[Giant cell hepatitis of benign evolution in adults].
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Biomedical subjects
Publications and source records attributed to E Dussaix.
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To determine the prevalence of antibodies to hepatitis C virus (HCV) and the short-term evolution of HCV infection in children undergoing orthotopic liver transplantation, we retrospectively studied the sera and medical records of 149 children surviving from 9 months to 5 years after OLT. Fourteen children (9.4%) were found to be positive for anti-HCV with second-generation ELISA and RIBA tests. They were individualized in 2 distinctive groups. In 5 children, anti-HCV was present before OLT, and in 1 patient only HCV RNA was detected at that time. All 6 patients were positive for anti-HCV after OLT. In the other 8 children, anti-HCV and HCV RNA were only detected after OLT and likely reflect infection during or shortly after OLT. The antibody reactivities against the 3 antigens included in the second-generation RIBA test varied in a given patient throughout follow-up and between these 2 groups of children. In all patients, serum transaminase (ALT) activities returned to normal levels when prednisone therapy was lowered and given every other day. These results indicate that the search for HCV infection in these children is necessary in the differential diagnosis of other liver complications in order to avoid excessive immunosuppressive treatment.
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Seventeen patients with presumed chronic herpetic uveitis of all anatomic types underwent systemic treatment with oral and/or intravenous, acyclovir. The diagnosis of herpes had been established on data from serological tests of the aqueous humor. Results were judged according to corticodependance and visual acuity. Results were all the more positive as treatment was more prolonged and also correlated with the dose of acyclovir injected intravenously or taken orally every day. Follow-up ranged from 6 months to several years.
The role of neurotropic virus in the etiopathogeny of uveitis is being emphasized by recent findings. Serology of aqueous humor is the first step towards the diagnosis since it indicates in many cases a local production of specific antibodies. Different entities seem to correspond to different viral specificities. The relationship between measles virus and multiple sclerosis may be one of the most fascinating aspects of this problem.
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Some viral infections, such as rubella, cytomegalovirus and parvovirus B 19 infections or varicella, are particularly feared in pregnant women in view of the risk of foetal infection. Laboratory tests play an important role since there is no other way of diagnosing the infection and determining whether it is primary or secondary, a distinction which to a great extent conditions the severity of the foetal disease. However, no virological diagnosis can be made unless the examinations needed are prescribed correctly and at the right moment. The diagnosis of rubella is now well codified, but that of CMV infection still suffers from interpretation problems and that of parvovirus B 19 infection can only be obtained from specialized laboratories. The application of rapid diagnostic methods and molecular biology to foetal specimen collected under ultrasonography should provide a more accurate prenatal diagnosis of congenital viral infections.
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7 cases of multifocal choroiditis and panuveitis are reported here (6 females, 1 male). All clinical data were carefully considered. In all cases an aqueous sampling was made for the detection of anti-herpes virus antibodies in aqueous and serum. 3 specificities were tested: herpes simplex (HSV), herpes zoster (HVZ) and cytomegalovirus (CMV). An intraocular synthesis of specific antibodies was found against VZV in 2 cases and against HSV in 1 case. There was another presumptive case for HSV.
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Clinical data and histopathologic report of the association of a retinal malignant lymphoma and acute retinal necrosis. Demonstration of virus particle and vitreous herpetic antibodies.
From November 1985 to August 1987, 22 children underwent orthotopic liver transplantation (OLT). Primary cytomegalovirus (CMV) infection was observed in 3 of 10 seronegative recipients (30%). It was severe in 2 cases, which were treated successfully by a combination of DHPG and CMV hyperimmune globulin. From September 1987 to August 1988, a virologic survey was undertaken. It enabled us to take prophylactic measures and to make an early diagnosis of CMV infection, permitting early antiviral treatment. During this period, 26 children received liver grafts. Nine of 13 seronegative recipients (69, 2%) developed primary CMV infection. Seven had received immunoprophylaxis and 8 were treated by DHPG. None had severe disease and all improved rapidly.
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