2024-03-29T17:38:15Z
https://aeji.journals.ekb.eg/?_action=export&rf=summon&issue=3608
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Hepatitis C Virus: From Liver to Bone Disease, There are Multiple Stations
Mohamed
Radwan
Ehab
Darweish
Osteoporosis is defined as a "progressive systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture" Common fractures are vertebral compression fractures, fractures of the distal radius, and proximal femur . World Health Organization defines osteoporosis as a bone mineral density (BMD) measurement of 2.5 standard deviations or more below the population mean BMD of sex-matched young adults, i.e., a t-score of ≤−2.5. The term "established osteoporosis" includes the presence of a fragility fracture . Osteoporosis can result in spontaneous or low trauma fractures in the patients, adversely affecting morbidity, quality of life. The prevalence of osteoporosis associated fracture ranges from 5% to 20% . Osteoporosis and osteopenia are well known complications in patients with chronic liver disease. Its prevalence varies considerably. It ranges from 12 to 55% according to many factors including patient selection, diagnostic criteria, underlying liver disease and it also increases with the increased severity of the liver disease defined as advanced Child-Pugh score . Osteoporosis is a risk factor for development of fractures, which may be a source of morbidity in patients already debilitated by chronic liver disease. Prevention of morbidity of hepatic osteodystrophy is to identify those patients who are predisposed to development of osteopenia and osteoporosis
2014
09
20
114
116
https://aeji.journals.ekb.eg/article_17183_d420c41be6498526f2b9107a064d5000.pdf
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Ascitic Fluid Calprotectin and Serum C-Reactive Protein as Diagnostic Markers for Spontaneous Bacterial Peritonitis
Ehsan
Rizk
Rasha
Elzehery
Sahar
Zakaria
Ahmed
Abdel-Razik
Dina
Elhammady
Background and study aim: Spontaneous bacterial peritonitis (SBP) is an important cause of morbidity and mortality in cirrhotic patients with ascites. The diagnosis of SBP is based on PMN leukocyte cell count exceeding 250/μL in ascitic fluid. However, this procedure is time consuming as well as subjective. C-reactive protein (CRP) has been reported to be a reliable predictor of SBP and an index of therapeutic effectiveness in adults. Ascitic fluid calprotectin reliably predicts PMN count >250/μL, which may prove useful in the diagnosis of SBP. This work was planned aiming to evaluate both ascitic fluid calprotectin and serum CRP as accurate diagnostic laboratory markers for detecting SBP. Patients and methods: From 140 patients; only 124 patients with ascites were included in this study. They were divided into SBP group including 70 patients (49 males and 21 females) and non-SBP group of 54 patients (25 males and 29 females). Serum CRP was determined by latex agglutination and ascitic fluid calprotectin was measured using an enzyme-linked immunosorbent assay. Results : Ascitic fluid calprotectin and serum CRP were significantly higher in SBP patients in comparison with the non-SBP group (754.67 ±256.06 vs. 280.77 ±230.97 and 62.4 ±28.39 vs. 9.81 ±8.98) respectively. In addition, both were positively correlated with ascitic fluid proteins and PMN count as well as with each other. At a cutoff value of 270 mg/dl, ascitic fluid calprotectin had 86% specificity and 97.5% sensitivity for detecting SBP [Area under the receiver operating characteristics curve (AUC) = 0.924 with negative and positive predictive values (NPV, PPV) for ascitic calprotectin 96% and 69% respectively. Conclusion : Ascitic fluid calprotectin and serum CRP may be used as accurate and reliable markers for the diagnosis of SBP.
Ascitic fluid calprotectin
SBP
CRP
2014
09
20
117
125
https://aeji.journals.ekb.eg/article_17184_d05b3155fe6cecb4605c22215d6d9d65.pdf
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Osteoporosis in Chronic Hepatitis C
Abeer
Abdelkader
Ibraheem
Hegazy
Elased
Elbadrawy
Ayman
Zeid
Jihan
Shawky
Soha
El-Hawary
Amal
Jouda
Mohamed
Emara
Background and study aim: Hepatitis C virus infection is a multisystemic disease with many extrahepatic manifestations. Affection of bone matrix density is a common complication of chronic hepatitis and cirrhosis. The pathogenesis of osteoporosis in chronic liver disease is still unknown and is expected to be multifactorial. The aim of this work is to assess the frequency of osteoporosis/osteopenia in patients with chronic hepatitis C virus infection with or without cirrhosis. Patients and methods:This study was carried out on 30 patients with chronic HCV infection without cirrhosis (Group II), 30 patients with chronic HCV infection with compensated cirrhosis (Group III) and 20 age and gender matched healthy controls (Group I). All subjects of the study performed liver function tests, viral markers, liver biopsy, hormonal assay and Bone Mineral density measurement (BMD) by Dual energy X-ray absorptiometry (DEXA). Results : In patients with chronic hepatitis C (group II) the frequency of osteopenia was 11 (36.7%), osteoporosis 2 (6.7 %), total patients with low BMD was 13 (43.3%). In cirrhotic patients (group III), the frequency of osteopenia was 13 (43.3%), osteoporosis was 3 (10.0%), and total patients with low BMD was 16(53.3%) vs 1(5.0%) in the control group (group I). there was also no significant difference between patients with low BMD and patients with normal BMD as regards age, gender, common risk factors, liver function tests or hormonal levels. Conclusion : Reduced BMD is common chronic HCV-infected patients with and without cirrhosis. HCV infection is a risk factor of osteoporosis.
