Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 47, Issue 7
Displaying 1-6 of 6 articles from this issue
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Case Reports
  • A fatal case of severe acute exacerbation due to hepatitis B virus with YMDD motif mutation
    Hidetaka Shibata, Tatsuki Ichikawa, Kazuhiko Nakao, Yasuhide Motoyoshi ...
    Article type: Case Report
    2006 Volume 47 Issue 7 Pages 329-333
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.329
    JOURNAL FREE ACCESS
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    A 54-year-old woman was diagnosed as decompensated cirrhosis due to hepatitis B virus (HBV) in August 2001. Administration of Lamivudine was started in September 2001 and lead to undetectable HBV DNA level in serum in August 2002, accompanied by clinical and biochemical improvement. In January 2003, severe acute exacerbation developed, following increased HBV-DNA level. She had biochemical and virological improvement by conservative management. In January 2004, HBV DNA level again increased but ALT level remained normal. In September 2004, severe acute exacerbation developed and adefovir was readily administered. Although plasmapheresis and continuous hemodiafiltration were carried out, hepatic failure and encephalopathy worsened. She was complicated by bacterial pneumoniae and died in October 2004. Our case is thought to give an important information about timing of administration of adefovir for YMDD mutant.
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  • A case of chronic hepatitis C with malignant lymphoma arising from porta hepatical lymph node in follow up period
    Satoshi Hirai, Hidero Ogino, Shunji Tomita, Hidenobu Ohsaka, Katsushi ...
    Article type: Case Report
    2006 Volume 47 Issue 7 Pages 334-340
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.334
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    We reported a case of malignant lymphoma appearing from porta hepatical lymph nodes in chronic hepatitis C. A 44-year-old man was diagnosed as choronic hepatitis C by liver biopsy in 1993. He was treated with the six million units of Interferonα-2a for six months, but there was no response. We followed up with abdominal ultrasonography, and detected a 35mm low-echoic mass. We recommended an operation, but he refused. The mass had grown to 78mm on December 2004, we biopsied it with ultrasonograpy assist. The mass was diagnosed as diffuse large B cell lymphoma. We started CHOP plus rituximab chemotherapy and the mass had shrunken. A chronic hepatitis C patient have a high incidence of porta hepatical lymph nodes swelling, so we need to be careful about appearance of malignant lymphoma from porta hepatical lymph nodes, if the lympho node size increased.
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  • A case of severe autoimmune hepatitis triggered by discontining long term Celestamine® treatment
    Hidenao Noritake, Fujito Kageyama, Yasunori Takehira, Masami Yamada, G ...
    Article type: Case Report
    2006 Volume 47 Issue 7 Pages 341-346
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.341
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    The patient was a 70-year-old man. He had been treated with Celestamine® about three years for his chronic sinusitis. He was admitted to our hospital for his clinical symptoms including nausea, pruritus, and yellow urine. We diagnosed autoimmune hepatitis from the examinations and clinical course. At first, we treated him with UDCA (600mg/day). His general condition was not well for several days, so we then treated him with PSL (30mg/day), where upon he improved. The pathological findings showed inflammation cell permeation and rosette formation. It was thought that his discontinuation of Celestamine® triggered deterioration resulting in serious autoimmune hepatitis. Moreover, much remains unclear as to the implications of the excess iron deposits in liver tissue in terms of autoimmune hepatitis. Thus, further investigations are necessary in this regard.
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  • A case of woman who was diagnosed as Wilsons disease because of lethe and baldness at 45 years old, who had been diagnosed as idiopathic portal hypertension
    Toshiyuki Otsuka, Satoshi Hagiwara, Hiroki Tojima, Kazumi Nagasaka, Sh ...
    Article type: Case Report
    2006 Volume 47 Issue 7 Pages 347-351
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.347
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    We experienced a 45-years-old woman who could be diagnosed as Wilsons disease. The patient was admitted to our hospital due to general fatigue in 1998 and was diagnosed idiopathic portal hypertension. However, the patient suffered progressive neurological disability from July, 2004 and was admitted to our hospital in August 2005. Laboratory data showed decreased serum ceruloplasmin level, increased 24-hour urine copper level. Liver biopsy showed copper deposits in hepatocytes. The patient was diagnosed as Wilsons disease. Her brother was also diagnosed as Wilsons disease because of copper-related marker, presence of Kayser-Fleisher rings and copper deposits in hepatocytes. Both individuals were treated with D-penicillamine. We suggest that Wilsons disease must be considered in adult patients with nondiagnostic hepatic disease.
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Short Communications
  • Hyperthermia by hot pack prevents sharp pain and skin symptom at IFN injection intramuscularly
    Saya Akashi, Yoshiaki Inui, Yoshiko Kinoshita, Isae Nobori, Naoe Yoshi ...
    Article type: Short Communication
    2006 Volume 47 Issue 7 Pages 352-354
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.352
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    Forty-four patients with chronic hepatitis C who took an IFN treatment were included in this study. An injection part was warmed by hot pack before and after intramuscular injection. Hyperthermia by hot pack decreased the cases that appealed for sharp pain from 63% to 32% (p<0.01), and was effective for prevention of sharp pain and of a skin symptom. This result suggests that hyperthermia by hot pack is effective means for patients forced to intramuscular injection for a long term.
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  • An early prognosis for the treatment of chronic hepatitis C patients with pegylated interferon-α2b plus ribavirin: Monitoring analysis by the serum HCV core antigen values
    Tatsuya Fujino, Kazuto Goto, Eiichiro Arimura, Yumiko Sakiyama, Ryosuk ...
    Article type: Short Communication
    2006 Volume 47 Issue 7 Pages 355-356
    Published: 2006
    Released on J-STAGE: December 21, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.355
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    The capability of an early prognosis for the treatment of Chronic Hepatitis C (CH-C) patients with genotype 1b and high viral loads with Pegylated Interferon-α2b plus Ribavirin was evaluated by the levels of serum HCV core antigens. Serum samples were drawn before the treatment, 3 days or 1, 2, 4, and 12 weeks after the treatment. Out of 45 cases with CH-C, 36 cases (80%) and 9 cases (20%) were early virological response (EVR) and non-early virological response (NEVR), respectvery.
    The serum levels of core antigen in EVR were significantly lower than those in NEVR from the third day to the 12th week after the treatment. The levels of core antigen less than 1000fmol/L in the second week could predict a better prognosis in the 12th week. The measurement of serum HCV core antigen was useful for the early prognosis of the treatment in CH-C patients with genotype 1b and high viral loads with Pegylated Interferon-α2b plus Ribavirin.
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