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Early diagnostic value of liver stiffness measurement in hepatic sinusoidal obstruction syndrome induced by hematopoietic stem cell transplantation

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World Journal of Clinical Cases 2022年第26期10卷 9241-9253页

作者： you-wen tan Yi-Chun Shi Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212003Jiangsu ProvinceChina

Hematopoietic stem cell transplantation(HSCT)-sinusoidal obstruction syndrome(SOS),also known as veno-occlusive disease,is a clinical syndrome characterized by symptoms,such as right upper quadrant pain,jaundice,fluid retention,and hepatomegaly,and is caused by pre-treatment-related hepatotoxicity during the early stages after *** diagnosis of HSCT-SOS is based on the revised Seattle or Baltimore *** revised standard by the European Society for Bone Marrow Transplantation in 2016 has good practicability and can be used in combination with these two *** studies have shown the value of liver stiffness measurement(LSM)in the early diagnosis of *** studies investigated LSM specificity and sensitivity for the early diagnosis of *** can distinguish SOS from other post-HSCT complications,enabling a clear differential *** has been shown that median LSM of patients with SOS is significantly higher than that of patients with other treatment-related liver complications(e.g.,acute cholecystitis,cholangitis,antifungal drug-related liver injury,liver graft-versus-host disease,isolated liver biochemical changes,and fulminant Epstein Barr virus related hepatitis reactivation).Therefore,the above data confirmed the utility of LSM and strongly suggested that LSM improves the positive predictive value of the SOS diagnostic clinical score after allogeneic *** diagnosis of SOS is beneficial in preventing severe HSCT complications.

关键词： Hematopoietic stem cell transplantation Sinusoidal obstruction syndrome Liver stiffness measurement Stem cell

Argon-helium cryoablation for thoracic vertebrae with metastasis of hepatocellular carcinoma-related hepatitis B: A case report

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World Journal of Clinical Cases 2020年第2期8卷 377-381页

作者： you-wen tan Yun Ye Li Sun Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu University

BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for *** SUMMARY A 54-year-old man was diagnosed with HCC related to hepatitis B one year ago and underwent surgical tumor resection and tenofovir antiviral ***, a new lesion developed on the right liver after 1 mo. Transarterial chemoembolization was performed four times. One month ago, the patient developed back pain, and metastasis on the 11 th thoracic vertebra was ***-helium cryoablation was performed to treat the right occupancy and metastatic lesion, which immediately alleviated the pain and prolonged *** The use of argon-helium cryoablation for thoracic vertebrae with metastasis of HCC achieved favorable results.

关键词： Cryoablation Metastasis Hepatocellular carcinoma Hepatitis B Case report

Efficacy of artificial liver support system in severe immuneassociated hepatitis caused by camrelizumab:A case report and review of the literature

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World Journal of Clinical Cases 2021年第17期9卷 4415-4422页

作者： you-wen tan Li Chen Xing-Bei Zhou Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212003Jiangsu ProvinceChina

BACKGROUND Immune checkpoint inhibitors(ICIs)can lead to immune-related hepatitis(IRH)and severe liver damage,which is life-threatening in the absence of specific *** SUMMARY A 75-year-old man was admitted to our hospital complaining of loss of appetite,yellow urine,and abnormal liver function for the past 2 *** months prior to admission,he was treated with two rounds of capecitabine in combination with camrelizumab for lymph node metastasis of esophageal *** liver function was normal before treatment,abnormal liver function appeared at week *** and camrelizumab were *** acid and methylprednisolone 40 mg daily were *** function continued to *** time and international normalized ratio were 19 s and 1.8,*** patient was diagnosed with acute liver failure.A pathological analysis of liver biopsy indicated a strongly positive immunohistochemical staining of T8+cells,thereby suggesting that drug-induced liver injury was related to IRH caused by ***,we performed sequential dual-molecule plasma adsorption system(DPMAS)treatment with plasma exchange(PE).After two rounds of treatment,the patient's appetite significantly improved,the yellow color of urine reduced,and liver function improved(total bilirubin level decreased)after five rounds of *** function normalized 4 wk after *** The use of sequential DPMAS with PE can reduce liver injury and systemic toxic reactions by clearing inflammatory mediators and harmful substances from blood,and regulate immune cell activity,which may be effective in the treatment of severe ICI-induced IRH.

