Idiopathic hypereosinophilic syndrome presenting with liver mass: report of two cases

Herein, we report on two cases of hypereosinophilic syndrome presenting as liver mass. One patient was a 22-year-old woman presented with fever, upper abdominal pain, nausea/vomiting and a mass in the right liver lobe. The second patient was a 54-year-old man who presented with nausea and abdominal pain with significant weight loss. He had multiple lesions in both liver lobes. Both patients had eosinophilia that was not attributed to other causes such as allergy or parasites. The patients were treated with glucocorticosteroid and improved clinically. Imaging and laboratory abnormalities resolved

frequency of non-organ-specific autoantibodies in patients with chronic hepatitis C and its relation with disease severity and response to therapy

Increased levels of non-organ-specific autoantibodies are frequently seen in patients suffering from chronic hepatitis C [CHC]; however, the etiology and its effects on the course of the disease and response to therapy are largely undetermined. Particularly, it seems of utmost importance to define whether this increase is solely an insignificant coincidence or a major finding which have an impact on the course of the disease. Materials and methods: Fifty-two patients with CHC [case group] and 52 aged- and sex-matched IBS patients [controls] were enrolled. The sera of all subjects were checked for non-organ-specific autoantibodies, including antinuclear antibody [ANA], anti-smooth muscle antibody [ASMA], anti-mitochondrial antibody [AMA], and anti-liver/kidney microsomal antibody [ALKM]. All cases underwent a liver biopsy and treated with a 12-month course of combination therapy with interferon and ribavirin. The mean age of cases and controls was 32.8 +/- 12.7 and 31.6 +/- 14.1 years, respectively. The overall frequency of non-organ-specific antibodies was significantly higher in anti-HCV positive patients in comparison with controls [36.5% vs 7.7%, p < 0.001]. Seropositivity of ANA and ASMA was significantly higher in patients with CRC than in controls [11.5% vs. 1.9%, p < 0.05 and 13.5% vs. 1.9%, p < 0.027, respectively]. There was no significant relationship between seropositivity of different autoantibodies and patients' age and sex, duration of disease and serum aminotransferases levels. Nor this seropositivity had significant relationship with grade and stage of the liver disease and response to treatment, while serum globulin level was significantly higher in ANA positive patients. Seroprevalence of ANA and ASMA seems to be higher in patients with CHC but its impact on the severity of disease and response to therapy is the subject for further investigations. Keywords: Hepatitis C, Autoantibody, Response to treatment, Aminotransferases

Gastrointestinal complications in two patients with common variable immunodeficiency

Common variable immunodeficiency [CVID] is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections especially in respiratory and gastrointestinal systems. We present here 2 cases of CVID with gastrointestinal complications. Case 1 is a 25-year-old man with a history of chronic diarrhoea from childhood. Ultrasonography revealed ascites, with liver size smaller than normal. Liver biopsy showed non-specific hepatitis. Lymphoid proliferation and Histiocytosis were reported in his ascites cytology. Moreover friability in colonoscopy due to moderate active chronic colitis was detected. Case 2 is a 26-year-old man with chronic diarrhoea since 8 years. Abdominal sonography revealed increased liver echogenicity, increased liver size, and some enlarged lymph nodes beside pancreas. Colonoscopy revealed friability and decreased vascularity while biopsy showed moderate active chronic colitis. Lymph node biopsy showed unusual immunologic reaction. Moreover, small bowel transition test showed nodularity. CVID should be considered in any patient with gastrointestinal manifestations especially chronic diarrhoea in association with recurrent bacterial infections in other organs. Diagnostic delay results in more morbidity and complications in untreated patients