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Hodgkin's lymphoma coexisting with liver failure secondary to acute on chronic hepatitis B

World Journal of Clinical Cases 2013年第1期1卷 37-40页

作者： Renee Palta amy mcclune Karl Esrason Division of Gastrointestinal and Liver Disease Department of Transplant Hepatology Kaiser Permanente Los Angeles Medical Center Los Angeles CA 90027 United States Division of Hepatology University of California Los Angeles CA 94607 United States

Acute on chronic liver failure(ACLF) is rarely the initial manifestation of a malignant process or precipitated by the initiation of anti-viral treatment with a nucleoside or nucleotide agent. We report an unusual case of ACLF temporally associated with initiation of Entecavir for treatment of chronic hepatitis B. Early Hodgkin's lymphoma(HL) was unmasked with initiation of the antiviral treatment which may have exacerbated ACLF. To the best of our knowledge, this has not been described in the literature. In reviewing our patients clinical course and liver autopsy, he developed a severe acute exacerbation of his chronic hepatitis B virus coinciding with the institution of antiviral therapy and the underlying HL perhaps modulating the overall degree of hepatic injury.

关键词： Entecavir Hepatic flare Fulminant hepatic failure Chronic hepatitis Acute liver failure Hodgkin’s lymphoma

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Microscopic colitis:A large retrospective analysis from a health maintenance organization experience

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World Journal of Gastroenterology 2009年第25期15卷 3122-3127页

作者： Kevin T Kao Benito A Pedraza amy C mcclune David A Rios Yi-Qiong Mao Robert H Zuch Michael H Kanter Sony Wirio Chris N Conteas Department of Gastroenterology Kaiser PermanenteLos Angeles Medical Center Los Angeles California 90027United States Department of Internal Medicine Kaiser Permanente Los Angeles Medical Center Los Angeles California 90027 United States Department of Pathology Southern California Kaiser Permanente Medical Group California 90027 United States

AIM： To examine the demographic data on a large multi-ethnic population of patients with microscopic colitis （MC） in Southern California and to determine the association of MC with inflammatory bowel disease （IBD） and colorectal cancer. METHODS： All patients diagnosed with MC by co- Ionic biopsy from 1996-2005 were identified utilizing a pathology database. All biopsies were reviewed by experienced pathologists utilizing standard histologic criteria. Patients＇ medical records were reviewed and data regarding patient age, co-morbidities, sex, ethnic- ity, and medications were analyzed. An age- and sex- matched standard control group was also generated. Chi-square test was used to evaluate the associations of co-morbidities between lymphocytic colitis （LC）, col- lagenous colitis （CC） and the control group. RESULTS： A total of 547 cases of MC were identified, 376 patients with LC and 171 patients with CC. The fe- male/male ratio was 3：1 in CC and 2.7：1 in LC patients. Celiac disease （P 〈 0.001）, irritable bowel syndrome （IBS）（P 〈 0.001）, and thyroid diseases （P 〈 0.001） were found to have a higher occurrence in MC com- pared to the control group. No statistical differences in the occurrence of colorectal cancer, diabetes and IBD were found between the MC group and the control group. CONCLUSION： This is the largest group of patients with MC known to the authors that has been studied to date. Conditions such as celiac disease, IBS, and thyroid diseases were found to be related to MC. Fur- thermore, neither an increased risk of colorectal cancer nor IBD was associated with MC in this study.

关键词： Collagenous colitis Inflammatory bowel disease Lymphocytic colitis Microscopic colitis

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