Kanzo

[title in Japanese]

[in Japanese]

1995 Volume 36 Issue 12 Pages 687-689
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.687

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Incidence and risk factors for the development of interferon retinopathy in patients with type C chronic active hepatitis

Kouichi SEKI, Yoshiharu ITOH, Yasuaki IMAI, Hiroki KAKIMOTO, Taku HARA ...

1995 Volume 36 Issue 12 Pages 690-696
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.690

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Incidence and risk factors for the development of interferon retinopathy were studied in patients with type C chronic active hapatitis. Eighty-eight patients without retinal change before interferon treatment were enrolled. Incidence of retinopathy was 25%; all the retinopathy developed within 12 weeks after the start of interferon treatment, the fastest onset being 2 weeks. Four variables including percent decrease in platelets and percent increase in triglyceride at 12 weeks after the beginning of interferon treatment, and HbA1C and mean blood pressure before the treatment have been selected by stepwise regression analysis for the development of interferon retinopathy. These results suggest that interferon retinopathy tends to develop in patients with diabetes mellitus or hypertension, and the decreas in platelets and the increase in triglyceride are other factors associated with interferon retinopathy. However, careful ophthalmologic follow-up enables interferon treatment to be continued.

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Immunohistochemical analysis of immune abnormalities on the mechanism of bile duct destruction in primary biliary cirrhosis

Hiroshi KANEKO

1995 Volume 36 Issue 12 Pages 697-705
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.697

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In an attemt to elucidate the mechanism of bile duct destruction in primary biliary cirrhosis (PBC), the present study was designed to examine the immune abnormalities of chronic nonsuppurative destructive cholangitis (CNSDC) in the early stages by immunohistochemical microscopy. Surgical liver biopsy specimens from seven patients with PBC (Scheuer's stage I-II) and five unicteric patients with gallstones were observed by the indirect immunoperoxidase method using the monoclonal antibodies. In PBC, the average percentage of CD4-positive and CD8-positive T cell subsets infiltrated around the interlobular bile ducts characterized by CNSDC was almost even. Some of these T cells were found to be in direct contact with the epithelial cells of the bile duct showing CNSDC and were also positive for lymphocyte function-associated antigen (LFA)-1. In PBC, intercellular adhesion molecule (ICAM)-1 was most strongly expressed particularly on the basal and luminal plasma membranes of the bile duct showing CNSDC and aberrantly expressed by HLA-DR. On the other hand, in PBC, HLA-ABC expression was enhanced particularly on the bile duct epithelial cell plasma membranes in comparison with that of cholelithiasis. Both of the activated CD4 (MHC class II-restricted) and CD8-positive (MHC class I-restricted) T cells would directly or indirectly act on the target epithelial cells of the interlobular and septal bile duct under the aberrant expression of HLA-DR and the enhancement of HLA-ABC. The interactions between the ICAM-1 on the bile duct epithelium and the LFA-1 on the CD4-positive and CD8-positive lymphocyte surface is considered to be a key immune process for the bile duct destruction in PBC.

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A case of fulminant hepatitis B occurred in an asymptomatic hepatitis B virus carrier

Tazuko OOISHI, Naoki KUMAGAI, Naoto IWABUCHI, Kanji TSUCHIMOTO, Shiger ...

1995 Volume 36 Issue 12 Pages 706-711
Published: December 25, 1995
Released on J-STAGE: January 19, 2010

DOIhttps://doi.org/10.2957/kanzo.36.706

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A 54-year-old male was admitted to our hospital because of general malaise and jaundice. He had been an asymptomatic hepatitis B surface antigen (HBsAg) carrier and persistently positive for anti-hepatitis B e antigen (HBeAg) and negative for HBV DNA polymerase. His serological examination on admission revealed negative for HBeAg and positive for HVB DNA polymerase (2930 cpm) and the stop codon point mutation from G to A at uncleotide 83 in the precore region (mutant HBV83) was detected by MSSA method. Fluminant hepatitis developed, but the he gradually recovered with a support of intensive treatment, including a plasma exchange procedure. Afterward interferon treatment was performed, which finally normalized his liver function and a mutant HBV was disappeared from his serum. In this case, we could not approve any trigger for occurence of fluminant hepatitis associated with a HBV mutant.

