Signs Of Hepatitis Research Articles

Ayurvedic management of Alcoholic Liver Disease : A Case Report

Alcoholic liver disease (ALD) is one of the most prevalent types of liver disease worldwide. According to a 2023 study, the prevalence rate of alcoholic liver disease in India is 4.8%. This case report deals with a 51-year-old male patient initially came to OPD with complaints of yellowish discoloration of eyes, skin, and urine, loss of appetite, anorexia, distention of the abdomen, bilateral pedal edema, easy fatiguability, weakness and weight loss. Liver function test shows-high bilirubin and high transaminase, USG of the abdomen shows-Moderate Hepatomegaly with signs of Hepatitis. It was diagnosed as Kostha-Shakhashrita/Bahupitta Kamala based on the etiopathology and investigations. The patient was treated with Ayurvedic interventions viz, NABB Swarasa, Arogyavardini Vati, Phalatrikadhi Kashaya with Katuki Churna, Patolakaturohinyadhi Kashaya, Laghusoothshekara Rasa and Tab Nirocil were prescribed. After 68 days of treatment protocol, there was marked relief in the symptoms and a reduction in bilirubin and transaminase levels. The above-mentioned oral medications have shown significant results in the present study.

A case of infectious mononucleosis caused by Epstein-Barr virus complicated by autoimmune hemolytic anemia

We represent a rare clinical case of infectious mononucleosis with hepatitis, caused by Epstein-Barr virus, complicated by rare secondary autoimmune hemolytic anemia associated with warm agglutinins in a 16-year-old patient. The disease was long-lasting, with a two-wave course of febrile fever. Signs of hepatitis with the development of anemia of moderate severity appeared during the second wave of febrile fever. The etiology of the disease was confirmed by the detection of Epstein-Barr virus DNA in blood and the detection of anti-VCA IgM antibodies to Epstein-Barr virus in the absence of anti-EBNA IgG antibodies. Hemolytic anemia was verified using markers of hemolysis (increased lactate dehydrogenase activity, decreased haptoglobin concentration), and positive results of a direct Coombs test. After successful initiation of prednisone therapy and clinical improvement, the patient was discharged from the hospital on the 24th day of disease to continue treatment on an outpatient basis (prednisone was replaced by methylprednisolone).This case demonstrates the development of a rare autoimmune complication in infectious mononucleosis caused by the Epstein-Barr virus.

Hepatitis B immunization in sickle cell disease patients

Introduction: Sickle cell disease, also known as sickle cell anaemia, is an inherited haemoglobinopathy resulting in the production of the abnormal haemoglobin of sickle cell disease: haemoglobin S. Sickle cell patients are exposed to frequent deglobulation crises, often requiring several blood transfusions and hospitalisations at risk of transmission of infectious diseases such as hepatitis B (HBV). The objective of our study is to describe the immunisation against hepatitis B of vaccinated sickle cell patients and then to propose a course of action for non-immunised patients in the Haematology Department of the Joseph Ravoahangy Andrianavalona University Hospital (JRAHU). Material and Methods: The study was a prospective descriptive study investigating on the immunisation against hepatitis B of vaccinated sickle cell patient’s patients in the Haematology Department of the Joseph Ravoahangy Andrianavalona University Hospital (JRAHU) from June 2019 to March 2020. The study population concerned all sickle cell disease children under 15 years of age, girls or boys, of any ethnic origin, with or without clinical or biological signs of hepatitis, vaccinated against hepatitis B according to expanded program of immunization with at least 3 injections of hepatitis B vaccine, transfused or not. The included patients were be tested for HBsAg and anti-HBsAb. Results: During the study period, a total of 36 sickle cell patients were included. The average age was 8.2 years with an extreme of 2 and 13 years. Of the 36 sickle cell patients vaccinated, none had HBsAg and 28 patients (77.8%) were anti-HBsAb positive, protected against hepatitis B and 8 patients (22.2%) were serologically negative and at risk of contracting hepatitis B. Conclusion: Sickle cell disease patients are exposed risk of transmission of infectious diseases, if their antibody level between 1 and 10 mIU mL-1 is considered a poor response, those affected should receive a booster.

