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1.
Dig Liver Dis ; 45(11): 915-9, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23684896

ABSTRACT

BACKGROUND AND AIMS: We evaluated the prevalence of low phospholipid-associated cholelithiasis, a specific form of cholelithiasis associated with at least 2 of the 3 following criteria: first symptoms before the age of 40; intrahepatic comet tail artefacts, sludge or microlithiasis on ultrasound imaging; and recurrence of symptoms after cholecystectomy. METHODS: We prospectively studied the cases of 60 consecutive female patients under 30 with symptomatic cholelithiasis. RESULTS: A diagnosis of low phospholipid-associated cholelithiasis was made in 14/60 patients (23%). The molecular analysis showed ABCB4 (n=4) and ABCB11 (n=4) gene mutations. Low phospholipid-associated cholelithiasis was frequently observed in non-overweight patients [13/27 (48%)], was present in most patients whose biliary symptoms occurred before the age of 18 [7/10 (70%)] and was often associated with cholangitis or acute pancreatitis [9/14 (64%), p<0.05] while "common" cholelithiasis was mainly associated with cholecystitis [16/46 (35%), p<0.05]. CONCLUSION: Nearly one quarter of the female patients under the age of 30 admitted for symptomatic cholelithiasis had low phospholipid-associated cholelithiasis; particularly if body weight was normal, the symptoms began before the age of 18 or in the presence of severe biliary complications.


Subject(s)
Cholelithiasis/epidemiology , Phospholipids/metabolism , ATP Binding Cassette Transporter, Subfamily B/genetics , ATP Binding Cassette Transporter, Subfamily B/metabolism , ATP Binding Cassette Transporter, Subfamily B, Member 11 , ATP-Binding Cassette Transporters/genetics , ATP-Binding Cassette Transporters/metabolism , Adolescent , Adult , Cholelithiasis/diagnosis , Cholelithiasis/metabolism , DNA/genetics , DNA Mutational Analysis , Diagnosis, Differential , Female , Follow-Up Studies , France/epidemiology , Humans , Point Mutation , Prevalence , Prospective Studies , Young Adult
2.
Gastroenterol Clin Biol ; 30(1): 142-6, 2006 Jan.
Article in French | MEDLINE | ID: mdl-16514397

ABSTRACT

The DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) corresponds to a drug reaction generally including cutaneous eruption, fever, hematologic abnormalities such as eosinophilia and atypical lymphocytosis and one or more specific visceral lesions specially in the liver. We report a case of drug hypersensitivity syndrome or DRESS associated with intra and extra-hepatic biliary lesions. This syndrome was associated with sulfasalazine and naproxene therapy. A reactivation of HHV6 was documented in the continuations of the DRESS and could play a role in the symptomms.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cholangitis/chemically induced , Drug Hypersensitivity/complications , Naproxen/adverse effects , Sulfasalazine/adverse effects , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Eosinophilia/chemically induced , Exanthema/chemically induced , Humans , Male , Naproxen/therapeutic use , Sulfasalazine/therapeutic use
3.
Eur J Gastroenterol Hepatol ; 18(3): 287-9, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16462543

ABSTRACT

We report the case of a 45-year-old man with HCV treated with pegylated interferon-alpha/ribavirin, in whom fatal cardiomyopathy occurred. Cardiomyopathy is a rare complication of high dose of standard interferon but has never been reported with pegylated interferon. The relationship between pegylated interferon-alpha/ribavirin and the development of cardiomyopathy is highly probable for the following reasons: (1) a cardiologist consultation with specific investigations had been performed before treatment excluding a pre-existing cardiomyopathy; (2) symptoms of advanced dilated cardiomyopathy appeared immediately after the end of treatment; (3) other causes of cardiomyopathy have been ruled out. In all except one of the 21 reported cases with standard interferon, cardiomyopathy was reversible. In our patient, fatal cardiomyopathy occurred with a usual dose of pegylated interferon-alpha. Clinicians should be aware of this potential complication when evaluating the ratio benefit/risk of treatment in patients with chronic hepatitis C infection.


Subject(s)
Antiviral Agents/adverse effects , Cardiomyopathy, Dilated/chemically induced , Hepacivirus , Hepatitis C, Chronic/drug therapy , Interferon-alpha/adverse effects , Polyethylene Glycols/adverse effects , Ribavirin/adverse effects , Antiviral Agents/administration & dosage , Drug Administration Schedule , Drug Therapy, Combination , Fatal Outcome , Humans , Interferon alpha-2 , Interferon-alpha/administration & dosage , Male , Middle Aged , Polyethylene Glycols/administration & dosage , Recombinant Proteins , Ribavirin/administration & dosage
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