Daily Archives: March 5, 2017
Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis
Primary sclerosing cholangitis (PSC) is an orphan hepatobiliary disorder associated with inflammatory bowel disease (IBD). We aimed to estimate the risk of disease progression based on distinct clinical phenotypes in a large, international cohort of pa… Continue reading
Direct-acting Antiviral Therapy Restores Immune Tolerance to Patients With Hepatitis C Virus-induced Cryoglobulinemia Vasculitis
Interferon-free direct-acting antiviral (DAA) therapies are effective in patients with hepatitis C virus-induced cryoglobulinemia vasculitis (HCV-CV). We analyzed blood samples from patients with HCV-CV before and after DAA therapy to determine mechani… Continue reading
An Adolescent With Severe Abdominal Pain, An Unexpected Outcome
Question: A 14-year-old girl of African descent, presented with severe abdominal pain at the pediatric department. The pain had started 3 days earlier and initially was intermittent, diffuse, and cramping. At presentation it had become continuous, prog… Continue reading
Uncommon Cause of Dysphagia in a Liver Transplant Recipient
Question: A 71-year-old woman with a past medical history of living unrelated donor transplant done 15 years ago for primary biliary cirrhosis was referred for evaluation of dysphagia. Dysphagia was primarily to solid foods and later progressed to thic… Continue reading
An Unusual Cause of an Arterial Enhancing Liver Mass
Question: A 47-year-old woman was referred to our department for a liver mass. She had a significant past history of being a hepatitis B carrier on yearly abdominal ultrasound imaging in an outpatient setting. Her last abdominal ultrasound was performe… Continue reading
Reply
In 1985, Drs Chu, Liaw, and colleagues described the first phase of chronic hepatitis, referred to as immune tolerant (IT), as “The high replicative phase, characterized by HBeAg reactivity in serum and only minor histologic activity,” including no… Continue reading
A Question on Liver Function Tests in Patients With Celiac Disease
I read with great interest the study by Choung et al1 conducted on a population living in Olmsted County, Minnesota. In this community, the prevalence of undiagnosed celiac disease was 1%. Furthermore, to compare the proportion of comorbidities betwee… Continue reading
Immune Tolerance Phase of Chronic Hepatitis B
We read with great interest the article of Mason et al1 and 2 related editorials2,3 debating the suitability of the time-honored term immune tolerance phase. Their debate was based on current molecular and immunologic findings, and did not reach a con… Continue reading
Young Onset Breast and Colon Cancer
Question: A 37-year-old G2P1 woman was diagnosed with ER+, PR+, Her-2 negative invasive ductal carcinoma without metastasis at 35 weeks’ gestation and after labor induction underwent neoadjuvant chemotherapy with bilateral mastectomy. BRCA1/2 testing… Continue reading