Pilot study on the assessment of unrecognized alcoholic liver disease in patients with metabolic dysfunction-associated steatotic liver disease using the ANI score.

This pilot study evaluates the presence of potential unrecognized steatotic liver disease with moderate alcohol consumption (MetALD) in patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) using the ALD/NAFLD index (ANI) score. A retrospective single-center study was conducted on 85 patients attending Digestive Diseases consultations in May and June 2024. MASLD was defined by hepatic steatosis with limited alcohol intake (<20 g/day for women and <30 g/day for men) and at least one cardiovascular risk factor.

Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a high mortality neoplasm which usually appears on a cirrhotic liver. The therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at diagnosis. Notwithstanding the current deployment of treatments with curative intent (liver resection/local ablation and liver transplantation) in early and intermediate stages, a high rate of HCC recurrence persists, underscoring a pivotal clinical challenge.

Current characteristics of patients with hepatitis C virus: results from an automated alert system.

Alert systems are proving to be useful to increase hepatitis C virus (HCV) diagnoses and facilitating access to antiviral treatment. Since 2020, our health department has had a fully automated alert system set up at the Microbiology Department. In this study, we present the results of the 2022-2023 period to assess the current characteristics of HCV diagnosed patients.

Extrahepatic ischemic complications following transarterial chemoembolization for hepatocellular carcinoma.

Transarterial chemoembolization of hepatocellular carcinoma consists of the selective release of chemotherapeutic agents in the tumor feeding arteries (and their subsequent occlusion) and presents a low risk of extrahepatic complications. However, the presence of anatomical variants of the celiac trunk is common and facilitates these complications by connecting the hepatic arterial vascularization with that of the surrounding organs. We present three clinical cases of extrahepatic ischemia in three different organs (esophagus, stomach and gallbladder) following transarterial chemoembolization in patients who presented one of these anatomical variants.

Hepatitis B virus reactivation after ibrutinib treatment.

New immunosuppressive and antineoplastic drugs are becoming both more numerous and more widely used, even during several years. Most of them present a low-moderate risk of hepatitis B virus (HBV) reactivation in HBsAg-negative and anti-HBc-positive patients. However, their reactivation capacity has not been clearly studied.

Outcomes of an automated alert system from Microbiology to link diagnosis to treatment in patients with hepatitis C virus.

Introduction: simplification strategies for the care circuit of patients with hepatitis C virus (HCV) are key to achieve eradication. An electronic identification system was set up for HCV serology to link diagnosis to specialist management, aimed to reduce patient loss.

Material And Methods: a retrospective, single-center study was performed in patients with HCV identified from 15/3/2020 to 15/12/2021, using an alert system from Microbiology that notified specialists of positive cases.

Abnormal liver chemistry constitutes an independent prognostic factor of less favorable clinical course in patients with COVID-19.

Introduction: abnormal liver biochemistry (ALB) is correlated with increased clinical involvement or severity in COVID-19, but its prognostic implications have not been studied extensively. The aim of this study was to determine whether ALB is a risk factor for unfavorable clinical outcome and involvement.

Materials And Methods: a retrospective, single-center study in confirmed COVID-19 cases.

Assessment of liver damage in patients with COVID-19 is sub-optimal: results of a survey of medical practitioners.

Liver damage, defined by an increase in liver chemistry parameters, is related to more unfavorable severity and prognosis in patients with COVID-19. These patients are also treated with immunomodulatory drugs capable of reactivating hepatitis B virus (HBV), with an indication for prophylaxis in specific situations. Due to its importance in this pathology, we wondered whether physicians should perform a systematic search for liver damage and HBV.

Diagnostic yield of the capsule endoscopy and enteroscopy combination for early small bowel carcinoid tumors.

Small bowel carcinoid tumor is a difficult to diagnose entity that can present an aggressive clinical course even if they are small in size. The diagnosis based on tumor markers and imaging tests is limited, but the combination of capsule endoscopy followed by enteroscopy when the carcinoid tumor is suspected, has been shown to be useful for its early diagnosis, as well as for reaching a thorough study of the small bowel. We present a clinical case of two small synchronous carcinoid tumors of the ilium that were diagnosed by using this strategy.

Epithelioid hemangioendothelioma: a rare cause of a liver tumor.

Hepatic hemangioendothelioma is a rare tumor which has malignant potential and a difficult radiological differential diagnosis that includes many others liver tumors as metastasic carcinoma, cholangiocarcinoma and, especially, angiosarcoma. Thus, it is an entity that is usually not diagnosed in an accurate way by radiology and further histolopathological study is needed. However, hemangioendothelioma can present certain specificied patterns in contrast-enhanced imaging.

Hepatic encephalopathy due to a congenital portosystemic shunt: a disease with a changeable presentation.

The presence of congenital portosystemic shunts in adult patients is an uncommon entity that can manifests itself with hepatic encephalopathy symptoms. However, its clinical presentation can be very diverse and varied, hence it is essential to bear it in mind to be able to diagnose it. In this manuscript we exemplify this variability by presenting a patient with complex long-standing neurological syndrome of uncertain origin, that was finally diagnosed of portosystemic shunt.

An outbreak of acute hepatitis due to the hepatitis A virus in 2017: are we witnessing a change in contagion risk factors?

There has been an increase in the incidence rates in recent years of sexually transmitted diseases within the cohort of males who have sex with other men (MSM). An outbreak of acute hepatitis due to the hepatitis A virus was reported in 2017, both nationally and internationally. The sexual practices of this cohort are strongly implicated as a mechanism of infection.

Retroperitoneal schwannoma.

Schwannoma is a mesenchymal tumor that is mainly located in the peripheral nerves or the central nervous system. Its retroperitoneal location is rare and commonly asymptomatic. Thus, it is usually diagnosed when imaging tests are performed for other purposes.

[Gastrointestinal bleeding and acute hepatic failure by leptospirosis: an entity that should not be forgotten].

Leptospirosis disease is caused by the spirochete Leptospira. It is a worldwide distribution zoonosis, with predominance in the tropics. In Spain, it is not frequent but some cases have been noticed especially in humid areas surrounded by rivers, lakes or ponds, such as Catalonia, Andalucia or the Valencian Community.

Cystic dystrophy of the duodenal wall: A rare but need-to-know disease.

Cystic dystrophy of the duodenal wall (CDDW) is a serious but uncommon complication of heterotopic pancreatic tissue characterized by increased duodenal wall thickness associated with intraparietal cystic lesions. It is mainly observed in middle-aged male patients with alcoholic chronic pancreatitis. Clinical symptoms are usually nonspecific and it is important to take them into account in patients with the abovementioned history.

Ulcerative colitis in a patient with common variable immunodeficiency: does the treatment differ from the routine?

Common variable immunodeficiency (CVID) is associated with gastrointestinal manifestations, in particular diarrhea (1,2). It is linked to autoimmune disorders such as nodular lymphoid hyperplasia (NLH), possibly increasing the risk of lymphoma (3). The prevalence of chronic inflammatory bowel disease (CIBD) in these patients is increased, above all Crohn's disease (4,5) and its treatment does not seem to differ from the standard (2).

[Collagenous sprue: secondary or independent from celiac disease?].

Collagenous sprue is a rare disease that goes with persistent diarrhea, weight loss and bad absortion, because it affects the small intestine, mainly duodenum and proximal jejunum. Diagnosis is made by having clinical signs and histological proof of atrophy and subepitelial deposit of collagenous material. Its etiology is not known completely, it is proposed that the origin is autoimmune because its relationship with celiac disease.