A 63-year-old returned traveller with fever, rash, hepatitis and eosinophilia

Jeimy, Samira; MCRAE, K. D.; Pattani, Reena

doi:10.1503/cmaj.171134

Cited by 3 publications

(1 citation statement)

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“…Other symptoms recorded in this study include itching (in 46% of patients), itching (in 33% of patients), Arthralgia (in 20% of patients) and decompensated liver cirrhosis (in 3 patients, of which one is 72 years old) have also been reported by previous studies. 45,46 Liver cirrhosis has been reported to be the mode of AIH presentation in 30% to 50% of patients while Czaja and Carpenter described a greater frequency of cirrhosis at presentation (33%) in elderly patients. 47,48 Delays in diagnosis resulting from low awareness of AIH among patients and doctors as well may be the major contributor to these presentations in Iraq.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Hepatitis: Evaluation of Clinical Presentation, Diagnosis and Response to Treatment in Iraqi Patients

Algraittee

2021

JCD

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Introduction: Autoimmune hepatitis (AIH) is a chronic heterogeneous inflammatory disease of the liver activated by unknown triggers. The details of its pathogenesis remain unclear. Sufficient data on AIH in terms of epidemiology as well as disease phenotype amongst the Iraqi population is not available. Objectives: To evaluate and document the experience of Iraqi AIH patients with respect to clinical presentation, diagnosis, treatment and response to treatment in accordance with the IAIHG guidelines. Method: A prospective study was conducted on patients who attended the Gastroenterology Hepatology Teaching Hospital in Baghdad, Iraq. After examination, many biochemical and pathological parameters were analysed. Liver biopsy, abdominal ultrasound, and upper endoscopy were done. Results: Among the 70 respondents, jaundice, fatigue, arthralgia, and itching were the major symptoms recorded at presentation. Immunologic findings were positive for ANA (31 patients) and ASMA (25 patients) while hypergammaglobulinemia was recorded in 97% of all patients. Pre-treatment scoring revealed 56 definite and 14 probable AIH patients while post-treatment scoring yielded 13 definite and 23 probable AIH patients. Response to treatment showed 6 patients as non-responders, 34 patients (49%) exhibited complete response while 30 patients (43%) had a partial response. Conclusions: Iraqi patients with AIH presented late at the advanced stage of the disease with a majority having hypergammaglobulinemia which forms a solid base for disease suspicion. It is recommended that a complementary study with a larger sample size, longer follow-up duration and inclusion of cases of idiopathic hepatitis is needed.

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Section: Discussionmentioning

confidence: 99%

Autoimmune Hepatitis: Evaluation of Clinical Presentation, Diagnosis and Response to Treatment in Iraqi Patients

Algraittee

2021

JCD

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Sulfasalazine

2018

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Drug reaction with eosinophilia and systemic symptoms (DRESS) caused by sulfasalazine: a case report and literature review

Fedorov,

Savelyeva,

Grabovetskay

et al. 2024

Sovremennaâ revmatologiâ

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Drug-induced hypersensitivity syndrome (DIHS) or drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially fatal systemic reaction characterized by multiorgan damage involving the liver, hematopoietic system and skin, and heterogeneous manifestations of fever, rash, lymphadenopathy and eosinophilia with unpredictable course.We describe a 41-year-old female patient who developed DRESS syndrome after taking sulfasalazine prescribed for non-radiographic axial spondyloarthritis. Treatment with intravenous and then oral glucocorticoids was effective. A review of the literature on this topic is presented.

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A 63-year-old returned traveller with fever, rash, hepatitis and eosinophilia

Cited by 3 publications

References 10 publications

Autoimmune Hepatitis: Evaluation of Clinical Presentation, Diagnosis and Response to Treatment in Iraqi Patients

Autoimmune Hepatitis: Evaluation of Clinical Presentation, Diagnosis and Response to Treatment in Iraqi Patients

Sulfasalazine

Drug reaction with eosinophilia and systemic symptoms (DRESS) caused by sulfasalazine: a case report and literature review

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