Syncytial giant-cell hepatitis: sporadic hepatitis with distinctive pathological features, a severe clinical course, and paramyxoviral features

Article Abstract:

Ten cases of a possibly new form of hepatitis were seen over a six-year period; in five the tentative diagnosis was non-A, non-B hepatitis, while in the other five autoimmune chronic active hepatitis was suspected. Pathological features and details of the cases indicate that these 10 cases may be examples of a previously undescribed and very severe form of hepatitis, one which may be caused by measles virus or a close viral relative of measles. Examination of liver biopsies revealed the presence of large syncytia, which are formed as individual cells fuse together to form large multinucleated cells. Such syncytia are not uncommon in childhood liver disease, but they are rare in liver disease in adults. However, syncytia are a hallmark of infection with paramyxoviruses, a class of viruses that includes measles virus. In eight of the 10 patients, electron microscopic examination revealed the presence of tiny structures within the cytoplasm of the liver cells whose appearance was similar to that viral nucleocapsids (the internal framework of the virus which includes the genetic material and around which the viral envelope is wrapped to create a new virus particle). In at least one case, a recurrence of hepatitis was accompanied by a measles-like rash and the elevation of antibodies which react to measles virus in the patient's serum. Two chimpanzees were injected with homogenized liver material, and it was found that the chimpanzees did not develop an immune response against hepatitis A, B or C, but did develop a response against the paramyxoviruses measles and parainfluenza 4. Some other paramyxoviruses tested, mumps and parainfluenza viruses 1, 2, and 3, did not react. The observations suggest that paramyxovirus infection be considered as a possible cause of hepatitis in some sporadic cases. The hepatitis cases presented here were especially severe; five patients required liver transplantation and the other five died. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Hepatitis, Viral, Viral hepatitis, Paramyxoviruses, Hepatitis, Measles virus

---

Selective or total shunts for variceal bleeding

Article Abstract:

Esophageal varices (enlarged, swollen and tortuous veins at the lower end of the esophagus) and life-threatening variceal bleeding may result from portal hypertension (increased pressure in the portal vein of the liver). Portal hypertension may be caused by liver cirrhosis (degenerative disease in which liver tissue is replaced by fibrous tissue and fatty deposits), which obstructs the flow of blood through the liver. Shunt surgery is an important option in managing patients with bleeding esophageal varices. Selective distal splenorenal shunt (DSRS) allows for selective decompression of that portion of the portal vascular system involved in the bleeding. At the same time, this procedure maintains the pressure in the portal system so that blood perfusion of the liver may be maintained. The hemodynamic and physiologic consequences of total and selective shunts are discussed. Selective distal shunts have a lower incidence of long-term encephalopathy (abnormal brain function), and in the nonalcoholic patient this shunt may provide longer survival. Total shunt is technically easier to perform and is more widely performed than selective shunt; because of these factors it is preferred in an emergency situation. For elective surgery, selective shunts are preferred. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Gastrointestinal bleeding, Gastrointestinal hemorrhage, Surgery, Esophageal varices, Splenorenal shunt, Surgical, Surgical splenorenal shunt

---

Running like water- The omnipresence of hepatitis E

Article Abstract:

Hepatitis E virus (HEV) identified as the main cause in massive waterborne epidemics of acute hepatitis in Asia is commanding attention in regions of Sudan and Iraq. As HEV is not commonly transmitted from person to person, it is suggested that improving sanitation and boiling or chemically purifying the water can reduce the burden of disease.

Science & research, Asia, Research, Risk factors, Waterborne infections, Hepatitis E

Similar abstracts:

• Abstracts: Correlation of clinical and histopathologic features in clinically atypical melanocytic nevi. Clinical characteristics of malignant melanoma developing in persons with dysplastic nevi
• Abstracts: Clinical trials: concerns of the patient and the public. Ethical considerations in randomized controlled clinical trials
• Abstracts: Severe hepatitis caused by cyproterone acetate. Pancreatic pseudocyst causing portal vein thrombosis and pancreatico-pleural fistula
• Abstracts: A cluster of Legionella sternal-wound infections due to postoperative topical exposure to contaminated water. Potable water as a cause of sporadic cases of community-acquired Legionnaires' disease
• Abstracts: Relation between zinc status and hepatic functional reserve in patients with liver disease. Alcohol consumption in patients with colorectal adenomatous polyps

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.