ABSTRACT
The association of hepatitis C and certain hemotological diseases (non-Hodgkin B-cell lymphoma, villous splenic lymphoma.) is a debated question which remains open due to discordant epidemiological data. We report the case of a new patient with chronic hepatitis C and tricholeukocyte leukemia.
Subject(s)
Hepatitis C, Chronic/complications , Leukemia, Hairy Cell/complications , Adult , Antineoplastic Agents/therapeutic use , Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Humans , Interferon-alpha/therapeutic use , Leukemia, Hairy Cell/drug therapy , Male , Ribavirin/therapeutic useABSTRACT
BACKGROUND/AIMS: Adult Still's disease is one of the febrile disorders of unknown etiology, characterized by high fever, transient cutaneous rash and leukocytosis. Liver dysfunction in adult Still's disease has been described in some case reports. The objective of this study was to analyze the pattern and the frequency of liver abnormalities in a monocenter series of adult Still's disease patients. METHODOLOGY: Data of 17 patients with adult Still's disease (fulfilling Yamaguchi's diagnostic criteria) were retrospectively reviewed. These patients were followed in an Internal Medicine Department over a period of 7 years. RESULTS: The median age was 27 years with a sex ratio M/F of 1.4. Fever was present in 100% of the cases and hepatomegaly occurred in 47% of the cases. Abnormalities in liver biochemistry, apparent in 76% of the subjects were characterized from moderate (elevation of transaminases between 2 and 5 N) (65%) to severe cytolysis (level of transaminases > 5 N) (12%), cholestasis (elevation of gamma GT and/or PAL) (65%), and increase in the level of LDH (35%). All of these symptoms disappeared either spontaneously or under treatment (83%), within a median period of 18 days. CONCLUSIONS: This study confirms the high frequency of liver dysfunction in adult Still's disease patients. Although it is moderate and asymptomatic in most cases, severe cytolytic hepatitis has been described. This study especially puts forward the need for exploring the possibility of adult Still's disease in the presence of a fever and hepatic cytolysis.
Subject(s)
Liver Diseases/etiology , Still's Disease, Adult-Onset/complications , Adult , Female , Humans , Liver Diseases/diagnosis , Liver Diseases/therapy , Male , Retrospective Studies , Severity of Illness Index , Still's Disease, Adult-Onset/diagnosis , Still's Disease, Adult-Onset/therapyABSTRACT
Our aim was to compare the sensitivity of various diagnostic criteria for adult Still's disease in 17 patients with established adult Still's disease who were followed in a department of internal medicine over a mean period of 7 years. The median age of the 17 patients was 27 years and the sex ratio M:F was 1:4. The patients had essentially systemic manifestations with fever (n=14), inflammation and leukocytosis (n=16), and moderate liver dysfunction (n=13) that disappeared after a mean of 21 days (range 8-48 days). In the first week of hospitalization, the sensitivities of the criteria proposed by Yamaguchi, Reginato, and Kahn were 94, 18, and 23%, respectively. One month later, the sensitivity was 100% for Yamaguchi's diagnostic criteria versus only 88% for Reginato's and Kahn's criteria. This study confirms that Yamaguchi's diagnostic criteria are more sensitive and are met earlier than Reginato's and Kahn's criteria in patients followed in internal medicine.
