Autoimmune hepatitis (AIH) is a disease of unknown etiology,its hallmark being ongoing hepatic inflammation.By its very nature,it is a chronic condition,although increasingly,we are becoming aware of patients with acu...Autoimmune hepatitis (AIH) is a disease of unknown etiology,its hallmark being ongoing hepatic inflammation.By its very nature,it is a chronic condition,although increasingly,we are becoming aware of patients with acute presentations,some of whom may have liver failure.There are very limited published data on patients with AIH with liver failure at initial diagnosis,which consist mostly of small retrospective studies.As a consequence,the clinical features and optimal management of this cohort remain poorly defined.A subset of patients with AIH who present with liver failure do respond to corticosteroids,but for the vast majority,an urgent liver transplantation may offer the only hope of long-term survival.At present,there is uncertainty on how best to stratify such a cohort into responders and non-responders to corticosteroids as soon as possible after hospitalization,thus optimizing their management.This editorial attempts to answer some of the unresolved issues relating to management of patients with AIH with liver failure at initial presentation.However,it must be emphasized that,at present,this editorial is based mostly on small retrospective studies,and it is an understatement that multicenter prospective studies are urgently needed to address this important clinical issue.展开更多
Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to be specific for the gene enc...Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to be specific for the gene encoding the 30 kDa molecule of this pathogenic ameba were used in the test. Liver aspirates obtained from 23 patients with amebic liver abscess substantiated by typical clinical manifastation or with very high titres of anti-E histolytica antibedies by ELISA were found to be positive by PCR. Fourteen control samples (3 cases of bacterial liver abscess, I of liver cancer and 10 of other abscess) were all found to be negative to this reaction- The results suggested PCR to be a specific and sensitive tool for diagnosing amebic liver abscess infections.展开更多
文摘Autoimmune hepatitis (AIH) is a disease of unknown etiology,its hallmark being ongoing hepatic inflammation.By its very nature,it is a chronic condition,although increasingly,we are becoming aware of patients with acute presentations,some of whom may have liver failure.There are very limited published data on patients with AIH with liver failure at initial diagnosis,which consist mostly of small retrospective studies.As a consequence,the clinical features and optimal management of this cohort remain poorly defined.A subset of patients with AIH who present with liver failure do respond to corticosteroids,but for the vast majority,an urgent liver transplantation may offer the only hope of long-term survival.At present,there is uncertainty on how best to stratify such a cohort into responders and non-responders to corticosteroids as soon as possible after hospitalization,thus optimizing their management.This editorial attempts to answer some of the unresolved issues relating to management of patients with AIH with liver failure at initial presentation.However,it must be emphasized that,at present,this editorial is based mostly on small retrospective studies,and it is an understatement that multicenter prospective studies are urgently needed to address this important clinical issue.
文摘Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to be specific for the gene encoding the 30 kDa molecule of this pathogenic ameba were used in the test. Liver aspirates obtained from 23 patients with amebic liver abscess substantiated by typical clinical manifastation or with very high titres of anti-E histolytica antibedies by ELISA were found to be positive by PCR. Fourteen control samples (3 cases of bacterial liver abscess, I of liver cancer and 10 of other abscess) were all found to be negative to this reaction- The results suggested PCR to be a specific and sensitive tool for diagnosing amebic liver abscess infections.
