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Biomedical subjects

A Cargnel

Publications and source records attributed to A Cargnel.

At least 73 records · Page 4Linked to original sources

Persistent elevation of the aminoterminal peptide of procollagen type III in serum of patients with acute viral hepatitis distinguishes chronic active hepatitis from resolving or chronic persistent hepatitis.

We measured the serum concentration of the aminoterminal propeptide of collagen type III (PIIIP) in 22 patients with acute viral hepatitis (19 hepatitis B, 3 hepatitis non-A, non-B). Nine patients showed persistent biochemical remission, 13 patients developed chronic active hepatitis (CAH); 6 of those underwent therapy with methylprednisolone and azathioprine. Thirteen patients with chronic persistent viral hepatitis (CPH) and 38 healthy individuals were also investigated. In the control group, PIIIP values were 9.5 +/- 2.25 ng/ml (chi +/- SD; range 4-14 ng/ml). All patients with acute hepatitis showed elevated PIIIP values (range 20-125 ng/ml). In the 9 patients with biochemical resolution, PIIIP normalized after a maximum of 6.5 months (range 7.5-14 ng/ml). In CAH, PIIIP was persistently elevated on the day of the diagnostic biopsy (range 15.6-35.7 ng/ml). In comparison, the patients with chronic persistent hepatitis showed a range of 5.0-15.4 ng/ml. Differences between controls and CAH and CPH/CAH were statistically highly significant (P less than 0.001). Treatment of patients with CAH by immunosuppression resulted in normal PIIIP values in 3 and persistently elevated values in 3. One additional patient had normal PIIIP after treatment with an increased dose of methylprednisolone of 16 mg p.d. Serum concentrations of PIIIP offer a non-invasive index for the development of chronic active hepatitis from acute viral hepatitis. This blood test may also be useful for monitoring immunosuppressive treatment in CAH.

Acute Disease↗

The significance of protein C antigen in acute and chronic liver biliary disease.

Protein C, a naturally occurring inhibitor of blood coagulation, was measured immunologically in 160 patients with acute and chronic liver and biliary disease. In 31 patients with acute viral hepatitis serially studied from admission to discharge from hospital, protein C antigen (PC:Ag) was low on admission in a high proportion of cases (61%) but became normal in 90% of them after two weeks at a time when the prothrombin time was still prolonged in 46% of the cases. PC:Ag was also low in 25 cirrhotic patients and in 20 patients with chronic active hepatitis. In chronic hepatitis and cirrhosis, PC:Ag levels significantly correlated with indexes of liver synthetic function. In primary biliary cirrhosis (n:40), PC:Ag was low in patients with advanced disease (stages III-IV) but high in the early phases, when cholestasis was not yet accompanied by impaired protein synthesis. PC:Ag was also very high in 20 patients with large bile duct obstruction and highly correlated with indexes of cholestasis. The authors' findings indicate that PC:Ag is reduced in liver disease proportionally to the impairment of the liver synthetic function and that its normalization after acute hepatitis might represent an early marker of recovery of this function.

Acute Disease↗

Mixed Schistosoma infection in an asymptomatic patient.

We report a case of a male, 26 years old Egyptian patient, who was investigated for a long-lasting hepatomegaly and altered transaminase levels. No symptom was reported. Liver biopsy and intestinal biopsy were positive for S. mansoni ova. Urine test initially showed negativity for S. haematobium ova, which only appeared with subsequent investigation, in spite of lack of urinary symptomatology.

Adult↗

Epidemiologic patterns of infection with the hepatitis B virus-associated delta agent in Italy.

To assess the epidemiology of infection with the delta agent associated with hepatitis B virus, sera from 1314 carriers of the hepatitis B surface antigen (HBsAg) and 687 patients with hepatitis B collected in 1978-1981 from different regions of Italy were tested for delta antigen and antibody to the antigen (anti-delta), and the characteristics of delta-positive patients were analyzed. Anti-delta was found in each center participating in the study, indicating that delta infection has spread throughout Italy. Its prevalence was higher in carriers in southern Italy and in those with chronic hepatitis. In northern Italy, delta infection predominated among southern emigrants in industrial towns but also among parenteral drug addicts with hepatitis B virus infection. The prevalence of delta markers was variable and generally low in acute hepatitis B, suggesting that in Italy self-limited forms of delta infection occur sporadically or by limited outbreaks. Delta infection appears to be endemic in southern Italy but a new epidemiologic event in northern Italy, where it was probably introduced by southern emigrants and is presently exceeding its ethnic confinement to spread selectively in communities of drug addicts. Presumably, the endemicity of delta is maintained by transmission of this agent from carrier to carrier of the HBsAg.

Adolescent↗

Sporadic acute non-A non-B hepatitis complicated by aplastic anemia.

