ABSTRACT
BACKGROUND/AIMS: In several studies markers of hepatitis C virus infection have been shown to be present in alcoholic patients with cirrhosis. Our work was designed to test the likely hypothesis that this association is due to an interaction between hepatitis C virus and alcohol in the pathogenesis of cirrhosis. METHODS: We compared alcohol consumption and repartition of anti-HCV antibodies detected by an immunoblot recombinant assay in 101 male patients with cirrhosis and in 120 male controls. Interactions between anti-hepatitis C virus, alcohol and cirrhosis were calculated using log linear hierarchical models for frequency data. The basis of the method is that an interaction between hepatitis C virus and alcohol implies that a model built on the hypothesis of a role of hepatitis C virus and alcohol in the disease should be improved by a coefficient associated with multiplicative effects of hepatitis C virus and alcohol. RESULTS: In patients with cirrhosis the mean alcohol consumption (148 +/- 100 g per day) and the incidence of positivity for anti-HCV antibodies (45%) were significantly higher than in controls. The results were consistent with a theoretical model built with the hypothesis of an independent role of both alcohol and hepatitis C virus. The goodness of fit between this model and the actual distribution of alcohol consumption and hepatitis C virus markers was not improved by introduction of an interaction between hepatitis C virus and alcohol. CONCLUSIONS: In alcoholic subjects with hepatitis C virus infection, the probability to have cirrhosis seemed to be explained by additive effects of alcohol and hepatitis C virus. From a purely statistical point of view, no interaction between hepatitis C virus and alcohol consumption on a multiplicative scale could be demonstrated.
Subject(s)
Alcohol Drinking , Hepacivirus/isolation & purification , Liver Cirrhosis/etiology , Probability , Aged , Case-Control Studies , Factor Analysis, Statistical , Humans , Liver Cirrhosis/virology , Male , Middle Aged , Risk AssessmentSubject(s)
Common Bile Duct Diseases/complications , Gallbladder Diseases/complications , Gallbladder/abnormalities , Aged , Cholangiography , Cholecystography , Common Bile Duct Diseases/diagnostic imaging , Common Bile Duct Diseases/surgery , Dilatation, Pathologic , Endoscopy, Digestive System , Gallbladder/pathology , Gallbladder/surgery , Gallbladder Diseases/diagnostic imaging , Gallbladder Diseases/pathology , Gallbladder Diseases/surgery , Humans , MaleABSTRACT
Watermelon stomach is a rare disorder causing gastric blood loss and iron deficiency anemia. We report a case that occurred during the course of post-hepatitis C cirrhosis, which condition was dramatically improved by alpha-interferon treatment.
Subject(s)
Hepatitis C/therapy , Interferon-alpha/therapeutic use , Stomach Diseases/pathology , Aged , Female , Hepatitis C/complications , Humans , Stomach Diseases/complicationsABSTRACT
We describe a case in which a transjugular intrahepatic portosystemic shunt (TIPS) was inserted to enable palliative treatment of an adenocarcinoma of the esophagus. The cirrhotic patient presented with esophageal varices in contact with a tumor of the esophagus. By relieving portal pressure, TIPS reduced the risk of hemorrhage during laser resection and prevented recurrence of esophageal varices.
Subject(s)
Adenocarcinoma/surgery , Esophageal Neoplasms/surgery , Palliative Care , Portal Vein , Stents , Blood Loss, Surgical/prevention & control , Esophageal and Gastric Varices/diagnostic imaging , Esophageal and Gastric Varices/pathology , Esophageal and Gastric Varices/therapy , Esophagoscopy , Hepatic Veins , Humans , Male , Middle Aged , Portal Vein/diagnostic imaging , RadiographyABSTRACT
In this study, the authors report two observations of granulomatous hepatitis. The secondary appearance of a mononucleosis syndrome, three weeks after the onset of fever, in healthy adults, evoked the diagnosis of a cytomegalovirus infection. The authors insist on the histologic and virologic differences of the CMV infection between the healthy adults and the immunodepressed patients. They also note the difficulties of the diagnosis of the CMV infection in healthy adults.
Subject(s)
Cytomegalovirus Infections/complications , Granuloma/etiology , Infectious Mononucleosis/etiology , Liver Diseases/etiology , Adult , Aged , Cytomegalovirus Infections/diagnosis , Female , Health Occupations , Humans , Immunologic Deficiency Syndromes/complications , Male , Occupational Exposure , SyndromeABSTRACT
A 17 year-old man with a one-year history of Crohn's disease presented with superior sagittal sinus thrombosis in spite of an apparent remission of the inflammatory bowel disease. Under treatment, the neurological disorders rapidly improved. Hematological studies showed mild thrombocytosis, spontaneous platelet aggregation, and an increase of the fibrinogen level, plasmatic viscosity and red blood cells aggregability. Mild hypofibrinolysis and antiphospholipid antibodies were also noted. Nine fully documented cases of cerebral venous thrombosis associated with an inflammatory bowel disease are reviewed. The possible prothrombotic role of thrombocytosis and other hematological disorders is discussed.
Subject(s)
Cranial Sinuses , Crohn Disease/complications , Thrombosis/etiology , Adolescent , Blood Coagulation Disorders/complications , Brain/diagnostic imaging , Cerebral Angiography , Humans , Male , Subtraction Technique , Thrombocytosis/complications , Thrombosis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Coexistence of IgA deficiency with sarcoidosis has been reported occasionally. Enteropathy occurs exceptionally in this association. We report the case of a 45 year-old woman experiencing disseminated sarcoidosis which involved mediastinum, chest, lymph nodes, liver, bone marrow, and skin. Immunoglobulin deficiency involving essentially IgA was found 15 years later. Digestive investigations showed gastroduodenal specific localizations associated with lymphoid nodular hyperplasia without villi atrophy.
