S 21 ANNUAL CONFERENCE—2013 D LI industrial applications, on liver carcinogenesis still remain elusive. Aims: To study the role of isocyanate in liver carcinogenesis. Methods: Experiments were performed on the cultured human liver epithelial cell line to ascertain the possible molecular risks associated with isocyanate exposure using Nsuccinimidyl N-methylcarbamate, a chemical entity that mimics the effects of methyl isocyanatein vitro. Qualitative and quantitative assessment of phosphorylation states of ATM, H2AX, ATR and p53, put forth the kinetics of DNA damage. Analyses of apoptosis in treated cells and inflammatory cytokines secreted in culture supernatant were done through annexin-V FITC/PI assay and cytometric bead array respectively. Cytogenetic studies along with inter simple sequence repeat PCR were done in control and treated cells to check for the possible precariousness at the chromosomal and microsatellite levels of the genome. Results: An increasing trend of all the DNA damage responsive parameters along with the apoptotic index were displayed in treated cells. Isocyanate exposed cells secreted an elevated levels of inflammatory cytokines in the culture supernatant. Cytogenetic analysis and inter simple sequence repeat PCR revealed varied chromosomal anomalies with greater instability at the microsatellite level. Conclusion: To conclude, these findings demonstrate that human liver epithelial milieu could confront with molecular risks due to isocyanate exposure attributing to defective DNA repair pathway along with de-regulated cell cycle and genomic instability which may accelerate the development of HCC. Corresponding author. Kewal Krishan Maudar. E-mail: maudarji@yahoo.com A CASE OF SEVERE JAUNDICE CAUSED BY THIAMAZOLE THERAPY Maria Sergeevna Zharkova, Marina Trofimovich Maevskaya, Elena Nikolaevna Shirokova, Tatjana Petrovna Nekrasova, Marina Victorovna Ivashkin Hepatology Department, University Clinical Hospital N 2, First Moscow State Medical University, Moscow, Russia Objective:Hepatotoxicity is a rare serious adverse reaction to antithyroid agents. It occurs with a frequency of 0.1– 0.2% of treated patients. Here we describe a case of severe jaundice with expected poor prognosis in a Thiamazoletreated patient with thyrotoxicosis. Case report: A 48-year-old woman with thyrotoxicosis developed jaundice after two weeks of Thiamazole therapy (40 mg/day). Viral hepatitis and mechanical biliary obstruction were excluded. Drug-induced liver injury had S38 been suspected. Despite drug discontinuation, weakness, skin itching, weight loss intensified. She was hospitalized to our clinic six weeks after disease onset. There were significant jaundice and visible traces after scratching; tachycardia. Liver and spleen were not palpable. Laboratory analyses showed elevation of ALT> AST (5-6 times higher ULN), total bilirubin (36 times higher ULN) due to both fractions, hypoalbuminemia (2.6 g/dl). Tests for autoantibodies were negative. Serum thyroid-stimulating hormone level was less than 0.01 uIU/ml (N: 0.4–4), free thyroxine two times higher ULN. Liver biopsy revealed parenchymatous and canalicularbilirubinostasis, necrosis of some hepatocytes. We diagnosed: Thiamazole-induced hepatitis. Hepatic failure: jaundice, hypoalbuminemia, thyrotoxicosis. In spite of drug withdrawal and administration of Ademethionine, UDCA, plazmapheresis, we observed a very slow regression of jaundice. Prednisolone prescription led to a rapid full patient's recovery with normalization of all biochemical markers during a month. The patient passed later radioactive iodine ablation of the thyroid gland. Discussion: Here we observed a mixed (dose-dependent and idiosyncratic) liver injury. There was an untypical form of hepatotoxicity hepatocellular damage with jaundice, without increase in laboratory markers of cholestasis, what makes the uniqueness of this clinical case. Conclusion: Severe jaundice is a rare adverse effect of antithyroid drugs’ therapy. The liver injury is usually reversible after drug withdrawal but in some cases can require Prednizolone administration. Physicians should keep in mind such a rare adverse reaction of antithyroid drugs. Corresponding Author. Maria Sergeevna Zharkova. E-mail: zharkovamaria@mail.ru HCV INFECTION IN THE HIV PATIENT IN ORAN ALGERIA Nadjet Allab Mouffok, Fatima Bensadoun, Ahmed Kouiad Belkadi