Hepatic cirrhosis in Jamaica

The aetiology, biochemistry, clinical features and complications of histologically confirmed hepatic cirrhosis in 45 patients (26 females, 19 males) seen at the University Hospital of the West Indies, Jamaica, between 1984 and 1994 was presented. The age range was 1 to 72 years (mean 48 years). Abdominal swelling and weight loss were the commonest symptoms, occurring in 51 percent and 47 percent of patients, respectively. Jaundice was a presenting feature in 44 percent. Hepatomegaly was present in 71 percent of patients and splenomegaly in 33 percent. The aetiological factors were: alchol (36 percent), bush tea (18 percent), chronic active hepatitis (11 percent), drugs (7 percent), and haemochromatosis (2 percent). Hepatitis B surface antigen was detected in 2 of 20 patients tested. 24 percent of the patients also had diabetes mellitus, 29 percent were anaemic, 29 percent were thrombocytopenic, 4 percent were leukopenic, and the prothrombin time was prolonged in 22 percent. The albumin/globulin ratio was reversed in 71 percent of the patients. The alkaline phosphatase was elevated in 56 percent, the aspartate aminotransferase was increased in 58 percent and the gamma glutamyl transpeptidase in 56 percent. 56 percent of the patients had macronodular cirrhosis; the liver showed a micronodular pattern in 18 percent; 7 percent had biliary cirrhosis; 7 percent chronic active hepatitis with cirrhosis; and 13 percent showed a mixed macro-micronodular pattern. Ascites and fluid overloaded developed in 44 percent of the patients. Hepatic encephalopathy occurred in 18 percent and upper gastrointestinal bleeding in 18 percent.

Pulmonary nocardiosis in a patient with human immunnodeficiency virus disease

Nocardiosis is an uncommon disease which occurs most often in patients with impaired cellular immunity, yet is rarely reported in patients with human immunodeficiency virus disease. We present the first case of Nocardiosis seen at the University Hospital of the West Indies, occurring in a well-controlled diabetic with human immunodeficiency virus disease.

Eosinophilic meningitis: is angiostrongylus cantonensis endemic in Jamaica?

A case of eosinophilic meningitis presenting as pseudotumour cerebri is described, along with evidence to suggest that the causative agent was angiostrongylus cantonensis.

Multicentric angiofollicular lymph node hyperplasia in ulcerative colitis: a case report

Multicentric angiofollicular lymph node hyperplasia (MAFH) is a rare disorder which has been associated with various disease entities. This is the first report of its association with ulcerative colitis. details of lymph node histology and views on pathogenesis

Asymptomatic cardiac involvement in systemic lupus erythematosus

Cardiologic and laboratory parameters were studied in 21 patients with systemic lupus erythematosus (SLE) with cadiopulmonary symptoms (CPS), 20 SLE patients without CPS and 45 age-and sex- matched healthy controls. The most frequent cardiac abnormalities in patients with CPS included pericardial effusion (24 per cent), ventricular enlargement (20 per cent), mitral regurgitation (19 per cent) and tricuspid regurgitation (14 per cent). No structural abnormalities were observed in SLE patients without CPS. Mean calculated and derived echocardiacgraphic values in both groups of SLE patients differed significantly from those observed in normal controls (p< 0.004). Patients with CPS had significantly lower mean values of ejection fraction (p< 0.05) and fractional shortening (p< 0.03). However, the frequencies of functional abnormalities in patients with CPS did not differ significantly from those observed in patients without CPS. There were no remarkable laboratory findings in SLE patients with CPS compared to those without. The finding that some SLE patients may have functional cardiac abnormalities in the absence of CPS is an important one. It raises the question as to whether asymptomatic cardiac involvement in SLE is a separate entity or whether it heralds symptomatic cardiopulmonary involvement