Синдром полигландулярной недостаточности с проявлениями аутоиммунного гепатита в детском возрасте

This article presents a review and a case report of autoimmune polyglandular syndrome type 1 (APS-1) in a child with autoimmune hepatitis (AIH) as a first clinical manifestation. The duration of the disease was 9 years. The first signs of hepatitis (jaundice, hepatosplenomegaly, impaired pigment metabolism, cytolysis) with a high degree of activity and a morphological picture of monolobular liver cirrhosis with stromal and parenchymal activity were noted at the age of 2.5 years. The child received therapy with prednisolone. After one year, symptoms not typical of AIH were noted: salting food, candidiasis of the nail plates on hands and feet. Upon repeated examination, the diagnosis of APS-1 (hypoparathyroidism, candidiasis, autoimmune thyroiditis, chronic adrenal insufficiency, autoimmune hepatitis) was confirmed genetically – the homozygous R257X mutation was detected. The therapy was corrected: fludrocortisone and diflucan were added, therapy was continued with gradual transition to a maintenance dose of prednisolone. This case report demonstrates the difficulty of early APS-1 diagnosis, resulting in late initiation of baseline therapy, which can determine the prognosis of the disease. Key words: children, autoimmune polyglandular syndrome, autoimmune hepatitis

Safety of therapies using ustekinumab in patients with psoriasis who have had hepatitis B virus infection

Biological therapies used in psoriasis treatment pose a risk of reactivation of hepatitis B virus (HBV) infection. This risk occurs not only in patients with HB surface antigen (HBsAg) (+) but also in patients with past or occult HBV infection (with negative HBsAg, positive HB core antibodies (HBcAb), and positive HBV deoxyribonucleic acid [DNA]). Ustekinumab (UST) is a biologic agent acts by blocking the IL-12/23 pathway. Thus, hindering this response may lead to HBV reactivation. UST therapy is associated with mild HBV-r risk; however, there is insufficient data to confirm that hypothesis. Herein, we present observations on the safety of UST therapy in patients with psoriasis and serologically proved past HBV infection. One-hundred and six consecutive patients with moderate to severe psoriasis treated with biological therapy between May 2013 and January 2020 were retrospectively analyzed. Out of 106 patients, there were five who reported having past HBV. Those five patients were tested for the presence of HBsAg, HBcAb, HBsAb as well as HBV DNA at baseline and at the end of the follow-up period. HBV reactivation was defined as changing of "undetectable" to "detectable" viremia. All five patients were treated with UST. Five patients in our cohort group were found to have resolved HBV infection: HBsAg (-), HBcAb (+), and HBV DNA (-); 4/5 were HBsAb (+) and 1/5 HBsAb (-). None of the patients experienced an increase in their liver function tests values and no signs of hepatitis or HBV reactivation were observed at any point during the study. All the patients were HBsAg and HBV DNA negative at the end of the follow-up period. The average treatment time was 82.4 (28, 96) weeks. The average follow-up time was 75.2 (31, 176) weeks. Based on the available literature and the results from our observations, UST therapy seems to be a safe option for patients with resolved HBV infection.

Clinical, serological and epidemiological features of hepatitis A in León, Nicaragua.

