Granulomatous hepatitis following open heart surgery with cardiopulmonary bypass.
Article
in English
| IMSEAR
| ID: sea-119803
ABSTRACT
BACKGROUND:
Cardiopulmonary bypass (CPB) initiates an inflammatory cascade, predisposing the patient to a number of infections. The stress of surgery and anaesthesia further expose the patient to a variety of non-infectious complications. We report a group of patients who developed granulomatous disease after open heart surgery.METHODS:
We retrospectively analysed a subset of patients who developed a syndrome of fever, jaundice and hepatomegaly after open heart surgery. We recruited age- and sex-matched controls who underwent open heart surgery during the same period (July 2002-July 2004). Details of demographic profiles, diagnostic evaluation and drug treatment were noted and compared between the two groups using the SPSS software.RESULTS:
Five patients were identified to have the specific syndrome of high grade intermittent fever with jaundice and hepatomegaly with investigations revealing an intrahepatic cholestasis. A detailed evaluation revealed granulomas in tissue specimens of the bone marrow and/or liver in these patients. An extensive evaluation for an alternative aetiological agent was non-contributory.CONCLUSION:
We found granulomatous hepatitis in 5 patients following open heart surgery and they were given conventional antituberculous therapy to which they responded. It is possible that in these patients, tuberculosis was re-activated from a dormant focus due to a period of transient immunodeficiency caused by an extracorporeal circulation.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Time Factors
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Female
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Humans
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Male
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Cardiopulmonary Bypass
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Case-Control Studies
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Retrospective Studies
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Adult
/
Fever
/
Granuloma
Type of study:
Observational study
/
Prognostic study
Language:
English
Year:
2008
Type:
Article
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