1
|
Hofer KD, Bühler MM, Roncador M, Rechsteiner M, Maggio EM, Tchinda J, Schanz U, Haralambieva E, Widmer CC. Mutational patterns in therapy-related acute lymphoblastic leukemia subgroups: one step closer to unveiling the genetic odyssey. Leuk Lymphoma 2024:1-8. [PMID: 38385617 DOI: 10.1080/10428194.2024.2315171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
There is increasing evidence that therapy-related acute lymphoblastic leukemia (trALL) resulting from chemo- and/or radiotherapy represents a distinct entity. However, apart from KMT2A rearrangements, which have been repeatedly reported in this subgroup, the relevance of other aberrations remains controversial due to divergent study results and sparse molecular analyses. Within our ALL patient cohort, 15% (n = 19/131) met the criteria for trALL with a high proportion of Ph + and KMT2A rearrangements. On the molecular level, the most frequently observed mutation was KMT2D, followed by CDKN2A, KRAS and DNMT3A. No TP53 mutation was detected. Outcome was particularly poor in Ph + trALL compared to Ph+ de novo ALL, which seemed to be mitigated by allogeneic stem cell transplantation. Our findings further define trALL as a distinct entity but highlight the need for further molecular genome sequencing of somatic and germline variants to advance our understanding of trALL.
Collapse
Affiliation(s)
- Kevin D Hofer
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Marco M Bühler
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Marco Roncador
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Markus Rechsteiner
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Ewerton M Maggio
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Joëlle Tchinda
- Oncology Laboratory, University Children's Hospital Zurich, Switzerland
| | - Urs Schanz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Eugenia Haralambieva
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Corinne C Widmer
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
- Division of Hematology, University Hospital Basel, Switzerland
| |
Collapse
|
2
|
Bütikofer S, Lenggenhager D, Wendel Garcia PD, Maggio EM, Haberecker M, Reiner CS, Brüllmann G, Buehler PK, Gubler C, Müllhaupt B, Jüngst C, Morell B. Secondary sclerosing cholangitis as cause of persistent jaundice in patients with severe COVID-19. Liver Int 2021; 41:2404-2417. [PMID: 34018314 PMCID: PMC8242687 DOI: 10.1111/liv.14971] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND & AIMS Little is known about cholestasis, including its most severe variant secondary sclerosing cholangitis (SSC), in critically ill patients with coronavirus disease 19 (COVID-19). In this study, we analysed the occurrence of cholestatic liver injury and SSC, including clinical, serological, radiological and histopathological findings. METHODS We conducted a retrospective single-centre analysis of all consecutive patients admitted to the intensive care unit (ICU) as a result of severe COVID-19 at the University Hospital Zurich to describe cholestatic injury in these patients. The findings were compared to a retrospective cohort of patients with severe influenza A. RESULTS A total of 34 patients with severe COVID-19 admitted to the ICU were included. Of these, 14 patients (41%) had no cholestasis (group 0), 11 patients (32%, group 1) developed mild and 9 patients (27%, group 2) severe cholestasis. Patients in group 2 had a more complicated disease course indicated by significantly longer ICU stay (median 51 days, IQR 25-86.5) than the other groups (group 0: median 9.5 days, IQR 3.8-18.3, P = .001; and group 1: median 16 days, IQR 8-30, P < .05 respectively). Four patients in group 2 developed SSC compared to none in the influenza A cohort. The available histopathological findings suggest an ischaemic damage to the perihilar bile ducts. CONCLUSIONS The development of SSC represents an important complication of critically ill COVID-19 patients and needs to be considered in the diagnostic work up in prolonged cholestasis. The occurrence of SSC is of interest in the ongoing pandemic since it is associated with considerable morbidity and mortality.