Background and ObjectivesTo monitor and document the endemicity and disease burden of acute hepatitis A in the area of an ongoing vaccine effectiveness study in León, Nicaragua.MethodsAt community health centres in León, all children, adolescents and young adults presenting with jaundice and/or other clinical signs of hepatitis were offered free serologic screening (hepatitis A, B and C) and blood tests for liver enzymes and bilirubin. Clinical and socioeconomic data were collected with a structured questionnaire. Diagnosis of acute hepatitis A was confirmed by anti-HAV IgM testing. Using logistic regression we compared the characteristics and living conditions of acute hepatitis A cases with those of non-cases.ResultsOf 557 eligible subjects enrolled between May 2006 and March 2010, 315 (56.6%) were diagnosed with hepatitis A, 80.6% of them ≤10 years and five >18 years of age. No severe cases were encountered. Apart from jaundice (95.6%) and other signs of hepatitis A (fever, pale stool, dark urine, nausea, vomiting, anorexia), two thirds of patients had moderately raised liver enzymes. Cases occurred throughout the year, with highest incidences from August to March. Poor sanitary conditions and crowding were the main risk factors.ConclusionsIn the study area, hepatitis A is still highly endemic in young and school age children living in low socioeconomic conditions. There are, however, first indications that the endemicity level is shifting from high to high-intermediate.

A211 SPONTANEOUS HBV REMISSION AFTER HBV REACTIVATION FOLLOWING TREATMENT WITH SOFOSBUVIR AND VELPATASVIR IN A PATIENT WITH HCV AND HBV CO-INFECTION: CASE REPORT

Abstract Background In co-infected patients with hepatitis B (HBV) and hepatitis C (HCV), the treatment of HCV with direct-acting antiviral agents (DAA) can cause HBV reactivation. However, there are no clear guidelines on the timing of treatment initiation, especially in the absence of clinical signs of flare. Aims Here we discuss the case of a 34-year-old female with HBV and HCV genotype 3 who had HBV reactivation following HCV treatment, but did not require nucleos(t)ide therapy. Methods She initially presented with chronic inactive hepatitis B and chronic hepatitis C with HBV DNA level of 67.5 IU/mL and HCV RNA level of 3.33 x 106 IU/mL. She completed a 12 week course of sofosbuvir and velpatasvir for HCV and achieved sustained virologic remission, but subsequently developed reactivation of her HBV with HBV DNA peaking at 3.41 x 104 IU/mL twelve weeks post-treatment. She did not develop any signs of hepatitis and a decision was made to monitor her clinically. Results Two years later, she spontaneously went into remission with her HBV DNA levels being <10 IU/mL. Conclusions The significance of this case is to illustrate HBV reactivation following treatment of HCV with DAAs may not necessitate immediate treatment, especially if there are no signs of flare. There have been similar reported cases, but larger prospective studies are required to determine the appropriate clinical context where monitoring may be acceptable instead of immediate treatment. Funding Agencies None

Эпизоотология и патологоанатомические изменения при фасциолезе крупного рогатого скота в Алтайском крае

Fascioliasis in cattle continues to cause significant eco-nomic damage to cattle breeding in the Region due to de-creased weight gains of infested young animals and milk yields in cows culled due to liver affected by fascioliasis. On farms infected by liver flukes, there is increased culling of young animals and cows at the beginning of lactation with signs of hepatitis, jaundice, digestive disorders and decreased productivity against the background of general cachexia. The study of fascioliasis epizootology in cattle was carried out at different times of the year. All calves before and after infection were systematically subject to clinical, hematological, biochemical and helminthological studies as well as periodically weighed. The studies were carried out in the morning, usually before feeding the ani-mals. The animals were observed for five months after infection. It was determined that fascioliasis in cattle was found in the forest-steppe zone (the floodplains of the Ob, Charysh and Chumysh rivers). The increased percentage of invasion intensity to 30.2% in the autumn period is asso-ciated with a new wave of fasciole infection in cattle. Ac-cording to the findings of post-mortem examination, in win-ter, spring and summer, only imaginal fascioles were found. Thus, in the forest-steppe zone of the Altai Region, all age groups of cattle were affected by fascioles with prevalence of 10.4% which ranged from 8.7% to 13.5%. In autumn, imaginal and young fascioles were found

Discovery of in vivo Virulence Genes of Obligatory Intracellular Bacteria by Random Mutagenesis.