Hepatitis C virus
Bone Mineral Density
Osteoporosis
Cirrhosis
2014
09
19
126
135
https://aeji.journals.ekb.eg/article_17189_7ff004e44a86e47cded1a522abbbb216.pdf
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Transforming Growth Factor Beta One and Non Alcoholic Fatty Liver Disease
Khalid
Hadhoud
Hany
Elsadek
Ayman
Abdel-Rahman
Fawzy
Elmessallamy
Magy
Fawzy
Background and study aim: Hepatic steatosis reflects an imbalance between the uptake and synthesis of fatty acids by the liver and their oxidation and export. The mechanism of cell injury remains unclear. Transforming growth factor – beta 1 (TGF-β1) as a proinflammatory cytokine has become an important issue in the context of pathogenesis and progression of non alcoholic fatty liver disease (NAFLD). This study was planned to assess the value of TGF-β1 in different forms of NAFLD. Patients and methods:This study included 62 patients; 20 patients with benign steatosis (group 1), 20 patients with non alcoholic steatohepatitis (NASH) (group 2) and 22 patients with cirrhosis (group 3), as well as 7 healthy subjects who served as a control group. Each group was subclassified according to the presence of obesity, type 2 diabetes mellitus and hypertriglyceridemia. All participants were subjected to abdominal ultrasound, ultrasound guided needle liver biopsy and routine laboratory investigations e.g. complete blood picture, liver function tests, fasting and 2 hours postprandial blood glucose and serum triglycerides. Results : Serum TGF-β1 in the benign steatosis group was insignificantly different from the control group, while NASH and cirrhosis groups had significantly higher levels compared to control and benign steatosis groups (P<0.001). TGF-β1 in NASH group was significantly higher than in cirrhosis group (428.78 ± 117.15 vs 260.42 ± 110.22 ng/ml, P=0.032). In benign steatosis group, TGF-β1 was insignificantly different among subgroups. In NASH and cirrhotic patients, TGF-β1 was significantly higher in dyslipidemic subgroups. Conclusion : Serum level of TGF-β1 was higher in patients with severe forms of NAFLD (NASH and cirrhosis) than in patients with benign steatosis
Transforming growth factor – beta 1
non alcoholic fatty liver diseases
non alcoholic steatohepatitis
2014
09
29
136
142
https://aeji.journals.ekb.eg/article_17190_ca3dbb12351bc99e4b59f31f7fbfa49d.pdf
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictor for Development of Hepatorenal Syndrome in Patients with Hepatic Cirrhosis
Jihan
Shawky
Soha
Khorshed
Hany
Labib
Background and study aim: Liver cirrhosis has many complications, hepatorenal syndrome (HRS) is one of the most serious complications of it. Neutrophil gelatinase-associated lipocalin (NGAL) is a protein expressed by injured kidney tubular epithelia, urinary NGAL levels rise early in cases of acute kidney impairment before elevation of serum creatinine. The aim of this study is to evaluate NGAL as a biomarker for early detection of HRS in patients with hepatic cirrhosis. Patients and methods: Seventy five patients were studied and divided into two groups, group (I) 50 patients with liver cirrhosis without impairment of kidney functions and group (II) 25 patients with cirrhosis and impaired kidney functions. Urinary NGAL level were measured by ELISA. Results : The mean value of urinary NGAL level in patients with liver cirrhosis was 50 ± 33 ng/ml while in patients with cirrhosis and HRS was 750 ± 250 ng/ml which showed highly statistically significant difference between both groups of patients. Conclusion : Urinary NGAL increases significantly in patients with liver cirrhosis associated with impairment of kidney function than in those with stable cirrhosis and normal kidney function, so it can be used as a marker for prediction of development of HRS in cirrhotic patients.
Neutrophil gelatinase-associated lipocalin
Hepatorenal syndrome
Liver cirrhosis
2014
09
18
143
148
https://aeji.journals.ekb.eg/article_17193_7f5ae7f5219695cf9c805d7e54f21d7e.pdf
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7613
2014
4
3
Doxycycline Induced Extensive Esophageal Ulcerations: Case Report and Review of the Literature
Elsayed
Abd elbaser
Drug induced esophageal disease is common. Doxycycline is one of the commonest causes of drug induced esophageal disease. The diagnosis is usually clinical but endoscopy is the gold standard diagnostic modality. Treatment is mainly depending on discontinuation of the offending medication. If left untreated it can have serious consequences like delayed esophageal stricture. A 22-year-old male had been prescribed doxycycline capsules for acne and developed odynophagia. Endoscopy revealed extensive esophageal ulcerations. He was managed symptomatically with proton pump inhibitors and his odynophagia improved over a period of five days. He was discharged with proper advice regarding medication ingestion and proton pump inhibitor for four weeks.
2014
09
18
149
152
https://aeji.journals.ekb.eg/article_17194_4f2e80adaa587e27542e0f67e457fc31.pdf