Collapse
Affiliation(s)
- Simon Bütikofer
- Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| | - Daniela Lenggenhager
- Department of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | | | - Ewerton M. Maggio
- Department of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Martina Haberecker
- Department of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Cäcilia S. Reiner
- Institute of Diagnostic and Interventional RadiologyUniversity Hospital ZurichZurichSwitzerland
| | - Gregor Brüllmann
- Institute of Intensive CareUniversity Hospital ZurichZurichSwitzerland
| | | | - Christoph Gubler
- Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| | - Beat Müllhaupt
- Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| | - Christoph Jüngst
- Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| | - Bernhard Morell
- Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| |
Collapse
|
3
|
Raselli T, Hearn T, Wyss A, Atrott K, Peter A, Frey-Wagner I, Spalinger MR, Maggio EM, Sailer AW, Schmitt J, Schreiner P, Moncsek A, Mertens J, Scharl M, Griffiths WJ, Bueter M, Geier A, Rogler G, Wang Y, Misselwitz B. Elevated oxysterol levels in human and mouse livers reflect nonalcoholic steatohepatitis. J Lipid Res 2019; 60:1270-1283. [PMID: 31113816 PMCID: PMC6602130 DOI: 10.1194/jlr.m093229] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/19/2019] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic steatohepatitis (NASH), a primary cause of liver disease, leads to complications such as fibrosis, cirrhosis, and carcinoma, but the pathophysiology of NASH is incompletely understood. Epstein-Barr virus-induced G protein-coupled receptor 2 (EBI2) and its oxysterol ligand 7α,25-dihydroxycholesterol (7α,25-diHC) are recently discovered immune regulators. Several lines of evidence suggest a role of oxysterols in NASH pathogenesis, but rigorous testing has not been performed. We measured oxysterol levels in the livers of NASH patients by LC-MS and tested the role of the EBI2-7α,25-diHC system in a murine feeding model of NASH. Free oxysterol profiling in livers from NASH patients revealed a pronounced increase in 24- and 7-hydroxylated oxysterols in NASH compared with controls. Levels of 24- and 7-hydroxylated oxysterols correlated with histological NASH activity. Histological analysis of murine liver samples demonstrated ballooning and liver inflammation. No significant genotype-related differences were observed in Ebi2−/− mice and mice with defects in the 7α,25-diHC synthesizing enzymes CH25H and CYP7B1 compared with wild-type littermate controls, arguing against an essential role of these genes in NASH pathogenesis. Elevated 24- and 7-hydroxylated oxysterol levels were confirmed in murine NASH liver samples. Our results suggest increased bile acid synthesis in NASH samples, as judged by the enhanced level of 7α-hydroxycholest-4-en-3-one and impaired 24S-hydroxycholesterol metabolism as characteristic biochemical changes in livers affected by NASH.
Collapse
Affiliation(s)
- Tina Raselli
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Tom Hearn
- Swansea University Medical School Singleton Park, Swansea, United Kingdom
| | - Annika Wyss
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Kirstin Atrott
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Alain Peter
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Isabelle Frey-Wagner
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Marianne R Spalinger
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Ewerton M Maggio
- Institute for Surgical Pathology University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andreas W Sailer
- Chemical Biology and Therapeutics, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Johannes Schmitt
- Division of Hepatology Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Philipp Schreiner
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Anja Moncsek
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Joachim Mertens
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Scharl
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Marco Bueter
- Department of Visceral Surgery University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andreas Geier
- Division of Hepatology Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Yuqin Wang
- Swansea University Medical School Singleton Park, Swansea, United Kingdom
| | - Benjamin Misselwitz
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland .,Department of Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland
| |
Collapse
|
4
|
Purohit B, Winder T, Maggio EM, Kollias SS. Aggressive primary olfactory neuroblastoma of the sphenoclival region: a case report and literature review. Laryngoscope 2014; 125:822-5. [PMID: 25215962 DOI: 10.1002/lary.24925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/07/2014] [Accepted: 08/20/2014] [Indexed: 11/07/2022]
Abstract
Olfactory neuroblastoma (ONB) is an uncommon malignant tumor of neural crest origin, which commonly arises in the superior nasal cavity. Ectopic origin of an ONB is exceedingly rare. We describe a rare case of an ectopic sphenoclival ONB with extensive involvement of the central skull base and with development of systemic metastases. To our knowledge, ours is the first case that describes the imaging features of this rare entity on computed tomography (CT), magnetic resonance imaging, 18 F-fluorodeoxyglucose-positron-emission tomography/CT, and digital subtraction angiography. We also describe the histological features, imaging differentials, and treatment options for this tumor along with a brief literature review.
