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Centrilobular necrosis in acute presentation of Japanese patients with type 1 autoimmune hepatitis

World Journal of Hepatology 2012年第9期4卷 262-267页

作者： Kazumichi Abe Yukiko Kanno Ken Okai Fumiko Katsushima Kyoko Monoe Hironobu Saito Atsushi Takahashi Junko Yokokawa Hiromasa Ohira Department of Gastroenterology and Rheumatology Fukushima Medical University School of Medicine1 HikarigaokaFukushima 960-1295Japan

AIM: To compare clinicopathological features of acute presentation of type 1 autoimmune hepatitis (AIH) with or without centrilobular necrosis (CN). METHODS: Our study comprised 41 patients with biopsy-proven acute presentation (acute exacerbation phase 36, acute hepatitis phase 5) of type 1 AIH at our hospital from 1975 to 2009. Elevated serum alanine aminotransferase (ALT) (> 5x upper limit of normal) identified acute presentation of the disease. We compared clinicopathological features of these AIH patients with or without CN. The data used for analysis included patient background (age, sex, type of disease, presence of complications with other autoimmune diseases, human leukocyte antigen, and International Autoimmune Hepatitis Group score), clinical parameters at presentation (ALT, alkaline phosphatase, IgG, anti-nuclear antibodies, and anti-smooth muscle antibodies), histology and therapy. RESULTS: CN was found in 13 (31.7%) patients with acute presentation (acute exacerbation phase 10, acute hepatitis phase 3) of AIH. Serum IgG levels of patients with CN were significantly lower than those of patients without CN (mean: 2307 mg/dL vs 3126 mg/dL, P acute hepatitis phase and acute exacerbation phase of type 1 AIH, although AIH with CN often

关键词： Autoimmune hepatitis Centrilobular necrosis acute presentation acute exacerbation phase acute hepatitis phase

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Losartan Induced Angioedema, a Rare Case Report and the Dilemma of Using Angiotensin II Receptor Blockers in Patients with Previous Angioedema with Angiotensin Converting Enzyme Inhibitors

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Open Journal of Emergency Medicine 2024年第3期12卷 69-76页

作者： Sayani Banerjee Abdul Sajjad Pathan Department of Emergency Medicine Weston General Hospital University of Bristol & Weston NHS Foundation Trust Weston Super Mare UK Department of Emergency Medicine Royal Surrey NHS Foundation Trust Guilford UK

Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.

关键词： Angioedema Airway Emergency acute presentation

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