Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 12
Displaying 1-7 of 7 articles from this issue
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Feature Article
Editorial
Original Article
  • Epidemiology and clinical features of acute hepatitis B in Japan -Analysis with an emphasis on genotype A HBV-
    Norie Yamada, Hiroshi Yotsuyanagi, Yu Koitabashi, Yoshihiko Nagase, Ch ...
    Article type: Original Article
    2008 Volume 49 Issue 12 Pages 553-559
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.49.553
    JOURNAL FREE ACCESS
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    Virologic and clinical features of acute hepatitis B in the metropolitan area were analyzed with an emphasis on genotype A HBV. The proportion of patients infected with genotype A HBV was 31.8% between 1994 and 1997, 35.3% between 1998 and 2001, 41.5% between 2002 and 2005 and was increased to 73.0% between 2006 and 2008. The transmission route of genotype A HBV in recent years comprises sexual transmission from a steady Japanese heterosexual partner besides that from homosexual and unspecified heterosexual partners. One patient infected with genotype A HBV developed chronic hepatitis. Other two patients with a protracted course received Entecavir. Co-infection with human immunodeficiency virus was found in 14.3% of patients with genotype A HBV. Amino acid sequences in the "a-determinant region" were studied and demonstrated that one patient was infected with HBV which may escape vaccination. Education of people, surveillance of genotype A HBV and consideration of universal vaccination are important to prevent transmission of HBV, particularly with genotype A.
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Case Reports
  • A case of granulomatous hepatitis caused by Bacillus Calmette-Guerin (BCG) infection after BCG bladder instillation
    Masahisa Abe, Shun-ichi Matsuoka, Satomi Koizumi, Shintarou Nagai, Hir ...
    Article type: Case Report
    2008 Volume 49 Issue 12 Pages 560-567
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.49.560
    JOURNAL FREE ACCESS
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    A 58-year-old man was admitted to our hospital because of fever and liver dysfunction. He had been given BCG instillation therapy for preventing the recurrence of superficial bladder carcinoma. Mycobacterial cultivation was negative, but a liver biopsy revealed granulomatous hepatitis accompanied by multiple granulomatous lesions in bone marrow and transbronchial lung biopsies. So we suspected current case as miliary tuberculosis. An anti-tubercular treatment based on our clinical diagnosis successfully improved fever and liver dysfunction.In a case who had fever and liver dysfunction, physicians should keep granulomatous hepatitis in mind and examine the liver histology.
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  • Intrahepatic cholangiocarcinoma with portal vein tumor thrombus and elevated level of α-fetoprotein: a case report
    Takaaki Kato, Satoshi Katagiri, Shunichi Ariizumi, Yoshihito Kotera, Y ...
    Article type: Case Report
    2008 Volume 49 Issue 12 Pages 568-573
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.49.568
    JOURNAL FREE ACCESS
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    We report the case of a 77-year-old man with intrahepatic cholangiocarcinoma (ICC) with portal vein tumor thrombus (PVTT) and elevated level of α-fetoprotein (AFP). Computed tomogram shows heterogenous mass 9 cm in diameter in the lateral segment. The tumor was not enhanced in the arterial phase, and it was delayed enhancement in the portal phase. A tumor thrombus was seen in the left and right portal vein. A tumor marker AFP alone was elevated. He was given a diagnosis of hepatocellular carcinoma. He underwent left lobectomy, caudate lobe resection and tumor thrombetctomy in January 2007. Microscopic examination showed tubular adenocarcinoma and immunohistochemical staining was positive for CK19, EMA, and MUC-1, but negative for AFP and hepatocyte. To our knowledge, this is the first report of a case of ICC/PVTT with AFP elevation, in Japan.
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  • Marked secondary iron overload due to iron infusion, a case report
    Tomohiro Tanaka, Naoaki Hashimoto, Kenichiro Sekigawa, Masao Okubo, Ka ...
    Article type: Case Report
    2008 Volume 49 Issue 12 Pages 574-580
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.49.574
    JOURNAL FREE ACCESS
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    A 75-year-old woman was admitted because of slight fever and hepatic dysfunction, but hepatitis virus infection and autoimmune hepatitis were ruled out from her blood data. At the age of 65, she had distal gastorectomy for gastric cancer. She had no history of blood transfusion, but had had iron infusion for about 30 months for iron deficiency anemia. On admission, her serum Fe and ferritin increased (210 μg/dl and 6600 ng/ml). An abdominal CT showed increased hepatic and splenic CT density, compared with those before iron infusion. An abdominal MRI showed low intensity both on T1 and T2 weighted images. In a liver biopsy specimen, hemosiderin granules were densely deposited in not only Kupffer cells but also hepatocytes. Based on these findings, we diagnosed her as secondary iron overload (secondary hemochromatosis), and started the i.m. injection of deferoxamine (500 mg/day) followed by phlebotomy. Serum ferritin has come down to 1199 ng/ml now.
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  • Successful treatment of primary hepatic amyloidosis with melphalan plus dexamethasone: a case report
    Keiichi Onji, Shoichi Takahashi, Takayasu Kuwabara, Yuki Kimura, Takah ...
    Article type: Case Report
    2008 Volume 49 Issue 12 Pages 581-588
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.49.581
    JOURNAL FREE ACCESS
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    A 61-year-old man admitted to our hospital with hepatomegaly, abdominal fullness, and cholestatic disorders. The patient was diagnosed as primary amyloidosis (AL-type) by liver biopsy, and deposits of amyloidosis were revealed in multiple organs. At first, combination therapy of melphalan and prednisolone was effective, however, the exacerbation was observed one year after initial treatment. Another combination therapy of melphalan plus dexamethasone (M-Dex) achieved the improvement of the symptoms and reduction of liver volume. Primary amyloidosis has been reported as rare and poor prognostic disease. We experienced one interesting case in which combination of M-Dex was effective and accomplished 6-years survival.
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