Search PubMed⌕ Search

Biomedical subjects

F Ramalho

Publications and source records attributed to F Ramalho.

30 records · Page 2Linked to original sources

Increased stable E rosette-forming cells in alcoholic liver disease.

Circulating total E rosette-forming cells (E-RFC) and stable E-RFC (activated T cells) were studied in 10 patients with alcoholic hepatitis (AH), 15 with alcoholic cirrhosis (AC) and 20 normal controls. Total E-RFC were significantly reduced in AH and AC as compared to the controls. By contrast, both proportions and absolute numbers of stable E-RFC were significantly increased in AH and AC, the increase was greatest in AH. These findings represent evidence for abnormalities in T cell subpopulations in alcoholic liver disease and suggest that monitoring stable E-RFC may prove useful in assessing disease activity in AH.

Hepatitis, Alcoholic↗

Active E rosette-forming cells in the peripheral blood of patients with chronic active hepatitis.

E rosette-forming cells (E-RFC) and active E-RFC were studied in the peripheral blood in patients with chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and in control subjects. A significant reduction in active E-RFC (a subpopulation of T lymphocytes considered actively involved in cell-mediated immune reactions) was found in patients with untreated CAH, both HBSAg positive or negative. In contrast, patients with immunosuppressive-treated CAH showed an increased relative number of active E-RFC. A significant increase in active E-RFC was demonstrable in other immunosuppressive-treated chronic inflammatory disorders. In CPH active E-RFC were not different from normal controls. The number of E-RFC showed a relative and absolute decrease in both CPH and untreated CAH. These studies demonstrate an increase in active E-RFC in immunosuppressive-treated CAH and suggest that prednisone and azathioprine may have a differential effect on T lymphocyte subpopulations.

Adolescent↗

Autoimmune cholangitis: case report.

We report on 2 patients who showed mixed signs of primary biliary cirrhosis and autoimmune hepatitis. Both patients were female, in their fifties (54 and 58), their laboratory tests indicated cholestasis, and a liver biopsy revealed liver cirrhosis with significant lesions of the bile ducts. Both were treated with prednisolone with their liver tests showing a rapid normalization of their aminotransferases. These patients can be considered as presenting with what is known as the overlap syndrome or autoimmune cholangitis, which has the clinical, biochemical, immunological, and histopathological characteristics of primary biliary cirrhosis and autoimmune hepatitis type I.

Biopsy↗

[Autoimmune cholangiopathy].

We report two patients with mixed characteristics of primary biliary cirrhosis and autoimmune hepatitis. They are two female patients in their fifties (54 and 58 years-old) one of them with autoimmune phenomenon, rheumatoid arthritis and Sjögren syndrome. Both of them showed laboratory values of cholestasis and the liver biopsy revealed liver cirrhosis with significant lesions of the bile ducts. They were treated with prednisolone with a rapid improvement and normalisation of their blood tests. They belong to a group called as overlap syndrome or autoimmune cholangitis with mixed characteristics, clinical, biochemical, immunological, and histopathologic overlapping between primary biliary cirrhosis and autoimmune hepatitis type I.

Autoimmune Diseases↗

[Viral infections in intravenous drug addicts. Clinical and prognostic significance].

A retrospective analysis of 135 drug addicts followed between 1986 to 1987, was done, in order to asses the seroprevalence of hepatitis B virus (HBV), hepatitis Delta virus (HDV), hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV), as also their clinical and prognostic significance. A high prevalence of HBV, HDV and HCV infection was observed in this study: 81%, 64% and 83% respectively; in contrast just one case was positive for HIV. Among the drug addicts the frequency of multiple infections (HBV/HCV 51.6%; HBV/HDV/HCV 18.7%; HBV/HDV 2.2%; HCV/HIV 1.1%) was highest in comparison with isolated (HBV 5.5%; HCV 12.1%) or absent infection (73.6% vs 17.6% vs 8.8% respectively; p less than 0.001). Eleven of 12 (92%) patients with Delta hepatitis and HCV superinfection were seronegative for IgM anti-HD; in contrast the case without HCV superinfection was IgM anti-HD positive. In the former group the Alanine Amino-transferases (ALT) were significantly lower comparatively with those HBV positive patients superinfected by HCV (97 +/- 92 IU/L vs 249 +/- 125 IU/L; p = 0.001), and were not different from drug addicts with isolated HCV infection (62 +/- 49 IU/L). The results of this study indicate, a low prevalence of HIV infection in the Portuguese drug addicts and a high frequency of multiple HBV, HDV and HCV infection in the same period of study. Our observations suggest that HCV may have the capacity to inhibit the replication and pathogenic activity of hepatitis Delta virus.