Ehrlichia spp. are emerging tick-borne obligatory intracellular bacteria that cause febrile and sometimes fatal diseases with abnormal blood cell counts and signs of hepatitis. Ehrlichia HF strain provides an excellent mouse disease model of fatal human ehrlichiosis. We recently obtained and established stable culture of Ehrlichia HF strain in DH82 canine macrophage cell line, and obtained its whole genome sequence and annotation. To identify genes required for in vivo virulence of Ehrlichia, we constructed random insertional HF strain mutants by using Himar1 transposon-based mutagenesis procedure. Of total 158 insertional mutants isolated via antibiotic selection in DH82 cells, 74 insertions were in the coding regions of 55 distinct protein-coding genes, including TRP120 and multi-copy genes, such as p28/omp-1, virB2, and virB6. Among 84 insertions mapped within the non-coding regions, seven are located in the putative promoter region since they were within 50 bp upstream of the seven distinct genes. Using limited dilution methods, nine stable clonal mutants that had no apparent defect for multiplication in DH82 cells, were obtained. Mouse virulence of seven mutant clones was similar to that of wild-type HF strain, whereas two mutant clones showed significantly retarded growth in blood, livers, and spleens, and the mice inoculated with them lived longer than mice inoculated with wild-type. The two clones contained mutations in genes encoding a conserved hypothetical protein and a staphylococcal superantigen-like domain protein, respectively, and both genes are conserved among Ehrlichia spp., but lack homology to other bacterial genes. Inflammatory cytokine mRNA levels in the liver of mice infected with the two mutants were significantly diminished than those infected with HF strain wild-type, except IL-1β and IL-12 p40 in one clone. Thus, we identified two Ehrlichia virulence genes responsible for in vivo infection, but not for infection and growth in macrophages.

Thymus Involution and Intravenous Drug Abuse.

Thymus glands from 283 autopsy cases were sampled and evaluated with histochemical and immunohistochemical methods. A subpopulation of 41 intravenous drug addicts were compared with age-matched control cases.It was found that an accelerated involution of the thymus occurred in the 20- to 25-year interval and thereafter with a steady pace of 5% per year. Also the size of Hassall bodies declined successively.In drug addicts, an increased dystrophic calcification of the Hassall bodies and a significant difference in thymus size (atrophy) compared with controls were seen. Moreover, a difference was seen in the relative numbers of CD4 and CD8 lymphocytes where CD4+ cells were reduced in drug addicts.It is hypothesized that signs of hepatitis C virus infection that was found in the majority of drug addicts and the reduced number of functionally intact Hassall corpuscles could explain the reduction of CD4+ lymphocytes and thymic hypotrophy in this population.

Многофакторный анализ клинико-лабораторных показателей, уровней IL-17a, IL-23, IL-33, IL-35 и cпецифических антител в сыворотке крови у больных безэритемной формой иксодового клещевого боррелиоза

