Monthly Archives: February 2011

Radiology: Pseudocirrhosis

The hepatologist is frequently asked to consult on the cancer patient taking chemotherapy when their LFT increases.  Chemotoxicity, re-emergence of HBV and obstruction from metastatic disease should always be entertained. In the case of breast cancer, a diagnosis of pseudocirrhosis should enter the … Continue reading

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The Sunday Chronicles

  Learn to diagnose miniscule hepatic encephalopathy (mHE) in the clinic with this drawing exercise.

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Quotation

Good medicine means always thinking twice. – Cohen

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Hepatitis B

Question: A 22 year old Chinese female presents to you for evaluation of her hepatitis B virus.  Her AST is 41 and ALT is 44, both over the upper limit of normal (40).  Surface antigen is positive, surface antibody negative, … Continue reading

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Definition: fibrosing cholestatic hepatitis

Fibrosing cholestatic hepatitis (FCH) is diagnosed by biopsy when an aggressive recurrence of HCV follows liver transplantation (< 10% of cases).  Viral load is often very high, the patient may be jaundiced, and antiviral therapy (interferon, ribavirin) is most often unsuccessful.

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Definition: hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (or, hemophagocytic syndrome) may present itself in the immunosuppressed liver patient with a concurrent viral infection like EBV or CMV.  Cytokine dysregulation activates innumerable Tcells/macrophages that deplete cell lines and cause fever, splenomegaly, hypertriglyceridemia, hyperferritinemia and hypofibrinogenemia.

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Haiku: Hydroxycut

Is it worth the risk Not if you like your liver Try eating less food    

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