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Biomedical subjects

F Hardt

Publications and source records attributed to F Hardt.

At least 55 records · Page 3Linked to original sources

Diagnosis of Gilbert's syndrome. Reliability of the caloric restriction and phenobarbital stimulation tests.

The diagnostic role of the reduced caloric intake test and phenobarbitone treatment in Gilbert's syndrome was evaluated. During fasting the increase in unconjugated serum bilirubin concentration was significantly higher in patients with Gilbert's syndrome than in normal subjects but not when compared with the increase observed in patients with acute hepatitis, which is the clinically most relevant differential diagnosis. Phenobarbital treatment significantly reduced the level of unconjugated serum bilirubin in patients with acute hepatitis or Gilbert's syndrome, but without any difference within these two groups of patients. The reduced caloric intake test and phenobarbital treatment seem to have low diagnostic specificity in Gilbert's syndrome when the differential diagnosis is that of hepatitis. The fraction of plasma unconjugated bilirubin of total bilirubin was significantly different in all three groups examined. The clinical diagnosis of Gilbert's syndrome can be established with relative certainty if the patients have a mild hyperbilirubinemia with a high fraction of unconjugated bilirubin, normal values of liver enzymes, and no overt signs of hemolysis. Liver biopsy is not mandatory.

Acute Disease↗

Hepatitis B e antigen and antibody measured by radioimmunoassay in acute hepatitis B surface antigen-positive hepatitis.

The presence of the hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe) was studied by a solid-phase radioimmunoassay in 70 patients with acute hepatitis positive for hepatitis B surface antigen. HBeAg was found in 15 of 16 patients studied within two weeks after onset of symptoms. In total, 45 patients were found positive for HBeAg. The prevalence of this antigen declined constantly during the first 10 weeks after onset of symptoms. Chronic liver disease was demonstrated or suspected in 10 patients, including the five patients who had HBeAg for more than 10 weeks after onset of symptoms. In 33 patients with seroconversion from HBeAg to anti-HBe, 27 (82%) developed anti-HBe within two weeks after the clearance of HBeAg. Among the 58 patients who were or became HBeAg-negative, 53 (91%) had or developed anti-HBe. Thus HBeAg seems to be present regularly in early acute hepatitis B. The persistence of HBeAg may be of prognostic value for the development of a chronic carrier state with hepatitis B surface antigen and/or a chronic liver disease.

Adolescent↗

The expression pattern of hepatitis B e antigen and antibody in different ethnic and clinical groups of hepatitis B surface antigen carriers.

The presence of hepatitis B e antigen (HBeAg) and its antibody (anti-HBe) was studied in 249 asymptomatic carriers of hepatitis B surface antigen (HBsAg) of different ethnic origin and clinical course. Among male homosexuals, renal transplant recipients, and hemodialysis patients, > 90% were HBeAg-positive. In contrast, anti-HBe was present in > 85% of HBsAg-positive Danish pregnant women and blood donors. In presumably immunologically intact persons, significantly elevated levels of transaminases were found in the HBeAg-positive group as compared with the anti-BHe group (P < 0.0001). Among persons with Down's syndrome, males showed a tendency toward clearing of HBeAg and development of anti-BHe as compared with females. In Eskimos a correlation was found between presence of hepatitis B e markers, age of the HBsAg carrier, and geographic origin of the carrier. A similar age relationship was found in Vietnamese refugees. It is proposed that in the general population a correlation may exist between the prevalence of HBsAg carriers and the percentage of HBeAg-positive HBsAg carriers.

Adolescent↗

The role of acute hepatitis type A, B, and non-A non-B in the development of chronic active liver disease.

In 19 patients followed from biopsy-verified acute viral hepatitis to chronic active liver disease and 74 patients followed to complete resolution verified by a normal liver biopsy, sera from the acute phase were studied for serologic evidence of hepatitis type A and B. Eleven of the 19 patients who developed chronic active liver disease progressed from acute hepatitis type B and 7 from acute hepatitis type non-A non-B. One patient could not be classified because the sera were exhausted. None had serological markers of actual hepatitis type A infection. Of the 74 patients with a histologically complete resolution, the acute episode could be classified as type B hepatitis in 47 and type A hepatitis in 13 patients. The remaining 14 patients were classified as having acute viral hepatitis type non-A non-B. Our findings confirm that type B and non-A non-B hepatitis may give rise to chronic liver disease, whereas type A hepatitis so far has not been demonstrated to initiate a chronic liver disease.