Adolescent↗

[Therapy of chronic non-A, non-B hepatitis with recombinant interferon alfa and factors that influence the response to the treatment].

To assess the efficacy of therapy with alfa Interferon in chronic hepatitis C (NANB), 18 patients were enrolled in an open trial. Eleven were males and 7 females with a mean age of 43 years. Interferon alfa 2b was used in titrated doses for 9 months and the treatment was started with 5 m.U./Ti. During therapy, the patients were evaluated clinically and biochemically. A liver biopsy was done within 3 months after the completion of treatment. The serum alanine aminotransferase (ALT) level 1 became completely normal in 11 patients (61%) at 3 months of therapy and a partial response was seen in 3 (16%). At the 6 months the ALT sustained normal in 10 patients (55%) and a partial response was seen in 5 (27.7%). Four out of 7 patients (57%) who completed the therapy had complete response and 2 (28.5%) a partial response. From 5 patients who completed the follow-up, 3 (60%) had a relapse of ALT levels. A low level of ALT at the beginning of treatment had a predictive value of response to the therapy (P less than 0.05). The side effects of interferon therapy were usually mild. Fever, myalgias and headaches were seen in 72% of patients in the first two weeks of therapy. No haematological alterations were seen. We conclude that a 9 month course of interferon therapy is effective in controlling disease activity in many patients with chronic NANB hepatitis. However, the high relapse rate suggest that future studies should establish the optimal dose and duration of treatment to induce a complete resolution of the disease.

Adult↗

[Prevalence of chronic hepatic disease in Portugal. Apropos of a review carried out in a hepatology unit].

UNLABELLED: The chronic elevation of Aminotransferases is one of the most frequent indications for percutaneous Liver Biopsy (LB). From a retrospective study of LB performed in the Hepatology liver Unit of Santa Maria Hospital, between 1989 and 1993, we correlated the histologic diagnosis with the etiology of liver disease, sex, age and the Aspartate aminotransferase/Alanine aminotransferase (AST/ALT) and Gama-Glutamyl transpeptidase (gamma GT) index in patients with chronic liver test abnormalities. 790 LB were reviewed retrospectively, of patients aged between 11 and 78 years, 68% males and 32% females. The most common etiology was Hepatitis C (34.6%), followed by Hepatitis B (20.1%) and alcohol (15.8%). Autoimmune diseases (Primary Biliary Cirrhosis and Autoimmune Hepatitis) were present in 3% of cases, and metabolic liver diseases in 1.4%. The distribution by sex revealed a predominance of Hepatitis C in both, alcoholic liver disease being more frequent in males (21.5% vs 3.9%). The main histological diagnoses were Chronic Active Hepatitis (27.2%), Liver Cirrhosis (19.5%), Steatohepatitis (9.5%) and minor lesions (24.6%). In alcoholic liver disease, 47.2% had Liver Cirrhosis and 16% Steatohepatitis; in Hepatitis B, Liver Cirrhosis was found in 12.6% and in Hepatitis C in 11.4%. Liver Cirrhosis had a prevalence between the 4th and 6th decade of life (82%) with a peak incidence in the 5th, and appeared earlier in Hepatitis B and later in Hepatitis C. The prevalence between sexes was similar. The main etiology of Liver Cirrhosis was alcohol (38.3%). The gamma GT index was greater in alcoholic liver disease (average 4.1) and was nearly twice in Hepatitis C than in Hepatitis B (1.7 vs 0.8). CONCLUSIONS: 1) Hepatitis C in our Hepatology Unit was the main indication for Liver biopsy. 2) The prevalence of alcoholic liver disease is greater in males, being the main etiology of Liver Cirrhosis. 3) The progression to Liver Cirrhosis seems to be similar in Hepatitis B and C. 4) The progression to Liver Cirrhosis is similar in both sexes, being dominant in the 5th decade of life. 5) The progression to Liver Cirrhosis is earlier in Hepatitis B than in Hepatitis C. 6) A gamma GT index elevation, without alcohol abuse, is suggestive of Hepatitis C. 7) Autoimmune and metabolic liver diseases seem to be rare in Portugal.

Adult↗

[Infection with hepatitis C virus in porphyria cutanea tarda].

The authors make a literature review on hepatitis C virus infection in porphyria cutanea tarda, illustrated by one clinical case. They also present some considerations about pathophysiologic mechanisms involved in this association.

Diagnosis, Differential↗

Diphenylhydantoin-induced hepatitis: a case report.

This case report is of a 25-year old man with severe diphenylhydantoin-induced hepatitis, fever, rash and generalized lymphadenopathy. Hepatic histology and lymphocyte transformation tests strongly supported the diagnosis. He made an uneventful recovery with supportive therapy.

Adult↗