关键词： Plasma exchange Dual plasma molecular adsorption system Immune checkpoint inhibitors Immune-associated hepatitis Case report

Is simultaneous presence of IgG4-positive plasma cells and giantcell hepatitis a coincidence in autoimmune hepatitis?A case report

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World Journal of Clinical Cases 2021年第25期9卷 7527-7534页

作者： you-wen tan Jia-Min Wang Li Chen Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212003Jiangsu ProvinceChina

BACKGROUND The immune-mediated invasion of IgG4-positive plasma cells in the liver is found in some autoimmune ***-cell hepatitis(GCH)is a very rare pathological feature in adults,and the clinical characteristics of the simultaneous appearance of the two pathological phenomena are not *** SUMMARY A 68-year-old woman was hospitalized with fatigue,poor appetite,and yellow urine for 20 *** function tests and immunological indexes were significantly abnormal and accompanied by elevated serum IgG4 *** pathology revealed severe inflammation of the interface between the portal tract and hepatocytes,portal area inflammation,plasma cell infiltration,formation of rosette cells,IgG4-positive plasma cells>10/high-power field,IgG4/IgG>40%,and multinucleated liver cell ***4-related autoimmune hepatitis(AIH)combined with GCH was diagnosed,and methylprednisolone was administered at 40 mg/*** weeks later,the clinical symptoms disappeared,and the liver function and immunological indicators were significantly *** was reduced at a rate of 4–8 mg per week to 8 mg/day for maintenance.A second liver biopsy 48 wk later indicated that liver inflammation and fibrosis were significantly ***4-positive plasma cells and GCH were not detected.A literature search was conducted to analyze articles reporting similar pathological *** AIH with simultaneous IgG4-positive plasma cell infiltration and GCH,liver inflammation,and fibrosis is possibly more severe than typical AIH but sensitive to corticosteroids.

关键词： IgG4 Autoimmune hepatitis Giant-cell hepatitis Case report

Hemocholecyst caused by accidental injury associated with radiofrequency ablation for hepatocellular carcinoma:A case report

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World Journal of Clinical Cases 2023年第23期11卷 5610-5614页

作者： you-wen tan Xin-Yue Zhang Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212003Jiangsu ProvinceChina

BACKGROUND Radiofrequency ablation(RFA)is an effective and safe treatment for hepatocellular carcinoma that features a lower incidence of serious complications than surgical *** caused by RFA is a rare complication of secondary damage to the intrahepatic bile duct that results in *** SUMMARY Here we report on a case of a hemocholecyst caused by accidental injury during RFA that induced hematemesis and *** subtraction angiography revealed no gallbladder arterial *** conservative treatment and transcatheter arterial chemoembolization,the patient’s condition stabilized,and she was discharged 1 wk *** Therefore,when performing interventional procedures such as RFA,clinicians must be vigilant because even minor injuries can lead to serious complications such as hemocholecyst.

关键词： Radiofrequency ablation Hepatocellular carcinoma Complication Case report Hepatitis B

Therapeutic plasma exchange and a double plasma molecular absorption system in the treatment of thyroid storm with severe liver injury: A case report

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World Journal of Clinical Cases 2019年第10期7卷 1184-1190页

作者： you-wen tan Li Sun Kai Zhang Li Zhu Department of Hepatology the Third Hospital of Zhenjiang Affiliated Jiangsu University

BACKGROUND Thyroid storm is resistant to conventional treatments including antithyroid drugs and 131I therapeutic *** exchange(PE)and double plasma molecular absorption system(DPMAS)can be used as an effective treatment for thyroid storm with severe liver *** SUMMARY A 52-year-old woman presented with a 10-day history of nausea and vomiting accompanied by yellowing of the skin and ***,her free T3(FT3)and FT4 levels were significantly elevated,whereas her thyrotropin level was *** admission,her condition continued to deteriorate,and she presented with continued high fever,vomiting,palpitation,and shortness of *** being diagnosed with thyroid storm,the patient was immediately treated with PE combined with *** symptoms improved *** three PE+DPMAS treatments,and she was discharged from the *** was treated with methylprednisolone and *** six months,the patient spontaneously discontinued methylthimidazole *** previous clinical manifestations and liver dysfunction *** patient was treated with PE+DPMAS two times,and her condition rapidly *** histopathology indicated immunological liver *** Our experience suggests that PE combined with DPMAS can effectively relieve the development of thyroid storm.