Age Factors↗

Circulating autoantibodies in patients with acute viral hepatitis. Relation to etiology and clinical course.

The prevalences of liver-cell-membrane antibody (LMA), smooth-muscle antibodies, antinuclear antibodies and antimitochondrial antibodies were evaluated in 63 selected patients with acute viral hepatitis of types A, B, and non-A non-B. Twenty patients had a complete, uneventful recovery, 19 patients had fulminant hepatitis, and 24 progressed to a chronic liver disease. Acute-phase and follow-up sera from all patients were tested for antibodies of IgA, IgM, and IgG class. The prevalences of the IgM autoantibodies in the acute-phase sera were not significantly different in the three groups irrespective of clinical outcome. Similar prevalences were found with respect to IgG class; however, antinuclear antibodies of IgG class were predominantly found in acute-phase sera from patients who later progressed to a chronic liver disease. The diagnostic significance of these autoantibodies was stressed by the fact that 85% of the sera with LMA of IgG class and 100% of the follow-up sera with smooth-muscle antibodies of IgG class at a titer at or above 1:128 originated from patients with chronic liver disease. A similar pattern was found for antinuclear antibodies, and testing for all these antibodies of IgA anad IgM class did not yield any further information. In some serum samples LMA could be found independently of smooth-muscle antibody and vice versa, indicating the essential difference between these two autoantibodies.

Acute Disease↗

Human leucocyte antigens in patients with alcoholic liver cirrhosis.

No significant differences in the frequencies of HLA-B8, -B40, and other HLA-A, -B, and -C phenotypes were found among patients with histologically verified alcoholic cirrhosis compared with normal controls when the p values were multiplied by the number of comparisons. This was found both in the present study of 45 patients and in the combined data of this and three other similar studies. However, these findings do not rule out that alcoholic cirrhosis might be associated with HLA factors (for example. HLA-D/DR antigens) controlling immune responses.

Adult↗

Acute non-A, non-B hepatitis--clinical, epidemiological and histological characteristics.

Among 73 consecutive patients with biopsy documented acute non-toxic hepatitis, half of the patients (49%) had acute type B hepatitis, while 27 patients (37%) had acute type A infection. One patient had a significant rise in antibodies against cytomegalovirus. The remaining 10 patients (14%) fulfilled the criteria of hepatitis type non-A, non-B. The main type of exposure for hepatitis A was visit to endemic hepatitis areas (41%), and for type B it was drug addiction (46%). Half of the patients with hepatitis non-A, non-B had no known hepatitis exposure while some had visited endemic hepatitis areas or were drug addicts. The patients with non-A, non-B hepatitis had significantly less biochemical changes as compared to the patients with hepatitis B. In contrast, the histological findings showed the greatest activity in the biopsies from patients with hepatitis B and non-A, non-B. Follow-up liver biopsies in half of the patients with non-A, non-B hepatitis showed no signs of chronic active liver disease. It is concluded that hepatitis type non-A, non-B is a significant problem in Denmark.

Acute Disease↗

Immunoglobulin-bearing cells in the liver biopsies from patients with psoriasis.

Sections of liver tissue from 41 patients with psoriasis were examined histologically and by immunofluorescence microscopy to detect cells bearing the immunoglobulins IgG, IgA or IgM. Two patients with non-specific, reactive hepatitis and two with cirrhosis had more numerous immunoglobulin-bearing cells, while no correlation was found between the number of immunoglobulin-bearing cells and 1) other types of abnormal liver histology, 2) lymphocytic infiltrates in the liver, or 3) methotrexate therapy.

Adolescent↗

Alcohol-induced brain damage and liver damage in young males.

