A Case of Vanishing Bile Duct Syndrome Associated with Hypersensitivity to Allopurinol / 대한간학회지

Allopurinol is frequently used for the treatment of hyperuricemia and gout. Sometimes, a life-threatening reaction develops, as is illustrated by the following case report. We describe a 60-year-old male patient who was treated with allopurinol because of asymptomatic hyperuricemia, and he was presented with fever, skin rash, eosinophilia, worsening renal function and vanishing bile duct syndrome. In this report, we discussed vanishing bile duct syndrome as a serious side effect of allopurinol, and we briefly reviewed the etiology, prevention, and treatment modalities for vanishing bile duct syndrome.

Phase II Study to Topotecan and Cisplatin in Advanced Hepatocellular Carcinoma

BACKGROUND: Hepatocellular carcinoma remains a highly chemoresistant neoplasm and is a common malignancy with poor prognosis in Korea. We performed a phase II study to evaluate the efficacy and toxicities of topotecan and cisplatin combination chemotherapy for advanced hepatocellular carcinoma. METHODS: Between November 1999 and May 2001, ten patients with histologically proven hepatocellular carcinoma were enrolled in this study. The median age was 54 (range: 53~74) years and all were male. Six patients demonstrated stage IV, 1 stage IIIC, 2 stage IIIB and 1 stage IIIA. Six patients showed a ECOG performance status of 1. The treatment regimen consisted of topotecan 1.25 mg/m2 and cisplatin 20 mg/m2 for 5 days. The treatment was repeated every 4 weeks. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All ten patients were evaluable for response and toxicity. There was only one patient who achieved partial response. The overall response rate was 10% (95% C.I.) and the response duration was 46 weeks. The median survival of all patients was 21 (range: 17~54+) weeks. During a total of 24 cycles, neutropenia of WHO grade 3 and 4 occurred in 33%, thrombocytopenia in 33% and anemia in 21%. In non-hematologic toxicity, diarrhea and hepatoxicity of grade 3 occurred in 1 and 2 patients, respectively. But there was no treatment-related death. CONCLUSION: When used in this dose and schedule, topotecan and cisplatin combination chemotherapy does not seem to be effective for patients with advanced hepatocellular carcinoma.

Resolution of Chronic Idiopathic Thrombocytopenic Purpura after Eradication of Helicobacter pylori: A Case Report / 대한혈액학회지

Helicobacter pylori (H. pylori) has been recognized as a main cause of gastritis and most cases of peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. An immunological response to H. pylori infection has been suggested to play a major role in determining gastroduodenal damage through the production of cytokines and the autoantibody against gastric epithelial cell. H. pylori has been implicated in the pathogenesis of some autoimmune disease, such as Sjogren disease, Henoch-Schnlein purpura, rheumatoid arthritis, autoimmune thyroid disease, and idiopathic thrombocytopenic purpura (ITP). Serveral studies recently showed a high prevalence of H. pylori infection in patients with ITP and reported a platelet recovery after bacterial eradication therapy. We report a case of a 54-year-old man with chronic ITP who was resolved after eradication of H. pylori.