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Evaluation of intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis

World Journal of Gastroenterology 2020年第29期26卷 4302-4315页

作者： Tilmann Graeter Hai-Hua Bao Rong Shi Wen-Ya Liu Wei-Xia Li Yi Jiang Julian Schmidberger Eleonore Brumpt Eric Delabrousse Wolfgang Kratzer Department of Diagnostic and Interventional Radiology University Hospital UlmUlm 89081Germany Qinghai University Qinghai University First Affiliated HospitalXining 810001Qinghai ProvinceChina University First Affiliated HospitalWHO Collaborating Centre on Prevention and Care Management of EchinococcosisUrumqi 830054Xinjiang Uyghur Autonomous RegionChina Department of Internal Medicine I University Hospital UlmUlm 89081Germany WHO Collaborating Centre on Prevention and Treatment of Human Echinococcosis/National French Reference Centre for Echinococcosis University Bourgogne Franche-Comtéand Besançon University HospitalBesançon 25030France

BACKGROUND The main endemic areas of alveolar echinococcosis(AE)are in Central Europe and Western *** the infiltration of intrahepatic vascular and bile duct structures as well as extrahepatic disease can lead to further complications and may increase morbidity in patients with *** To evaluate vascular/biliary involvement in hepatic AE and its distant extrahepatic disease manifestations in an international collective was the *** Consecutively,five experienced examiners evaluated contrast-enhanced abdominal computed tomography(CT)scans for 200 patients with hepatic AE of each of four locations(n=50)in Germany,France and ***,we retrospectively included the 50 most recent abdominal contrast-enhanced CT examinations at each center,performed because of hepatic AE from September 21,2007 to March 21,*** liver lesions were classified according to the echinococcosis multilocularis Ulm classification for CT(EMUC-CT).Distant extrahepatic manifestations were documented either by whole body positron emission tomography–CT or with the addition of thoracic CT and cranial magnetic resonance ***/biliary involvement of the hepatic disease as well as the presence of distant extrahepatic manifestations were correlated with the EMUC-CT types of liver *** analysis was performed using SAS Version 9.4(SAS Institute Inc.,Cary,NC,United States).RESULTS Distant extrahepatic AE manifestations were significantly more frequent in China than in Europe(P=0.0091).A significant relationship was found between the presence of distant extrahepatic disease and AE liver lesion size(P=0.0075).Vascular/biliary structures were involved by the liver lesions significantly more frequently in China than in Europe(P<0.0001),and vascular/biliary involvement depended on lesion *** morphological types of AE liver lesions led to varying frequencies of vascular/biliary involvement and were associated with different frequencies of distant extrahe

关键词： Alveolar echinococcosis Echinococcus multilocularis Echinococcus multilocularis Ulm classification for computed tomography Vascular/biliary involvement extrahepatic manifestation XUUB project

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extrahepatic manifestations of chronic hepatitis C virus infection：297 cases from a tertiary medical center in Beijing, China

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Chinese Medical Journal 2014年第7期127卷 1206-1210页

作者： Cheng Zhaojing Zhou Baotong Shi Xiaochun Zhang Yao Zhang Lifan Chen Limeng Liu Xiaoqing Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100730China Department of Nephrology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100730China

Background Chronic hepatitis C virus （HCV） infection can affect multiple organ systems and cause a variety of extrahepatic manifestations （EMs）.We sought to assess the constituent ratio of EMs in Chinese patients with chronic HCV infection and identify the clinical and biological factors associated with *** The medical records of 297 patients with chronic HCV infection were analyzed and demographic and epidemiological information was *** diagnosis of chronic HCV infection was based on positive anti-HCV combined with a positive HCV-RNA or at least two times of elevated aminotransferases attributable to HCV *** with HBV and/or HIV coinfection,autoimmune hepatitis,and history of alcohol abuse were *** Sixty-two percent （184/297） of the patients had at least one EM,including fatigue （29.4％）,type 2 diabetes mellitus （28.2％）,renal involvement （12.5％）,lymphadenopathy （9.6％）,fever （9.4％）,thyroid dysfunction （8.1％）,and arthralgia （7.4％）.Neuropathy,sicca syndrome,B-cell lymphoma,Raynaud＇s phenomenon,and lichen planus were *** mean age of patients with EM was older compared with those without *** EMs were common in Chinese patients with chronic HCV infection,particularly fatigue,type 2 diabetes,renal impairment,lymphadenophy,fever,and thyroid *** age was associated with EMs.

关键词： chronic hepatitis C extrahepatic manifestation thrombocytopenia cryoglobulinemia

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Development of multiple myeloma in a patient with chronic hepatitis C: A case report and review of the literature

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World Journal of Gastroenterology 2006年第14期12卷 2297-2300页

作者： Peter Laszlo Lakatos Sandor Fekete Margit Horanyi Simon Fischer Margit E Abonyi 1st Department of Medicine Semmelweis University Budapest Hungary Department of Hematology Szent Laszlo Hospital BudapestHungary Virus Laboratory OGYK BudapestHungary

An association between chronic hepatitis C virus （HCV） infection and essential mixed cryoglobulinaemia and non-Hodgkin lymphoma （NHL） has been suggested. However, a causative role of HCV in these conditions has not been established. The authors report a case of a 50 year-old woman with chronic hepatitis C （CHC） who has been fol- lowed up since 1998 due to a high viral load, genotype lb and moderately elevated liver function tests （LFTs）. Laboratory data and liver biopsy revealed moderate activity （grade： 5/18, stage： 1/6）. In April 1999, one-year interferon therapy was started. HCV-RNA became negative with normalization of LFTs. However, the patient relapsed during treatment. In September 2002, the patient was admitted for chronic back pain. ACT examination demonstrated degenerative changes. In March 2003, multiple myeloma was diagnosed （IgG-kappa, bone marrow biopsy： 50% plasma cell infiltration）. MRI revealed a compression fracture of the 5^th lumbar vertebral body and an abdominal mass in the right lower quadrant, infiltrating the canalis spinalis. Treatment with vincristine, adriamycin and dexamethasone （VAD） was started and bisphosphonate was administered regularly. In January 2004, after six cycles of VAD therapy, the multiple myeloma regressed. Thalidomide, as a second line treatment of refractory multiple myeloma （MM） was initiated, and followed by peginterferon-α2b and ribavirin against the HCV infection in June. In June 2005, LFTs returned to normal, while HCV-RNA was negative, demonstrating an end of treatment response. Although a pathogenic role of HCV infection in malignant lymphoproliferative disorders has not been established, NHL and possibly MM may develop in CHC patients, supporting a role of a complex follow-up in these patients.

关键词： HCV Multiple myeloma Non-Hodgkin Lymphoma extrahepatic manifestation

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