Collapse
Affiliation(s)
- Bela Purohit
- Institute for Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | | | | | | |
Collapse
|
5
|
Lenggenhager D, Maggio EM, Moch H, Rössle M. HBME-1 expression in hyalinizing trabecular tumours of the thyroid gland. Histopathology 2013; 62:1092-7. [PMID: 23617709 DOI: 10.1111/his.12123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 03/04/2013] [Indexed: 11/26/2022]
Abstract
AIMS Hyalinizing trabecular tumour (HTT) is a rare thyroid neoplasm with a trabecular growth pattern, marked intratrabecular hyalinization and nuclear features of papillary thyroid carcinoma (PTC). Immunohistochemical HBME-1 expression was reported recently in PTC, but not in HTT. To clarify further the value of HBME-1 expression as a tool in differential diagnosis, we investigated the immunophenotype of HTT. METHODS AND RESULTS Eight HTT diagnosed from 1997 to 2012 were reviewed on H&E-stained tissue sections and analysed for HBME-1, galectin-3, CK19 and Ki67 expression by immunohistochemistry. Three of eight HTTs (37.5%) were HBME-1 positive, with staining of tumour cells as well as of intratrabecular hyaline matrix material. All cases were CK19 negative. Galectin-3 was expressed weakly in four of eight cases (50%). Five of eight cases (62.5%) showed weak-to-moderate cytoplasmic Ki67 positivity. CONCLUSIONS Immunohistochemical HBME-1 expression is present in HTT and may not serve as a reliable marker in differentiating HTT from PTC. The HBME-1 positivity of the hyaline matrix suggests that this material is partly of cytoplasmic origin.
Collapse
Affiliation(s)
- Daniela Lenggenhager
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | |
Collapse
|
6
|
Parise IZS, Haddad BR, Cavalli LR, Pianovski MAD, Maggio EM, Parise GA, Watanabe FM, Ioshii SO, Rone JD, Caleffe LG, Odone Filho V, Figueiredo BC. Neuroblastoma in southern Brazil: an 11-year study. J Pediatr Hematol Oncol 2006; 28:82-7. [PMID: 16462579 DOI: 10.1097/01.mph.0000199601.35010.52] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The authors report on the incidence and clinical characteristics of neuroblastoma in southern Brazil. The aims of the study were to evaluate the age at diagnosis, tumor stage, MYCN status, and tumor histopathology, and to relate these factors to survival. All patients with neuroblastoma, 15 years old or younger (n = 125), admitted to the three major pediatric oncology hospitals in the state of Parana over a period of 11 years (between January 1990 and December 2000), were included in the analysis. All patients were followed for at least 5 years. In addition, a FISH evaluation for MYCN status was conducted in a subset of 34 tumors. Overall survival for tumor stages 1, 2, 3, and 4 was 100%, 72%, 59%, and 17%, respectively. Sixty-two percent (77/125) of all patients were older than 2 years; these represented 71% (57/80) of the patients with stage 4 disease. Children who presented with an unfavorable histopathology had a significantly worse prognosis (20% survival) than children with a favorable histopathology (67% survival). MYCN amplification was detected most commonly in stages 3 and 4 tumors (13/16). These data showed a delayed diagnosis of neuroblastoma in children in southern Brazil, and consequently survival was considerably lower in these patients.