Aim: to determine the association between clinical laboratory parameters, the production of cytokines (IL-17A, -23, -33, -35), and specific IgM and IgG in the serum of patients with Lyme borreliosis without erythema migrans. Patients and Methods: complete blood count, the concentrations of IL-17A, -23, -33, -35, and the levels of specific IgM and IgG were measured during acute infection and convalescence (n=30). The control group included age- and sex-matched healthy individuals (n=30). Statistical analysis was performed using the StatSoft Statistica v 10.0 software (parametric and non-parametric methods and multifactorial analysis, i.e., principal component analysis). Results: most (80%) patients with Lyme borreliosis without erythema migrans are the people of working age. In most patients, the combination of the specific antibodies against Borrelia afzelii and Borrelia garinii (76.7%) and severe intoxication and inflammatory process (100%) were detected. Moderate and severe disease associated with meningism was diagnosed in 90% and 10%, respectively. The mean duration of hectic period was 8.3±1.27 days. Abnormal ECG was reported in 40% of patients, i.e., conduction abnormalities in 20%, sinus bradycardia in 16.7%,and sinus tachycardia in 3.3%. The clinical laboratory signs of hepatitis without jaundice were identified in 26.7%. During treatment, the significant reduction in band and segmented neutrophil counts as well as the significant increase in platelet count were revealed compared to these parameters at admission. Abnormal cytokine levels (i.e., the increase in IL-17A, -23, -33 and the deficiency of IL-35) were detected. Conclusions: multifactorial analysis has demonstrated that the severity of immunological abnormalities in patients with Lyme borreliosis without erythema migrans is associated with fever, cardiac and liver disorders, the high levels of IL-23 and IL-33, and the lack of IL-35 and specific IgM and IgG. KEYWORDS: tick-borne borreliosis, Lyme disease without erythema migrans, clinical laboratory signs, cytokines, specific antibodies, multifactorial analysis, principal component analysis. FOR CITATION: Sapozhnikova V.V., Bondarenko A.L. Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans. Russian Medical Inquiry. 2020;4(11):676–681. DOI: 10.32364/2587-6821-2020-4-11-676-681.

Clinical and epidemiological characteristics of measles in adults residents of the Altai territory

The aim of the study is to determine the clinical and epidemiological features of measles in the Altai territory. Materials and methods: a retrospective analysis of 92 medical histories of inpatient patients with a confirmed diagnosis of «Measles» at the age of 17 to 54 years, who were treated in the Infectious Departments of City Hospitals № 5 and №11 in Barnaul in 2015–2018, was made. Results: the epidemic situation of measles in the Altai territory is characterized by an increase of morbidity rate in 2015, as well as isolated cases in 2017–2018. The peculiarity of the outbreak of the disease was in-hospital infection of patients upon admission to medical hospitals and late diagnosis of measles, as well as the importation of infection from adjacent territories (regions of Russia and the Republic of Kazakhstan), which is confirmed by genotyping of the virus in patients. The development of the disease in 23,9% of those,who were vaccinated, was routinely observed in the age group older than 30 years. In the clinical picture of measles at the present stage, along with the classical manifestations, in 15.2% of patients in the first days of the disease gastroenteritis was marked, in 40,2% of patients the signs of hepatitis (cytolysis syndrome) were observed. Conclusion: the prevalence among the patientspersons, older than 30 years, may indicate the extinction of post-vaccination immunity. Timely immunization against measles in adulthood (after 30 years), will increase the effectiveness of measures to implement the program of elimination of measles in the Altai territory. The development of gastroenteritis up to the 5 days of the disease (on average 2,5±0.9 days), hepatitis in the period of height of the disease (in 15,2% and 40,2% of patients, respectively), determined the erroneous diagnosis of «Enterovirus infection», pseudotuberculosis, etc. and deserved the attention of practitioners.

Гастроинтестинальный дебют острого стафилококкового эндокардита

Staphylococci are now the most common cause of infective endocarditis (IE). The onset of staphylococcal endocarditis (SE) is acute, with high fever, severe intoxication, and therefore, during the initial visit to the doctor, there is an erroneous assumption of influenza, meningitis, hepatitis and other acute diseases. Sometimes the cause of the development of SE remains unclear, the initial clinical manifestations are characterized by high activity of the process, severe general condition of patients, hectic fever, stunning chills, sweats, yellow staining of the skin and mucous membranes, vomiting with blood, leukocytosis, anemia. A clinical case of gastrointestinal SE debut is described with signs of hepatitis and gastric ulcer. Hemorrhages and necrosis of the mucous membrane led to the formation of erosions and ulcers in the antrum and pyloric regions of the stomach, which was manifested by the sudden appearance of severe pain in the abdomen, vomiting with blood. Gastrointestinal manifestations of necrotic vasculitis at the beginning of the SE complicated its timely diagnosis. Hemorrhagic rash was characterized by extensive lesions with the transition to necrosis or suppuration. Cerebral embolism led to multiple brain abscesses, the symptoms of which became leading in the clinical picture. Coronary emboli caused the formation of myocardial abscesses. The use of a chemotherapeutic combination of vancomycin, amikacin and rifampicin with a highly virulent pathogen was ineffective: signs of severe heart damage with perforation of the coronary valve of the aortic valve developed. Progressive multi-organ failure has been fatal.

