower frequencies compared to other liver diseases. Several parameters have been recognized as risk factors for HCC development in AIH and PBC, including demographics such as older age and male sex, clinical features, the most decisive being cirrhosis and other co-existing factors, such as alcohol consumption. Moreover, biochemical activity and treatment response have been increasingly recognized as prognostic factors for HCC development in AIH and PBC. As available treatment modalities are effective only when HCC diagnosis is established early, surveillance has been proven essential for HCC prognosis. Considering that the risk for HCC is not uniform between and within disease groups, refinement of screening strategies according to prevailing demographic, clinical, and molecular risk factors is mandated in AILDs patients, as personalized HCC risk prediction will offer significant advantage in patients at high and/or medium risk. Furthermore, future investigations should draw attention to whether modification of immunosuppression could benefit AIH patients after HCC diagnosis.

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