A 19-year-old woman developed acute jaundice and abnormal liver tests showing acute viral hepatitis, presumably non-A non-B. The viral hepatitis, on the 4th day after admission, was complicated by aplastic anemia. Therapy with hydrocortisone promptly instituted was ineffective and a bone marrow transplantation was not possible because we could not find a compatible donor. Sixty-five days after admission the patient died of infection by Candida tropicalis. Postmortem examination showed total medullary aplasia with massive impoverishment of all the lymphatic structures and multiple fungal infarctions in the myocardium, lungs, spleen, kidneys, and liver.

Acute Disease↗

Influence of delta infection on severity of hepatitis B.

The prevalence of serum markers of primary delta infection was determined in 532 patients with acute benign hepatitis B seen in Italy, and in 111 patients with fulminant hepatitis B seen in Italy, France and England. Patients with fulminant hepatitis had significantly higher prevalence of delta markers (43/111, 39%) than did those with benign hepatitis (101/532, 19%). In 25 of the 43 patients with delta-positive fulminant hepatitis, serum markers indicated a primary hepatitis B infection while in the remaining 18, IgM antibody to hepatitis B core antigen was absent, indicating that hepatitis B preceded superinfection with the delta agent. The increased morbidity of HBsAg hepatitis with delta infection may result from the cumulative simultaneous exposure to hepatitis B virus and delta, or from superinfection of HBsAg carriers with delta.

Acute Disease↗

Blood T and B cells in patients with acute viral hepatitis A, B and non-A non-B.

We studied the blood distribution of T and B cells in relation to the etiology and the course of the hepatitis process, in 61 consecutive patients with acute viral hepatitis (AVH). Patients with acute viral hepatitis B showed a significant increase in total T, active T and SmIg cells, lasting the first two weeks of disease. These alterations disappeared in patients with resolving hepatitis. SmIg cells remained persistently elevated in the blood of three patients, who developed chronic hepatitis B. In patients with other types of viral hepatitis, lymphocytes were unaltered, with the exception of a transitory increase in SmIg cells, during the convalescence phase of hepatitis A. The finding that lymphocytes were activated exclusively in patients with acute hepatitis B, but not in those with other types of hepatitis, suggests that the mechanisms of liver injury in hepatitis B may differ from those involved in the pathogenesis of hepatitis A and nAnB.

Adolescent↗

A multicenter, prospective study of posttransfusion hepatitis in Milan.

We studied the risk of posttransfusion hepatitis in recipients of blood collected from volunteer donors who tested negative for HBsAg and had serum ALT levels less than 1.5 times the upper limit of the normal range. Between October, 1983 and September, 1984, 676 consecutive patients who needed blood or plasma transfusions during or after elective surgery, who had no history of liver disease and had never received blood previously, were studied. The patients were given a total of 4,813 (mean = 7) units. Ninety-six patients developed posttransfusion hepatitis, which yielded a hepatic incidence of 20 cases per 1,000 units of transfused blood. Ninety-two patients had non-A, non-B hepatitis, 3 had hepatitis B and 1 had cytomegalovirus infection. The incubation periods for non-A, non-B hepatitis ranged from 2 to 26 (mean = 9.5 +/- 4) weeks. In 68 (73%) patients, the hepatitis was completely asymptomatic; only 24 (27%) patients developed symptoms, including jaundice and hepatomegaly. There were no cases of fulminant hepatitis. Sixty per cent of the patients still had elevated serum ALT levels 1 year after the onset of hepatitis. The 96 patients with hepatitis had received a mean of 9.6 blood units, as compared to a mean of 6.7 units for the unaffected patients (p less than 0.001). This study demonstrated that non-A, non-B hepatitis remains a common and important complication of blood transfusion despite screening of blood donors for HBsAg and elevated serum ALT levels.

Adolescent↗

Cryoglobulinaemia in a patient with Proteus mirabilis sepsis.

Mixed polyclonal cryoglobulinaemia was evidenced in a 49-year-old woman admitted to our hospital because of Proteus mirabilis sepsis associated with polyarthralgia and purpuric manifestations on the lower limbs. Cryoglobulins and circulating immune complexes decreased during the second week of illness and disappeared after recovery. CH50, C3 and properdin factor B, which were low during the early phase of the illness, returned to normal; C4 was normal throughout. The rapid clearance of cryoglobulins and immune complexes and the restoration of a normal complement profile might all be explained by the gradual elimination of P. mirabilis due to chemotherapeutic treatment.

Complement C3↗

Attempted treatment of fulminant viral hepatitis with human fibroblast interferon.

Beta-interferon was administered by intravenous infusion to 16 patients affected with fulminant hepatitis B virus infection in third or fourth-grade coma. Ten patients presented a superinfection or a co-infection due to the delta (delta)-agent. None had detectable interferon (IFN) activity before therapy was begun. Besides fever, no significant side-effects were observed during treatment. Both the IFN-treated group as well as the "historical" control group, made up of 70 cases of fulminant virus hepatitis, not treated with IFN and observed during a previous ten year-period, received supportive therapy; survival rates were similar in both groups. Furthermore, the presence or absence of the delta-agent did not appear to affect survival rates significantly.

Adolescent↗