Microscopic changes in the liver, heart, and kidneys in alloxan diabetes rats

To make future researches of the results of treatment of diabetes possible, it is necessary to create a model of this pathology in experimental animals. It is crucial to trace the correlation between changes in organs when this pathology occurs in clinical cases and when it occurs in experimental cases. Today we have a number of methods used to form alloxan diabetes in animals, but alloxan monohydrate is the most frequently used. Thus, the purpose of our study was to: study microscopic changes in the liver, heart, and kidneys of alloxan diabetes rats. The experimental model of diabetes was reproduced by a 150 mg/kg single-dose subcutaneous administration of alloxan monohydrate in the form of a 5% solution per citrate buffer (pH 4.5). To prove the development of diabetes, blood glucose levels were measured by a Rightest GM500 blood glucose meter on the 20th day after administration of alloxan. There were used animals with medium severity diabetes (fasting glucose test showings 10 to 20 mmol/l). The experimental animals were euthanized by ethereal anesthesia decapitation. Samples of the liver, heart, and kidneys for histological examination were taken on the 20th day after administration of alloxan. Histologic sections were prepared according to the standard method, coloring was made by hematoxylin and eosin and based on Van Gizon method. We have found that on the 20th day after the simulation of alloxan diabetes, the liver showed microscopic signs of hepatitis with dystrophic changes in hepatocytes and intracellular cholestasis. The kidneys showed destruction of all structural components of the glomeruli with subsequent necrosis and dystrophic changes and destruction of the epithelium of the curvy and straight tubules. The heart showed granular degeneration of cardiocytes, in some areas, and distinct swelling between the muscle fibers bundles and inside the muscle fibers bundles, infiltration of the connective tissue stroma by erythrocytes in others. We believe that it is possible to obtain the most optimal spectrum of signs peculiar for type 1 diabetes by administration of alloxan as evidenced by microscopic changes in organs. Further, this model of diabetes will be used to study the influence of cell transplantation upon the development of the disease.

Синдром внутрипечёночного холестаза у больных с острыми и хроническими интоксикациями пестицидами

Objective. To study the incidence and peculiarities of intrahepatic cholestasis (IHC) syndrome in patients with toxic liver damage in acute and chronic intoxications with pesticides and to substantiate rational methods of diagnosis and treatment. Material and methods. The incidence has been analysed with the description of IHC syndrome peculiarities in acute and remote periods in 238patients with acute poisoning with pesticides: 162 — herbicides based on 2,4-dichlorophenoxyacetic acid (2,4-D), 62 — phosphororganic pesticides (POP), 14 — synthetic pyrethroids (SP) and 70 — with chronic intoxication with pesticides (CIP). Clinical-instrumental, biochemical and statistical methods of the study have been used. Results and conclusions. Along with neurological disorders, the toxic liver damage was observed in 35,8 % of cases of acute poisoning with 2,4-D-based herbicides, in 51,6 % of cases — with POP poisoning, in 64,2 % of cases — with SP poisoning and in 84,2 % of cases — with CIP. IHC syndrome was detected in 22,8 % of cases in patients with pesticide intoxication against toxic hepatitis and in 18,0 % of cases — without signs of hepatitis. The therapeutic efficacy of ursodeoxycholic acid has been established when it is included in the combined therapy of patients with IHC upon intoxication with pesticides. Key words: pesticides, acute and chronic intoxications, toxic hepatitis, intrahepatic cholestasis syndrome, ursodeoxycholic acid.

