Correlation between antroduodenal enterochromaffin cells, plasma serotonin [5-HT] and histopathological findings in patients with hepatosplenic bilharziasis and upper gastrointestinal bleeding

A correlative clinical, endoscopic, histopathological, histochemical and plasma 5-HT level study was done in 25 patients with hepatosplenic billharziasis recovered from upper gastrointestinal bleeding and 10 controls.Significant hyperplasia and hyperactivity of enterochromaffin [EC] cells in the gastroduodenal mucosa was found in all patients associated with significant increase in plasma serotonin [5-HT] level.This detected hyperserotoninaemia can be attributed not only to the defective hepatic degradation but also to over production by hyperplastic and hyperactive EC-cells. Increased plasma 5-HT level may have a double share in the causation of upper gastrointestinal bleeding by elevation of the portal blood pressure and the induction or gastroduodenal erosions found in patients with hepatosplenic bilharziasis

Therapeutic drug-induced liver injury in liver biopsies

35 patients admitted to Mansoura University Hospital with the clinical picture of hepatitis were selected for the present investigation after being asked carefully for history of drug intake and examined clinically. Stool examinations were negative for Bilharzia and other parasites. Serological tests were negative for hepatitis surface antigen. Ture cut needle biopsy for liver was done for all of these patients and stained with various stains. These were one patient with history of halothain intake, 10 with history of intake of oral contraceptive, 2 with history of chlorpromazine and 20 with history of phenyl-butazone and 20 with history of isoniazid. Histologically a spectrum of lesions was recognized as a result of liver injury by these drugs. The produced lesions were categorized as follows: 1-lesion resembling viral hepatitis. 2-Cholestasis with inflammation and liver cell damage. 3-Pure cholestasis. The drugs causing each of these lesions and their differential diagnosis specially from viral hepatitis were discussed

Studies on adriamycin side effects on the renal function and morphology in rats

Adriamycin [ADR] is an antitumor antibiotic, which is widly used in cancer chemotherapy Previous studies revealed cases of heavy proteinuria following single injection of 5 mg/kg ADR. Marked alteration in sodium and potassium contents were seen in cases of cardiomyopathy induced by chronic intoxication with ADR. We are interested to study the relationship between renal sodium and potassium content and proteinuria, in adriamycin treated rats [1mg/kg b.w. twice a week for 4 and 8 weeks], and the renal function and morphology The results showed impaired renal function as revealed by the significant increase in plasma creatinine and decreased urinary creatinine and creatinie clearance in ADR treated rats. ADR treatment also produced significant decrease in plasma proteins and proteinuria. Sodium content of the kidney was not significantly changed while potassium content was significantly decreased in ADR treated rats. These finding are consistant with the pathological examination which show glomerular sclerosis, cloudy swelling of the proximal convoluted tubules, dilated collecting tubules with protein casts and inflammation of the interstitial tissue. These changes are more marked in 8 weeks ADR treated rats. The study advise interrupted courses of ADR in the long treatment periods, with investigation for the kidney function

Primary splenic lymphoma in bilharzial splenomegaly [clinico-pathological study]

Primary splenic lymphoma is an uncommon disease, diagnosed pathologically during examination of the spleens removed in the course of treatment of hepatosplenic bilharziasis. 5cases were reported [2.5%]. All of them were non Hodgkin's lymphoma. 4 cases were in the form of well differentiated lymphocytic follicular lymphoma and one case was well differentiated lymphocytic lymphoma of the diffuse variety