Papillary Stenosis and Sclerosing Cholangitis in the Acquired Immunodeficiency Syndrome

Schneiderman, David J.; Cello, John P.; Laing, F C

doi:10.7326/0003-4819-106-4-546

Cited by 145 publications

(44 citation statements)

References 12 publications

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“…This may be responsible for the increase in the serum liver enzymes in the infected patients. As a support to our findings, various studies have shown a significant increase in the serum AST, ALT and the ALK-P activities in the ART naive, HIV positive cases as compared to the control subjects [26][27][28].…”

Section: Methodssupporting

confidence: 79%

Liver Function Profile Anomalies in HIV Seropositive Tuberculosis

Dey

Ghosh²,

Bhattacharjee³

et al. 2013

JCDR

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Background: The Human Immunodeficiency Virus (HIV) and the Tuberculosis (TB) co infection are contributory to each other in causing a progressive decline in the cell mediated immunity and a damage to the hepatobiliary system. The aim of our study was to estimate the extent of liver damage which was caused by these infections before the start of the therapy with hepatotoxic drugs like Antiretroviral Therapy (ART) and Antitubercular Drugs (ATD). Methods:One hundred and ninty three confirmed HIV positive cases were enrolled in this study. The cases were divided into 2 groups; Group 1-100 subjects with TB and Group 2-93 subjects without TB.80 age and sex matched controls were also included (Group 0). Some parameters of the serum Liver Function Test (LFT) were estimated biochemically by using an auto analyzer (ERBA XL600,Transasia). Results:The serum total bilirubin, Alanine Transaminase (ALT), Aspartate Transaminase (AST) and the Alkaline Phosphatase (ALK-P) levels were significantly higher in the cases as compared to those in the controls, more so in the cases with the associated TB co infection, except the AST levels. The Group 1subjects had lower serum total protein and albumin levels and altered albumin/globulin ratios as compared to the controls. A statistically significant difference was absent in the serum total protein levels between the Group 2 cases and the Group 0 controls. No significant differences were observed when the values for serum total protein, albumin and globulin and the albumin: globulin ratios among the two case groups (1 and 2) were compared. Conclusion:The results have shown the importance of estimating some LFT parameters, prior to the start of ATD and ART in these cases. Hence, a mandatory performance of LFT is recommended, as it is simple and cost effective.

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Section: Methodssupporting

confidence: 79%

Liver Function Profile Anomalies in HIV Seropositive Tuberculosis

Dey

Ghosh²,

Bhattacharjee³

et al. 2013

JCDR

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“…20,21 In spite of severe immunosuppression in the marrow transplant population, cholangitis due to cryptosporidiosis has not been previously reported. Case 4 had colitis secondary to cryptosporidium with intrahepatic biliary strictures that resolved after restoration of cell-mediated immunity and 1 year of treatment with spiramycin.…”

Section: Discussionmentioning

confidence: 99%

“…Papillitis with intra-and extrahepatic biliary strictures secondary to CMV has been reported in other immunocompromised patient populations but rarely in marrow transplant recipients. [17][18][19][20][21] In case 5, although CMV was never isolated from the biliary tree because of ganciclovir treatment, 22 the clinical and cholangiographic images were typical of CMV. In the past, CMV was a common opportunistic infection occurring in up to 60% of patients.…”

Section: Discussionmentioning

confidence: 99%

Biliary obstruction in hematopoietic cell transplant recipients: an uncommon diagnosis with specific causes

Murakami

Louie

Chan

et al. 1999

Bone Marrow Transplant

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Summary:Jaundice is a common problem in marrow transplant recipients. The incidence of bile duct obstruction in this setting is unknown. The purpose of this study was to determine the incidence of biliary obstruction, the causes, and outcomes following marrow transplant. Consecutive cases were reviewed at two major transplant centers in the United States from 1969 to 1996 at the Fred Hutchinson Cancer Research Center and 1989 to 1996 at the City of Hope National Medical Center. Nine cases of biliary obstruction were identified as a cause of jaundice in 7412 marrow transplant recipients, an incidence of 0.12%. The presentation was bimodal, with seven cases occurring prior to day 100 and two occurring 2 to 4 years after transplantation. The age distribution was 15 to 50 years and all patients had received allogeneic transplants. The causes of obstruction included gallbladder sludge (n‫,)1؍‬ a duodenal hematoma (n‫,)1؍‬ choledocholithiasis with biliary pancreatitis (n‫,)1؍‬ bile duct infection (n‫,)2؍‬ recurrent malignancy (n‫,)1؍‬ choledocholithiasis associated with a benign stricture (n‫,)1؍‬ Epstein-Barr virus-related lymphoproliferative disorder (n‫,)1؍‬ and a benign stricture of unknown etiology (n‫.)1؍‬ Biliary obstruction is a rare cause of jaundice in the post-transplant period. The presentation was similar to that of other post-transplant hepatobiliary problems, but with disparate causes.

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“…Nonspecific hepatic inflammatory changes including mononuclear cell infiltrates or fibrosis in the portal triads, and swollen hepatocytes with vacuolated cytoplasm in~ dicative of chronic hepatocellular injury that were also observed in our population, have also been frequently noted in HIV-infected adults.l,J Biliary tract disease is recognized as a complication of AIDS in adults. & 1~1 5 The prevalence of gallbladder and bile duct abnormalities on sonography has been reported to be as high as 50%.11 Abnormalities of the biliary tract include dilatation and wall thickening of the gallbladder, and dilatation, irregularity, and stricture of the intra-and extra-hepatic bile ducts. Bile duct dilatation is most likely related to acalculous inflammation of the biliary tract caused by the im- Chronic hepatocellular injury Normal mune deficiency itself or to secondary infection by opportunistic infections that typically involve the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Hepatobiliary abnormalities on sonography in children with HIV infection.

Chung

Sivit

Rakusan

et al. 1994

Journal of Ultrasound in Medicine

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Maadhava Ellaurie, MOOur purpose was to characterize the spectrum of hepatobiliary abnormalities on sonography in children with vertically transmitted HIV infection. Abdominal sonograms were performed on 41 children with HIV infection and correlated with clinical and histopathologic data. HepatobiIiary abnormalities were noted in 26 (63%) chilqren. Hepatomegaly (n = 13) and abnormal hepatic echotexture (11 ~ 13) were the most common abnormalities noted. Preexisting AIDS-related infections or neoplasms were noted significantly more frequently in children with hepatic or biliary abnormalities on sonography (18/26, 69%)

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Papillary Stenosis and Sclerosing Cholangitis in the Acquired Immunodeficiency Syndrome

Cited by 145 publications

References 12 publications

Liver Function Profile Anomalies in HIV Seropositive Tuberculosis

Liver Function Profile Anomalies in HIV Seropositive Tuberculosis

Biliary obstruction in hematopoietic cell transplant recipients: an uncommon diagnosis with specific causes

Hepatobiliary abnormalities on sonography in children with HIV infection.

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