Experimental infection of Marmota monax with a novel hepatitis A virus.

To establish an animal model for the newly identified Marmota Himalayana hepatovirus, MHHAV, so as to develop a better understanding of the infection of hepatitis A viruses. Five experimental woodchucks (Marmota monax) were inoculated intravenously with the purified MHHAV from wild woodchuck feces. One animal injected with PBS was defined as a control. Feces and blood were routinely collected. After the animals were subjected to necropsy, different tissues were collected. The presence of viral RNA and negative sense viral RNA was analyzed in all the samples and histopathological and in situ hybridization analysis was performed for the tissues. MHHAV infection caused fever but no severe symptoms or death. Virus was shed in feces beginning at 2dpi, and MHHAV RNA persisted in feces for ~2months, with a biphasic increase, and in blood for ~30days. Viral RNA was detected in all the tissues, with high levels in the liver and spleen. Negative-strand viral RNA was detected only in the liver. Furthermore, the animals showed histological signs of hepatitis at 45dpi. MHHAV can infect M. monax and is associated with hepatic disease. Therefore, this animal can be used as a model of HAV pathogenesis and to evaluate antiviral and anticancer therapeutics.

Патоморфологічна характеристика парвовірусного ентериту в собак

Viral enteritis occupy a leading place in the infectious pathology of dogs and lead to severe disorders of such systems as the gastrointestinal, cardiovascular and respiratory.The comprehensive diagnosis of this pathology in dogs is not developed enough. The high variability of clinical signs for parvovirus enteritis, the complexity of the appeal with a large number of qualitative indicators, complicate the diagnosis of this disease for a practical veterinarian. The methods of pathomorphological diagnosis are simple, cheap and accessible to any veterinarian doctor. It is precisely from them that the causes of death of the animal begin to be established, with many diseases and pathological conditions, these methods remain decisive when making a diagnosis.The aim of the work was to study and analyze the pathomorphological features in parvovirus enteritis of dogs.Materials and methods of research. The work was carried out at the Faculty of Veterinary Medicine of the Zhytomyr National Agroecological University, as well as in the veterinary clinics of the city of Zhytomyr: the private veterinary clinics «Bagira» and «Doctor-Zoo», the educational and scientific-production clinic of veterinary medicine of the Faculty of Veterinary Medicine of the (ZNAEU) in the city state Zhitomir Hospital of Veterinary Medicine and Aybolit Private Veterinary Clinic in the period from 2014 to 2017 in breeding and breeding dogs.Diagnostic studies to confirm parvovirus enteritis were performed using the VetExpert and ELISA and PCR rapid tests on the basis of the private veterinary laboratory of Bald Ltd. (Kyiv).The pathoanatomical section of dogs of all ages who died from parvovirus enteritis was performed by partial evisceration in a generally accepted sequence.The article presents the results of the study of pathoanatomical changes in dogs for parvovirus enteritis, which depended on the form of manifestation of the disease – intestinal, cardiac or mixed. The most pronounced pathological and anatomical changes were found in the gastrointestinal tract (intestinal form), mainly in the small intestine.In the dead animals, a complex of pathoanatomical signs that can be considered characteristic of parvovirus enteritis are found: hemorrhagic enteritis, serous-hemorrhagic inflammation of the mesenteric lymph nodes, signs of hepatitis, acute altered myocarditis, and in the lungs – hemorrhages and foci of atelectasis and enlargement of the spleen.

Hepatic Complications of Anorexia Nervosa.

