ABSTRACT
Chronic hepatitis C manifests with many extrahepatic features including renal involvement. However, less commonly, interferon therapy for chronic hepatitis C can also result in renal involvement and we describe a case when interferon therapy resulted in minimal change glomerulopathy, a form of involvement which, carries a good prognosis. Our patient developed nephrotic syndrome while on interferon therapy and HCV RNA levels were undetectable at that time. The disease showed excellent response to steroid therapy.
Subject(s)
Antiviral Agents/adverse effects , Hepatitis C, Chronic/drug therapy , Interferons/adverse effects , Nephrotic Syndrome/chemically induced , Adult , Drug Therapy, Combination , Humans , Liver Function Tests , Male , Ribavirin/administration & dosageABSTRACT
A prospective descriptive study of Primary Biliary Cirrhosis at Hospital Kuala Lumpur was undertaken from January 1992 to December 1999. A total of 17 patients were seen with a female to male ratio of 3.25:1. The mean age at presentation was 45.9 years (range: 14 years to 67 years) with a mean follow-up of 33.4 months (range: 3 months to 95 months). Fatigue was the most common clinical symptom at presentation. Alanine transaminase and alkaline phosphatase levels were elevated in 93% of patients at presentation. The antimitochondrial antibody was positive in 87% of patients. Ursodeoxycholic acid therapy resulted in significant symptomatic relief and biochemical improvement in all those who were treated.
Subject(s)
Liver Cirrhosis, Biliary/epidemiology , Adolescent , Adult , Aged , Female , Follow-Up Studies , Hospitals/statistics & numerical data , Humans , Liver Cirrhosis, Biliary/diagnosis , Liver Cirrhosis, Biliary/therapy , Malaysia/epidemiology , Male , Middle Aged , Outcome Assessment, Health Care/statistics & numerical data , Retrospective Studies , Time FactorsABSTRACT
Pancreatic sphincter hypertension (PSH) is one of the causes of recurrent pancreatitis. The diagnosis can be established by direct measurement of pancreatic sphincter pressures at pancreatic sphincter manometry. This procedure is not without risks, and in cases with PSH, it certainly carries a higher risk of post procedure pancreatitis. The treatment of this disorder is pancreatic sphincterotomy, which on its own carries risk of acute pancreatitis. Therefore it is important to establish the diagnosis reliably before undertaking this procedure. In order to overcome the false positive readings that are possible in sphincter manometry, we proposed to use secretin stimulated endoscopic ultrasound (SSEUS) to measure pancreatic ductal response as an adjunctive method to aid and supplement the diagnosis. Here we describe 3 cases in which this was carried out to optimal effect.
Subject(s)
Endoscopy , Hypertension/diagnosis , Hypertension/etiology , Pancreatic Diseases/complications , Secretin , Sphincter of Oddi , Ultrasonography , Adolescent , Adult , Female , Humans , Injections, Intravenous , MaleABSTRACT
Tuberculosis, in its extrapulmonary form, though emerging as a common clinical problem, rarely affects the pancreas. Its indolent course, vague symptomatology along with its non-specific laboratory and radiographic findings call for greater vigilance. We report a case of pancreatic tuberculosis, previously managed as recurrent alcohol related pancreatitis which showed symptomatic improvement following commencement of antituberculosis drugs. The diagnosis of pancreatic tuberculosis in this case was based on the abdominal CT scan findings, response to anti-tubeculous chemotherapy and overall laboratory and radiological work-up.
Subject(s)
Pancreatic Diseases/complications , Pancreatitis/etiology , Tuberculosis/complications , Acute Disease , Humans , Male , Middle Aged , RecurrenceABSTRACT
In the setting of transplantation and chronic hepatitis B viral infection there is a unique histological feature termed cholestatic fibrosing hepatitis. The use of nucleoside analogues in the treatment of this condition has been successful. We describe a case of cholestatic fibrosing hepatitis, which occurred after intense immunosuppression for graft versus host disease in a patient with bone marrow transplantations. She was commenced on lamivudine therapy and showed good clinical, biochemical and virological response. However she succumbed due to sepsis.
Subject(s)
Bone Marrow Transplantation/adverse effects , Cholestasis/etiology , Hepatitis B/etiology , Hepatitis/etiology , Liver Cirrhosis/etiology , Adult , Female , HumansABSTRACT
An analysis of 105 consecutive patients with chronic hepatitis C at the gastroenterology outpatient's clinic in Hospital Kuala Lumpur was performed. The clinical, laboratory and virological data was prospectively recorded in the case notes and comprised of data on patient characteristics, risk factors, clinical features, laboratory features, virology screen and management. Chronic Hepatitis C cases accounted for 2.1% of the total number of cases seen at this clinic during the entire period. There were 78 (74%) males and 27 (26%) females. The ethnic breakdown consisted of Chinese (44.2%), Malays (39.4%), Indians (15.4%) and others (1%). There was higher male preponderance in all the ethnic groups. The main mode of transmission was blood transfusion comprising 51 patients (48.8%). A total of 35.2% of cases underwent treatment, of which a proportion had interferon monotherapy for 6 or 12 months and a subsequent group of naïve patients and non-responders underwent combination therapy with interferon and ribavarin.
Subject(s)
Hepatitis C, Chronic/epidemiology , Outpatient Clinics, Hospital/statistics & numerical data , Adolescent , Female , Hepatitis C, Chronic/pathology , Hepatitis C, Chronic/virology , Humans , Malaysia/epidemiology , Male , Middle AgedABSTRACT
We report 2 cases where treatment of achalasia type symptoms due to severe non-specific oesophageal dysmotility have shown symptom resolution and manometric improvement to intrasphincteric botulinum injections either by itself or in combination with oesophageal dilatation.