Collapse
Affiliation(s)
- Ivy Zortéa S Parise
- Division of Pediatric Hematology and Oncology, Hospital de Clínicas, Federal University of Paraná, Brazil
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
Reed-Sternberg (RS) cells, the neoplastic elements of Hodgkin's lymphoma (HL), usually lack B-cell receptor expression. Normal germinal center B cells, with lack of or low-affinity B-cell receptor expression, are eliminated via FAS-induced apoptosis. RS cells express FAS, but are rescued from apoptosis by a transforming event. It is known that HL-derived cell lines are resistant to FAS-mediated apoptosis. To investigate potential causes for this resistance, FAS mutations and c-FLIP expression were studied in four HL-derived cell lines and 20 cases of HL. L1236 was found to have a splice donor site mutation in intron 7 that resulted in an aberrantly spliced FAS transcript. Screening of microdissected RS cells revealed loss of heterozygosity for a known exon 7 polymorphism in two of six informative cases indicating loss of one FAS allele. In one of the two cases with loss of heterozygosity a hemizygous mutation was detected in exon 9. c-FLIP expression was observed in all HL cell lines and in RS cells of all HL cases. Our data show that FAS mutations are rare and suggest that overexpression of c-FLIP, which was present in all cases, is involved in the resistance to FAS-mediated apoptosis.
Collapse
Affiliation(s)
- Ewerton M Maggio
- Department of Pathology and Laboratory Medicine, University Medical Center Groningen, The Netherlands
| | | | | | | | | |
Collapse
|
8
|
Maggio EM, Van Den Berg A, Visser L, Diepstra A, Kluiver J, Emmens R, Poppema S. Common and differential chemokine expression patterns in rs cells of NLP, EBV positive and negative classical Hodgkin lymphomas. Int J Cancer 2002; 99:665-72. [PMID: 12115499 DOI: 10.1002/ijc.10399] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hodgkin lymphoma (HL) is characterized by a minority of neoplastic cells, the so-called Reed-Sternberg (RS) cells and a vast majority of reactive cells. RS cells produce chemokines that can attract subsets of peripheral blood cells into HL tissues. To gain insight in the chemokines involved in HL, 16 chemokines were selected based on their ability to recruit different subsets of cells. Five HL, 5 non-HL-derived cell lines, 22 HL, 5 non-HL and 3 control tissues were analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR). Products for 13 of these 16 chemokines were detected in 1 or more of the cell lines tested. No or only very faint signals were obtained in HL for CXCL12, CCL7 and CCL8, but CXCL10, CCL5, CCL13, CCL17 and CCL22 were highly or differentially expressed in HL cell lines and tissues. Immunohistochemistry was performed with antibodies reactive with the latter 5 chemokines on paraffin sections of 21 cases of HL. CCL17 and CCL22 had the highest signals in RS cells at gene expression and at protein levels. CCL17 was specific for the classic HL subtypes, whereas CCL22 also had low signals in NLP samples, as well as in some non-HL. CXCL10 was expressed in a large proportion of HL cases with a predominant expression in EBV-positive cases. The results indicate that RS cells produce a complex pattern of chemokines that are involved in the recruitment of reactive cells and contribute to the paradox of an extensive but ineffective host immune response.
Collapse
Affiliation(s)
- Ewerton M Maggio
- Department of Pathology and Laboratory Medicine, University Hospital Groningen, Groningen, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
9
|
Maggio EM, Montemór-Netto MR, Gasparetto EL, Reis-Filho JS, Tironi FA, Torres LF. [Cerebrovascular diseases in patients aged 15 to 40 years: neuropathological findings in 47 cases]. Arq Neuropsiquiatr 2001; 59:920-5. [PMID: 11733838 DOI: 10.1590/s0004-282x2001000600015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cerebrovascular diseases in patients between 15 and 40 years old are not a frequent subject in Latin-American literature, especially when focusing on neuropathology. We analyzed 47 brains from necropsies performed from 1987 to 1997 and selected on a basis of age and the presence of vascular pathology. From the 47 analyzed brains, 26 belonged to females (55.3%). When distributed among age groups, 12.8% (n=6) affected patients from 15 to 20 yo, 51,1% (n=24) from 21 to 30 yo, 36,2% (n=17) from 31 to 40 yo. The underlying diseases were: cardiac and haemathologic (19.2%), pregnancy complications (12.76%), infections, diseases of blood vessels and neurological (10.1% each) amongst others. The neuropathological abnormalities included cerebral and/or cerebellar herniation (16%), cerebral edema (13.8%), subarachnoid hemorrhage (10%), recent cerebral infarction (9%), intraparenchymatous hemorrhage (8.14%), hypoxic-ischemic encephalopathy (3%) and other events such as Sneddon syndrome and Lupus vasculitis. These findings express that the cerebrovascular phenomena in this age group are unique and closely related with the underlying disease.