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A case report of Sho-saiko-to induced hepatic and renal injury

Takahisa SAKAI, Mikio KUNIYOSHI, Masatsugu NAKAMURA, Takeshi NAKANO, Y ...

1995 Volume 36 Issue 12 Pages 712-718
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.712

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We report a case of hepato-renal injury induced by Sho-saiko-to used in Japan for treatment of chronic hepatitis. A 60-year-old man with a history of acute hepatic injury and renal injury during administration of Sho-saiko-to for chronic hepatitis C, was admitted to our hospital because of acute hepato-renal injury. He took Sho-saiko-to again before admission, and suspected to have Sho-saiko-to induced hepatic injury. He was recovered but was readmitted because of fever and general fatigue on the following day due to accidental taking of Sho-saiko-to. Laboratory data on readmission revealed as follows; AST 314IU/l. ALT 308IU/l, serum bilirubin 2.8mg/dl, BUN 26.7mg/d/, Cr 1.8mg/dl.
He was recovered as soon as he stopped taking Sho-saiko-to. Lymphocyte stimulation test for each 4 components of Sho-saiko-to involving "Ninjin", "Hange", "Ougon", and "Taiso", was positive. It is necessary to take into consideration to hepatic and renal injury on the occasion of treatment with Sho-saiko-to.

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A case of chronic hepatitis C with Vogt-Koyanagi-Harada disease during natural interferon alpha administration

Yasunobu KAWAKAMI, Jun HAYASHI, Koya NAKASHIMA, Seizaburo KASHIWAGI

1995 Volume 36 Issue 12 Pages 719-722
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.719

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A 47-year-old female suffering from chronic hepatitis C was treated with natural interferon (IFN) alpha 6 MIU per day. Symptoms of the uveitis appeared eight weeks after the initiation of IFN therapy. Pleocytosis was found in her cerebrospinal fluid, so she was diagnosed as having Vogt-Koyanagi-Harada disease. It was controlled by the administration of prednisolone without cessation of IFN treatment. HCV-RNA was eliminated by the end of treatment, but reappeared six months later, indicating only transient response to the treatment. It should be noted that IFN may induce Vogt-Koyanagi-Harada disease.

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A case of primary biliary cirrhosis associated with multiple myeloma of Bence Jones kappa type

Hiroyuki INADA, Nobuyoshi YAMAMURA, Atsuo NAGATA, Toshitsugu NAKAMURA

1995 Volume 36 Issue 12 Pages 723-728
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.723

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A 62-year-old woman was admitted to our hospital for evaluation of liver dysfunction with a positive antimitochondrial antibody determination. The hepatic biopsy revealed chronic nonsuppurative destructive cholangitis which was compatible with Scheuer's stage 2 of primary biliary cirrhosis (PBC). One year after the diagnosis of PBC, she complained of lumbago and was diagnosed as Bence Jones (BJ) kappa type multiple myeloma (MM) because of compression fractures of the lumbar vertebrae, BJ proteinuria with monoclonal BJ-κ type protein by immuno-electrophoresis and 63.4% abnormal plasma cells by a bone marrow aspiration. PBC associated with MM is very rare and only 5 cases have been reported. In this paper, we have reported the first case of PBC associated with BJ type of MM, who received a successful treatment with recombinant interferon alpha 2b. We have discussed a possible mechanism for these two patho-logical conditions in the retrospective aspect of long term observation.

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A case of familial hyper-leucine aminopeptidasemia

Hiroaki MIYAOKA, Takeshi OKADA, Akira TANAKA

1995 Volume 36 Issue 12 Pages 729-734
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.729

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22 years old male was admitted to our hospital because of abnormal chest X-P and high leucin aminopeptidase (LAP) levels in serum. According to physical examination he was apparently healthy. All other biochemical liver function tests were normal. Upon electrophoresis, LAP migrated to the same position as that of α1 globulin. By light microscopy the liver biopsy spescimen showed no significant changes. By using L-leucin-p-nitoroanilide as substrate, the majority of LAP activity was found to be arylamidase. His mother and brother also had high levels of serum LAP activity. Out of 7 cases of idiopathic hyper-leucine aminopeptidasemia reported in Japan 6 cases have been found in Setonaikai area. Idiopathic hyper-leucine aminope-ptidasemia had not been reported in other countries.

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese]

1995 Volume 36 Issue 12 Pages 735
Published: December 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.735

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