37 alcoholic males under the age of 35 were examined clinically, by psychometric tests, by computerised tomography (CT scans), and by liver biopsy. Factors other than alcoholism that might have caused brain damage were excluded. The prevalence of brain damage in this group was far greater than that of severe liver damage: 59% were intellectually impaired and 49% had cerebral atrophy on CT scan, whereas only 19% had cirrhosis. There was no significant correlations between the degree of liver damage and the degree of intellectual impairment (p greater than 0-05), nor between the degree of intellectual impairment and the presence of cerebral atrophy. The CT scan is an inadequate measure of functional brain damage, psychometric testing is preferable. Other neurological complications of alcoholism were not impressive. Disabling intellectual impairment may be the earliest complication of chronic alcoholism and may arise early in the alcoholic career.

Adult↗

Hepatitis B virus infections among Danish surgeons.

Acute viral hepatitis B is considered to be an occupational risk to health-care workers worldwide. At the 1977 annual meeting of the Danish Society of Surgeons, 224 participants were examined for the presence of hepatitis B surface antigen (HGsAg) and antibody to HBsAg (anti-HBs) with use of a radioimmunoassay. None of the surgeons was HBsAg-positive, but 23% had anti-HBs. The prevalence of anti-HBs was five times higher among these surgeons than that in an age-matched control population. Hepatitis acquired during occupation as a surgeon was predominantly of type B, in contrast to hepatitis acquired before entering the surgical profession. Danish surgeons must be regarded as a group at high risk of hepatitis B infection.

Adult↗

Long-term follow-up of e-antigen (HBeAg)-positive acute viral hepatitis.

Eighteen consecutive patients with HBeAg in serum and histologically verified acute viral hepatitis were included in a follow-up study of the natural course of the disease. Five patients were followed up for from 2 to 6 months. Two of these healed clinically and cleared both HBeAg and HBsAg, while three were positive for HBeAg and HBsAg at the last control. Thirteen patients with a follow-up of from 27 to 102 months became HBeAg-negative during the time of observation. In all but one, progression of the liver disease stopped when HBeAg was cleared. The results further indicate a close association between the duration of HBe antigenemia and the severity of the liver disease.

Acute Disease↗

Epidemiology and clinical characteristics of acute hepatitis types A, B, and non-A non-B.

A consecutive series of 115 patients hospitalized with acute viral hepatitis in Copenhagen was studied for serological markers for hepatitis A and B virus. Thirty-nine patients had type B, 66 had type A, 3 had both type A and B, and 7 had type non-A non-B. Of the patients 81% were between 15 and 40 years of age, and there was a dominance of males due to an overrepresentation of homosexual males (30%) in both the A and B group. The main type of exposure to hepatitis type A was travel to foreign countries (53%), and for type B it was drug addiction (41%). In types A and B the duration of jaundice was positively correlated to the age of the patients but did not vary with sex or type of exposure. There was no difference in maximum alanine aminotransferase levels between the groups, but maximum bilirubin levels were lower for the type A group. Patients with hepatitis type A had a higher level of IgM than those with type B and with type non-A and non-B. We conclude that both clinically acute hepatitis type A and type B occur mainly in young adults and that foreign travel, drug addiction, and homosexuality increase the risk of getting acute hepatitis.

Acute Disease↗

Immunofluorescence studies for hepatitis A virus and hepatitis B surface and core antigen in liver biopsies from patients with acute viral hepatitis.

Immunofluorescence studies for hepatitis A virus and hepatitis B surface and core antigen were performed on liver biopsies from 48 patients with acute viral hepatitis. Hepatitis A virus was detected in 11 out of 17 patients with type A hepatitis and was not found in patients with type B or non-A non-B hepatitis. Hepatitis B surface and core antigens were detected in 2, hepatitis B core antigen alone in 1, and hepatitis B surface antigen alone in 4 out of 24 patients with type B hepatitis. Neither hepatitis B surface nor core antigen were found in patients with type A or non-A non-B hepatitis. One patient with both type A and B hepatitis were all negative for hepatitis A virus, and hepatitis B surface and core antigens. Immunofluorescence examination for hepatitis A virus in human liver biopsies appears to be a sensitive and specific technique and might be valuable in the search for possible chronic carriers of hepatitis A virus.

Adult↗