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Etiological role of brucellosis in autoimmune hepatitis

World Journal of Gastroenterology 2005年第14期11卷 2200-2202页

作者： colakoglu onder Taskiran Bengur Adnan Kirci Tunakan Mine Buyrac Zafer Unsal Belkis Aksoz Kadir Yorukoglu Gazi Clinics of Gastroenterology Izmir Ataturk Training and Research Hospital IzmirTurkey 3rd Clinics of Internal Medicine Izmir Ataturk Training and Research Hospital IzmirTurkey Department of Pathology Izmir Ataturk Training and Research Hospital IzmirTurkey

To show that brucellosis may trigger autoimmune hepatitis(AIH), in addition to nonspecific liver involvement and toxic hepatitis, due to a class effect of tetracycline family used for treatment. We present a female patient admitted to our hospital due to partially improved fatigue and elevated liver enzymes following doxycycline and streptomycin usage for brucellosis. Brucellosis is endemic in our country, Turkey. It may involve any organ in the body. Liver is frequently involved. Doxycycline used for treatment occasionally may lead to hepatotoxicity. AIH is a necroinflammatory disease of the liver. Certain drugs (e.g. Minocycline), toxins, and viruses (hepatitis B, hepatitis C, EBV, etc.) can trigger AIH. Only one case of AIH probably caused by doxycycline and brucellosis was reported. We discuss the relationship between brucellosis, AIH, and hepatotoxicity of doxycycline. Brucellosis may trigger AIH.

关键词： Brucellosis Autoimmune hepatitis Doxycycline

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Relationship between retinopathy and cirrhosis

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World Journal of Gastroenterology 2005年第14期11卷 2193-2196页

作者： colakoglu onder Taskiran Bengur Dayi Selcuk Sozmen Bulent Unsal Belkis Maden Ahmet Pasa Eser Aslan S. Leyla Clinics of Gastroenterology Izmir Ataturk Teaching and Research Hospital IzmirTurkey 3rd Clinics of Internal Medicine Izmir Ataturk Teaching and Research Hospital Izmir Turkey Clinics of Ophthalmology Izmir Ataturk Teaching and Research Hospital IzmirTurkey 3rd Clinics of Internal Medicine Izmir Ataturk Teaching and Research Hospital IzmirTurkey Clinics of Ophthalmology 9th September University Hospital IzmirTurkey

AIM: To evaluate ophthalmic disorders with special attention to retinopathy in cirrhotic patients. Vitamin A deficiency-related ophthalmopathy, xerophthalmia, and color blindness may be documented in cirrhosis due to various etiologies. Retinopathy is an obscure feature of cirrhosis. METHODS: Thirty-two cirrhotic patients, who were followed up by Clinics of Gastroenterology, Izmir Ataturk Teaching and Research Hospital, were enrolled to the study. Associated systemic diseases such as diabetes mellitus and hypertension were excluded. Thirty-two healthy volunteers took part as the control subjects. All participants had ophthalmologic examination in the same hospital. RESULTS: Five (15.6%) of the cirrhotic subjects had soft exudate in the retina. None of the control subjects had retinopathy (P＜0.05). Intraocular pressure (IOP) measured for both eyes were also significantly lower in the cirrhotics (P＜0.05 vs P = 0.01). There were no statistically significant differences between the two groups in terms of other ophthalmic pathologies. The ophthalmic findings did not show up any differences according to the etiology of cirrhosis. CONCLUSION: Soft exudates may develop in cirrhotic patients probably due to loss of synthetic function of liver and hemodynamic effects of portal hypertension. Retinopathy must be sought in cirrhosis because of its severe morbidity.

关键词： Cirrhosis Portal hypertension Retinopathy

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