Anorexia nervosa (AN) has the highest mortality rate of all psychiatric illnesses due to the widespread organ dysfunction caused by the underlying severe malnutrition. Starvation causes hepatocyte injury and death leading to a rise in aminotransferases. Malnutrition-induced hepatitis is common among individuals with AN especially as body mass index decreases. Acute liver failure associated with coagulopathy and encephalopathy can rarely occur. Liver enzymes may also less commonly increase as part of the refeeding process due to hepatic steatosis and can be distinguished from starvation hepatitis by the finding of a fatty liver on ultrasonography. Individuals with AN and starvation-induced hepatitis are at increased risk of hypoglycemia due to depleted glycogen stores and impaired gluconeogenesis. Gastroenterology and hepatology consultations are often requested when patients with AN and signs of hepatitis are hospitalized. It should be noted that additional laboratory testing, imaging, or liver biopsy all have low diagnostic yield, are costly, and potentially invasive, therefore, not generally recommended for diagnostic purposes. While the hepatitis of AN can reach severe levels, a supervised increase in caloric intake and a return to a healthy body weight often quickly lead to normalization of elevated aminotransferases caused by starvation.

Consistency analysis on acute hepatitis B inpatients reported by hepatitis B surveillance pilot spots in six provinces of China

Objective: To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved. Methods: Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System. We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made, on hepatitis B. Results: A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016. In terms of the durations of disease, among the 179 cases who were HBsAg positive, 32.40% (58/179) of them exceeding 6 months, 2.79% (5/179) within 6 months and 64.80% (116/179) tested the first time or never. Among the 179 cases who claimed having the history of hepatitis, 33.52% (60/179) of them identified as having hepatitis B, 1.12% (2/179) were hepatitis A, C or E, 41.34% (74/179) did not have the signs on hepatitis, while the rest 24.02% (43/179) did not know the situation. Only 79.89% (143/179) of the patients showed the symptoms or signs of hepatitis, but the rest 20.11% (36/179) did not. Among the 179 reported acute hepatitis patients, 67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B. The consistent rate of acute hepatitis B was 37.43% (67/179). Among the 112 cases that were diagnosed as non-acute hepatitis B, proportions of chronic hepatitis B and cirrhosis were 49.11%(55/112) and 16.07%(18/112) respectively. Conclusion: Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor. Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia, set by the government.

COMMD1-Deficient Dogs Accumulate Copper in Hepatocytes and Provide a Good Model for Chronic Hepatitis and Fibrosis

New therapeutic concepts developed in rodent models should ideally be evaluated in large animal models prior to human clinical application. COMMD1-deficiency in dogs leads to hepatic copper accumulation and chronic hepatitis representing a Wilson’s disease like phenotype. Detailed understanding of the pathogenesis and time course of this animal model is required to test its feasibility as a large animal model for chronic hepatitis. In addition to mouse models, true longitudinal studies are possible due to the size of these dogs permitting detailed analysis of the sequence of events from initial insult to final cirrhosis. Therefore, liver biopsies were taken each half year from five new born COMMD1-deficient dogs over a period of 42 months. Biopsies were used for H&E, reticulin, and rubeanic acid (copper) staining. Immunohistochemistry was performed on hepatic stellate cell (HSC) activation marker (alpha-smooth muscle actin, α-SMA), proliferation (Ki67), apoptosis (caspase-3), and bile duct and liver progenitor cell (LPC) markers keratin (K) 19 and 7. Quantitative RT-PCR and Western Blots were performed on gene products involved in the regenerative and fibrotic pathways. Maximum copper accumulation was reached at 12 months of age, which coincided with the first signs of hepatitis. HSCs were activated (α-SMA) from 18 months onwards, with increasing reticulin deposition and hepatocytic proliferation in later stages. Hepatitis and caspase-3 activity (first noticed at 18 months) increased over time. Both HGF and TGF-β1 gene expression peaked at 24 months, and thereafter decreased gradually. Both STAT3 and c-MET showed an increased time-dependent activation. Smad2/3 phosphorylation, indicative for fibrogenesis, was present at all time-points. COMMD1-deficient dogs develop chronic liver disease and cirrhosis comparable to human chronic hepatitis, although at much higher pace. Therefore they represent a genetically-defined large animal model to test clinical applicability of new therapeutics developed in rodent models.