关键词： Plasma exchange Thyroid storm Immunological liver injury Case report

Double plasma molecular adsorption system for Stevens–Johnson syndrome/toxic epidermal necrolysis:A case report

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World Journal of Clinical Cases 2024年第7期12卷 1371-1377页

作者： you-wen tan Li-Ping Liu Kai Zhang Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212003Jiangsu ProvinceChina

BACKGROUND Stevens–Johnson syndrome and toxic epidermal necrolysis(SJS/TEN)are very serious skin allergies,with an etiology related to infections and *** the coronavirus disease 2019(COVID-19)pandemic,severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/*** SUMMARY We report the case of a woman in her thirties who took acetaminophen after contracting *** 3 d of fever relief,she experienced high fever and presented with SJS/TEN symptoms,accompanied by intrahepatic *** days of corticosteroid treatment did not alleviate the skin damage;therefore,double plasma molecular adsorption system(DPMAS)therapy was initiated,with treatment intervals of 48 *** skin symptoms improved gradually and were resolved after seven DPMAS *** DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators(e.g.,tumor necrosis factor-alpha and interleukin-10 and-12)speculated to be involved in the pathology of the skin conditions.

关键词： Stevens-Johnson Toxic epidermal necrolysis COVID-19 Double plasma molecular adsorption system SARS-CoV-2 Case report

Rare spontaneous intrahepatic portosystemic shunt in hepatitis Binduced cirrhosis: A case report

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World Journal of Clinical Cases 2019年第17期7卷 2573-2579页

作者： you-wen tan Jian-Hui Sheng Hui-Ying tan Li Sun Yu-Mei Yin Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu University

BACKGROUND The portosystemic shunt is the pathway between the portal vein (PV) and systemic circulation.A spontaneous intrahepatic portosystemic shunt (SPISS) is a rare portosystemic shunt *** we report an extremely rare type of SPISS,a spontaneous intrahepatic PV-inferior vena cava shunt (SPIVCS).CASE SUMMARY A 66-year-old woman was admitted to our hospital with the complaint of abdominal distention and a decreased appetite for 1 *** patient had a 20- year history of hepatitis B surface antigen positivity and a 5-year history of *** had been treated with Chinese herbal medicine for a long *** function tests showed: alanine aminotransferase,35 U/L;aspartate aminotransferase,42 U/L;serum albumin (ALB) 32.2 g/L;and serum ascites ALB gradient,25.2 g/*** ultrasonography and enhanced computed tomography showed that the left branch of the PV was thin and occluded;the right branch of the PV was thick and showed a vermicular dilatation vein cluster in the upper pole of the right kidney that branched out and converged into the inferior vena cava from the bare area of the lower right posterior lobe of the *** diagnosed her with an extremely rare SPIVCS caused by portal hypertension and provided symptomatic treatment after *** week later,her symptoms disappeared and she was *** SPIVCS is a rare portosystemic shunt with a clear history of cirrhosis and portal *** the type PV shunt has important clinical significance.

关键词： Spontaneous Intrahepatic Portosystemic shunt Cirrhosis Case report

Establishment of a risk assessment score for deep vein thrombosis after artificial liver support system treatment

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World Journal of Clinical Cases 2021年第31期9卷 9406-9416页

作者： Yun Ye Xiang Li Li Zhu Cong Yang you-wen tan Department of Hepatology The Third Hospital of Zhenjiang Affiliated Jiangsu UniversityZhenjiang 212000Jiangsu ProvinceChina

BACKGROUND The artificial liver support system(ALSS)is an effective treatment method for liver failure,but it requires deep venous intubation and long-term indwelling ***,the coagulation mechanism disorder of basic liver failure diseases,and deep venous thrombosis(DVT)often *** To evaluate the risk factors for DVT following use of an ALSS and establish a risk assessment *** This study was divided into three *** the first stage,the risk factors for DVT were screened and the patient data were collected,including ALSS treatment information;biochemical indices;coagulation and hematology indices;complications;procoagulant use therapy status;and a total of 24 *** the second stage,a risk assessment score for DVT after ALSS treatment was *** the third stage,the DVT risk assessment score was *** A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage,including 12 with lower limb *** regression analysis showed that age[odds ratio(OR),1.734;P=0.01],successful catheterization time(OR,1.667;P=0.005),activity status(strict bed rest)(OR,3.049;P=0.005),and D-dimer level(≥500 ng/mL)(OR,5.532;P<0.001)were independent risk factors for *** then established a scoring system for risk *** the validation group,a total of 213 patients with liver failure were treated with ALSS,including 14 with lower limb *** the cutoff value of risk assessment was 3,the specificity and sensitivity of the risk assessment score were 88.9%and 85.7%,*** A simple risk assessment scoring system was established for DVT patients with liver failure treated with ALSS and was verified to have good sensitivity and specificity.

关键词： Artificial liver support system Deep vein thrombosis Liver failure Risk factors Thrombosis