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Biomedical subjects

V G Levy

Publications and source records attributed to V G Levy.

At least 19 recordsLinked to original sources

Hyperthyroidism in two patients with Crohn disease and Takayasu arteritis.

Thyroid abnormalities and Takayasu arteritis (TA) have been reported separately in patients with Crohn disease (CD). We report two patients with hyperthyroidism, CD and Takayasu arteritis and discuss hypothetical mechanisms. Case 1. A thyrotoxic goiter was diagnosed in 1987 in a 34-year-old woman treated since 1969 for severe CD and TA. Iodine urinary excretion was 405 microg/mL (20-500). Anti-thyrotropin receptor (TRAK) and anti-thyroid antibodies were not detectable. The ultrasonography showed a nodule in the right lobe of the thyroid and two nodules in the left lobe. A 123I thyroid scan showed a multinodular goiter with no hot nodule. She was treated successfully with propylthiouracile until 1991, when a new episode of thyrotoxicosis led to a subtotal thyroidectomy. Case 2. Hyperthyroidism was diagnosed in February 2000 in a 49-year-old woman treated for CD and TA, both diagnosed in 1980. TRAK and anti-thyroid peroxydase antibodies were not detectable. The ultrasonography disclosed a normal thyroid volume with an inhomogeneous parenchymal structure and nodular images in both lobes. A 123I thyroid scan showed one hot nodule in the lower part of each lobe. A subtotal thyroidectomy was performed. The association of these three diseases may not be fortuitous, possibly explained by genetic predisposing factors and disease-related iodine deficiency both involving Nuclear Factor kappaB pathway.

Adult↗

Liver disease from surreptitious administration of urethane.

We report subacute necrosis, peliosis hepatis, venoocclusive disease and hepatic angiosarcoma after long-term administration of urethane. We take this to be the 12th case of urethane-induced hepatitis and the first associated with vascular liver tumor.

Chronic Disease↗

Low early gallstone recurrence rate after successful extracorporeal lithotripsy in patients with solitary stones.

Piezoelectric lithotripsy with the EDAP LT-01 machine combined with adjuvant bile acid therapy results in complete clearance of radiolucent gallstones in selected patients. We assessed stone recurrence rate in 84 patients with complete clearance of stone fragments and followed up at least 12 months after cessation of bile acid therapy (mean 17 months, range 12-33). Fifty-four patients had a solitary stone and 30 multiple stones. Bile acid therapy was continued for 3 months after complete fragment stones clearance which was ascertained by two consecutive ultrasound examinations. Stone recurrence was assessed by ultrasonography at 6 and 12 months, and then at least once a year. Gallstone recurrence occurred in 5 patients (6%) between 9 and 12 months with no further recurrence up to 33 months. The rate of recurrence at one year was 3.7% in patients with a solitary stone and 10% in patients with multiple stones. Only one patient with stone recurrence had recurrent biliary pain. We concluded that early gallstone recurrence rate after successful lithotripsy seems to be low in patients with solitary stones.

Adolescent↗

[Acute hepatitis caused by wild germander. Hepatotoxicity of herbal remedies. Two cases].

While interest in herbal therapy is clearly increasing in Western countries, there are few available data about hepatotoxicity of herbal remedies. We report on two women who had severe acute hepatocellular liver injury occurring within one to two months of treatment with Wild Germander (Teucrium chamaedrys L.), a herbal medicine for losing weight. Clinical course was favorable after the treatment was discontinued. Involuntary rechallenge in one case resulted in reappearance of symptoms of liver injury. When a patient presents with unexplained hepatic abnormalities, it may be worthwhile to consider non-orthodox self-treatment with herbal remedy as a potential cause. Only systematic observation will provide a clear picture of the incidence of liver injury caused by herbal medicines.

Acute Disease↗

[Interferon alpha-2a treatment of 26 patients with chronic non-A non-B hepatitis. Predictive factors of response].

The type and predicting factors of response to alpha interferon therapy have been studied in 26 patients with chronic non-A non-B hepatitis. Interferon was administered three times weekly during 6 months at a dose of 3 millions units/day. Eleven patients (42 percent) had serum alanine aminotransferase levels below 1.5 times the upper limit of normal range at the end of treatment. Only eight (31 percent) patients had persistent normalization of seric alanine aminotransferase value, 6 months after the end of the interferon treatment. The main factors involved in the response to therapy were age, apparent duration of the disease, and mode of contamination: patients who responded to interferon were younger, had a shorter duration of hepatitis and a parenterally transmitted disease.

Adolescent↗

[Chylous ascites in adults: etiological, therapeutic and prognostic aspects. Apropos of 35 cases].

Chylous ascites is a rare disease which often poses difficult problems in diagnosis and management. We reported a series of 35 patients with chylous ascites, seen between 1976 and 1989. Diagnosis of chylous ascites was made on: (1) a milky appearance of ascites; (2) an ascitic concentration of triglycerides higher than in serum and higher than 1.5 mmol/l. Incidence was about 1/8 850 admissions. Cancers (mainly lymphomas and abdominal carcinomas), cirrhosis and retroperitoneal surgery accounted for more than 90 p. cent of cases. In all cases of cancer the tumor was extensive, and the prognosis was poor with a one year mortality rate of 80 p. cent. The two postoperative chylous ascites without cirrhosis were cured, after treatment with medium chain triglycerides in one case, and surgical repair in the other case. Chylous ascites in cirrhosis, spontaneous or after porto-systemic shunt, became refractory in 13 of 15 patients, and the one year mortality rate was high (69%).

Adult↗