Kanzo

Case Reports

A case of acute hepatitis E developed in a housewife who had cooked and eaten wild boar meat a month before

Gaku Inoue, Kojiro Michitaka, Kazuaki Takahashi, Natsumi Abe, Kiyohito ...

Article type: Case Report
2006 Volume 47 Issue 10 Pages 459-464
Published: 2006
Released on J-STAGE: January 29, 2007

DOIhttps://doi.org/10.2957/kanzo.47.459

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Here we report a 54 year-old woman who was admitted to our hospital due to jaundice and liver dysfunction. Virological markers for hepatitis A, B, and C viruses were negative, but later, it was revealed that she was positive for IgM and IgG antibodies against hepatitis E virus (HEV) as well as for HEV RNA of genotype 3. She did not have a history of traveling abroad in the past 30 years, but had a history of handling, cooking and eating wild boar meat one month before the onset of her disease. Since her husband, who had eaten the boar meat together, did not develop hepatitis E, and since the boar meat was served well-cooked, we suspected that the patient might have got infected with HEV by handling with raw boar meat in the kitchen, not by eating the well-done meat. HEV RNA of genotype 3 was recovered also from a piece of the boar meat that was left-over and kept frozen.

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Four cases of hepatitis E after eating wild boar meats in Aichi, Japan

Yuko Shimizu, Masahiko Yamada, Hidezumi Tatematsu, Makoto Ishihara, Ke ...

Article type: Case Report
2006 Volume 47 Issue 10 Pages 465-473
Published: 2006
Released on J-STAGE: January 29, 2007

DOIhttps://doi.org/10.2957/kanzo.47.465

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We experienced 4 cases (2 in 2005 and 2 in 2006) of hepatitis E, where the patients developed their disease one or two months after eating meats and/or entrails of wild boars captured in Aichi prefecture, Japan. All 4 were middle-aged men, and 3 had a history of significant alcohol drinking. One of them developed hepatic coma, received corticosteroid administration and plasma exchange therapy, and survived eventually. Another patient also suffered severe form of hepatitis but not encephalopathy. Hepatitis E virus (HEV) of genotype 4 was detected in all. Interestingly, the nucleotide sequences of HEV from the 4 patients showed quite a high degree of similarity to each other (98.8-99.8%) as well as to those from wild boars in Aichi (99.1-100%), despite showing only a significantly lower similarity to those reported as genotype 4 from other areas in Japan (85.4-89.3%). These findings suggest that an indigenous strain of HEV genotype 4 is now spreading in Aichi, and warrant a need for immediate countermeasures.

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A case of hepatic sclerosed hemangioma mimicking gastric submucosal tumor

Kazuki Hayashi, Hirotaka Ohara, Yasuhiro Kitajima, Hajime Tanaka, Hiro ...

Article type: Case Report
2006 Volume 47 Issue 10 Pages 474-481
Published: 2006
Released on J-STAGE: January 29, 2007

DOIhttps://doi.org/10.2957/kanzo.47.474

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A 82-years old woman was hospitalized due to acute cholecystitis. The CT clarified that the tumor existed between liver left lobe and stomach fornix part. The tumor was judged to be a tumor of the stomach origin by CT, MRI, roentgen examination of stomach and endoscopic ultrasonography. However, when the operation was enforced, the tumor was a tumor of the liver origin. The pathology inspection concluded that the tumor was sclerosed hemangioma. The tumor is not one disease concept of independent. It is a state similar to the last image of the regressive change that a usual cavernous hemangioma. Moreover, because it doesnt have a feature image, the distinction among the cholangiocellular carcinoma, the metastatic cancer of the liver, the inflammatory pseudotumor and the fibrosis hepatocellular carcinama is difficult.
Therefore, we thought this case was a very valuable and reported.

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Short Communication

Estimating portal flow reduction in hepatic dysplastic nodules may be prognostic for multistep progression to hepatocellular carcinomas

Ryuichi Kita, Norihiro Nishijima, Hiroo Matsuo, Yasuaki Sakamoto, Sumi ...

Article type: Short Communication
2006 Volume 47 Issue 10 Pages 482-483
Published: 2006
Released on J-STAGE: January 29, 2007

DOIhttps://doi.org/10.2957/kanzo.47.482

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Portal flow in the hepatic nodules is known to decrease during progression to hepatocellular carcinoma. We assessed the reduction in portal flow of the 37 hepatic nodules using the time-density curve of a single-level dynamic CTAP and expressed the results numerically. Retention of the portal flow was classified as three levels: good, moderate and almost zero, the last of which was considered to correspond to classical hypervascular hepatoma. Rather poor retention of portal flow may be an early signal that progression to hypervascular tumor is imminent. This numeric information may be help determine the most appropriate timing for the treatment of hepatic cancerous tumors.

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