Collapse
Affiliation(s)
- E M Maggio
- Seção de Microscopia Eletrônica e Neuropatologia, Serviço de Anatomia-Patológica, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil
| | | | | | | | | | | |
Collapse
|
10
|
Maggio EM, Stekelenburg E, Van den Berg A, Poppema S. TP53 gene mutations in Hodgkin lymphoma are infrequent and not associated with absence of Epstein-Barr virus. Int J Cancer 2001; 94:60-6. [PMID: 11668479 DOI: 10.1002/ijc.1438] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reed-Sternberg (RS) cells, the neoplastic cells of Hodgkin lymphoma (HL) have clonal immunoglobulin gene rearrangements. The presence of somatic mutations suggests a germinal center origin, whereas the presence of crippling mutations suggests rescue of RS precursors from apoptosis by a transforming event. Epstein-Barr virus (EBV), which can be detected in 30-50% of HL cases, probably plays a role in this transforming event. The frequent presence of p53 protein expression in RS cells also suggests a role of the TP53 gene in this escape from apoptosis. Although mutations of the TP53 gene occur infrequently in RS cells, it has been suggested that in EBV-negative cases this gene mutation may be fundamental for the inhibition of apoptosis. In this study, we tested the hypothesis that there is an inverse correlation between the presence of TP53 gene mutations and the presence of EBV. In 21 of 67 cases EBV encoded small RNA (EBER)1-2 mRNAs were detected. Immunostaining for p53 protein revealed positivity in all 67 cases with variable percentages of positive cells and staining intensity. Screening for mutations in exons 5, 6, 7 and 8 of the TP53 gene in single RS cells obtained by laser microdissection from 26 HL specimens and 4 HL-derived cell lines revealed mutations in 2 of 15 EBV-positive cases and in 1 of 11 EBV-negative cases. Our results confirm the presence of infrequent (11.5%) TP53 gene mutations in HL and suggest that mutations of the TP53 gene are not correlated to the absence of EBV.
Collapse
Affiliation(s)
- E M Maggio
- Department of Pathology and Laboratory Medicine, University Hospital Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands
| | | | | | | |
Collapse
|
11
|
Parolin MB, Langowiski AR, Ioshii SO, Maggio EM, Coelho JC. [Benign recurrent intrahepatic cholestasis: a seven-year follow-up report]. Arq Gastroenterol 2000; 37:231-4. [PMID: 11460604 DOI: 10.1590/s0004-28032000000400009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Benign recurrent intrahepatic cholestasis is a rare autosomal recessive disorder characterized by repeated episodes of intense pruritus and jaundice. Patients are completely asymptomatic for months to years between symptomatic periods. We report a case of a patient with a 7-year history of benign recurrent intrahepatic cholestasis. During the follow-up period the patient has suffered three attacks of cholestasis, confirmed by biochemical tests and histological exam. Liver enzymes were normal between the cholestasis episodes. Despite multiple attacks of cholestasis, no permanent liver damage has occurred. Although the diagnosis of benign recurrent intrahepatic cholestasis is rare, it should be included in the evaluation of a patient with cholestasis. The patients should be reassured of the benign course of this disorder.
Collapse
Affiliation(s)
- M B Parolin
- Serviço de Transplante Hepático, Hospital de Clínicas da Universidade Federal do Paraná-UFPR, Curitiba, PR
| | | | | | | | | |
Collapse
|