Detection of hepatitis C virus RNA by in situ hybridization in paraformaldehyde fixed biopsies

Fourteen hepatitis C virus (HCV) chronically infected patients were submitted to routine liver biopsy for histological evaluation. Liver samples were assayed to HCV-RNA by in situ hybridization, using digoxigenin labeled probe. HCV genotypes were found to be predominantly type 1 (71.4%), followed by genotype 3 (21.4%), and genotype 2 (7.2%). Alanine-aminotransferase levels were raised in 10 patients. The histopathological scores were minimal (21.4%), mild (57.2%), and moderate (21.4%). Viral RNA was detected in liver cells from nine patients (64.3%). ISH method provides localization and poor confirmation of HCV RNA in the liver tissue of HCV chronic patients.

[Gastroduodenal Crohn's disease - report of 4 cases and review of the literature]

BACKGROUND

Crohn's disease can affect all the gastrointestinal tract, but gastroduodenal involvement is rarely seen (0.5 to 13%).

OBJECTIVES

Report clinical, radiological and endoscopic findings and treatment of four patients with gastroduodenal Crohn's disease and review the literature.

PATIENTS AND METHODS

Four patients (one male of 24 years old three females of 37, 66 and 74 years old) with epigastric pain, weight loss and low grade fever were referred to the University Hospitals of Federal University of Rio de Janeiro and Fluminese Federal University. Two had also mild intermittent diarrhea and arthritis/arthralgia and the third developed pyloric obstruction and received surgical treatment. Anemia was observed in only one (the young female). Barium x-ray studies showed aphthous ulcers in stomach and duodenum with distal ileum lesions and deformity in both. Upper gastrointestinal endoscopy revealed aphthous ulcers in stomach and geographic duodenal ulcers. Polypoid lesions and serpiginous ulcers within gastric antrum were observed in the young female. Colonoscopy was performed in two patients and disclosed an ulcerated ileitis in one and ulcerated pancolitis in other. Histopathology findings of biopsy specimens were inconclusive (granulomas were not found) and other causes of granulomatous disease were ruled out. Corticosteroids and proton pump inhibitors were started and two patients had their disease controlled. The other patient developed pyloric obstruction and had to be operated.

CONCLUSIONS

Gastroduodenal Crohn's disease has distinct clinical, therapeutic and prognostic features. Advances in endoscopic methods and recognition of new histopathologic criteria for diagnosis have revealed an incidence higher than previously reported.

Liver pseudotumor: a rare manifestation of hepatic granulomata caused by Ascaris lumbricoides ova

A rare case of hepatic granulomata caused by Ascaris lumbricoides ova is reported. The patient presented clinically with hepatic mass simulating malignancy, and final diagnosis was performed after surgery, which provided enough material for histopathological examination.

Experimental infection of newborn mice with murine EDIM rotavirus

All four-day old Swiss mice whose dams were seronegative to rotavirus developed diarrhea 72 h after oral infection with EDIM rotavirus (HP strain). Electron microscopy of infected small intestine showed rotavirus particles of different sizes and morphology in the intestinal absorptive cells. In these cells rotavirus particles of 30 to 60 nm representing the various steps of virus maturation were visualized in viroplasm near the rough endoplasmic reticulum (RER). Mature rotavirus particles of 70 nm approximately were observed inside the RER of the intestinal absorptive cells. In the lamina propria rotavirus particles of approximately 30 nm and tubules were observed in phagosome-like structures of subepithelial phagocytes and were probably destroyed by lysosomal enzymes. The absence of signs of viral replication in phagocytes of lamina propria suggests that this may be the mechanism for viral antigen presentation to the host immunological system and may be one of the reasons for the fact that rotavirus infection is limited to the intestine.