Monthly Archives: January 2013

Pathology: ocular herpes

   A middle aged female 3 years post liver transplant presented to the hospital with a similar ocular finding to the one in the image above.  She was leukopenic.  Ocular herpes was diagnosed. There was involvement of the central nervous system as … Continue reading

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Lecture: primary biliary cirrhosis

Today’s lecture focused on the diagnosis of primary biliary cirrhosis (PBC), a non-supperative inflammatory condition of the small caliber bile ducts.  It is thought to be caused by a genetic predisposition, followed by an environmental insult.  No pathogen has been … Continue reading

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The Sunday Chronicles

“Frodo is hurt badly! What about silymarin!” “Well, randomly controlled trials say no.  But what more do we have?  Get him to the thistle!”

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Quotation

Any day lived without pain is a good day. – Cohen

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Clinical Pearl

A hepatic vein- portal pressure gradient (HVPG) greater than 12 mmHg is considered sufficient for esophageal varices to start bleeding.  Therefore, after a TIPS procedure if the HVPG is still >12 mmHg, the patient should still be considered high risk … Continue reading

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Cessation

In the absence of high risk factors for hepatitis B recurrence post transplant (high pre-transplant viral load; HBsAg+), the recipient can discontinue HBIG after several months.  In such a case, long term treatment with antivirals (single or in combination) can be … Continue reading

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Definition: mixed cryoglobulinemia

Mixed cryoglobulinemia is a Type II/III vasculitic disorder seen in hepatitis C and hepatitis B infections (as opposed to Type I cryoglobulinemia that occurs as a monoclonal blood dyscrasia, ie. multiple myeloma).  Although purpura, glomerulonephritis and arthralgia are hallmarks of the disease, symptoms like fatigue, … Continue reading

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