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The autoimmune liver disease constituent conditions include autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis and IgG-4 associated cholangitis. They remain a diagnostic challenge to the practicing physician due to their close resemblance in clinical course, and laboratory and imaging findings to the vast array of other etiologies of liver injury. We report a case of recurrent severe hepatitis of autoimmune origin in a female patient. The disease course was marked by initial onset at age 39, followed by nearly four years of remission, and a second flare with a more exaggerated severity. Systemic lupus erythematosus was initially deemed as the culprit, however formal diagnostic criteria were not fulfilled and the serological findings were not reproduced at a later date. With the aim of ascertaining the underlying process, the patient underwent an extensive array of testing with regards to infectious, genetic, systemic and autoimmune disease. Positive anti-dsDNA (double stranded DNA) and an antinuclear antibody titer of 1:160 provided the strongest support for an autoimmune etiology, specifically autoimmune hepatitis or possibly an overlap syndrome. An excellent outcome was achieved via treatment with corticosteroids, ursodeoxycholic acid and plasmapheresis.
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http://dx.doi.org/10.2478/prilozi-2021-0007 | DOI Listing |
Semin Radiat Oncol
April 2025
Department of Radiation Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX.
Reirradiation of the head and neck presents one of the most complex and challenging scenarios faced by (for) clinicians due to the narrow therapeutic window. Its use is increasing in clinical practice, often guided by empirical and pragmatic approaches due to the limited availability of high-level evidence from randomized clinical trials. Successful reirradiation requires a precise balance between tumor control probability (TCP) and normal tissue complication probability (NTCP).
View Article and Find Full Text PDFIntern Med
March 2025
Department of General Internal Medicine, Teine Keijinkai Hospital, Japan.
Hyponatremic hypertensive syndrome (HHS) is a rare disorder, particularly in adults. A 76-year-old woman presented with vomiting and severe hyponatremia. The patient had been hospitalized four times over the past four years due to hyponatremia and recurrent vomiting.
View Article and Find Full Text PDFJ AAPOS
March 2025
Ophthalmology Department, Cairo University, Cairo, Egypt.
Purpose: To compare the functional and aesthetic outcomes of two surgical techniques used to correct severe congenital ptosis with poor levator function (LF): frontalis muscle (FM) flap advancement and frontalis sling (FS) surgery.
Methods: This prospective interventional randomized comparative study included 42 eyelids of 34 children with severe congenital ptosis and poor LF. The children were randomly divided into two groups, with 21 eyelids of 19 patients undergoing FM flap advancement, and 21 eyelids of 15 patients undergoing FS surgery.
J Biomech
March 2025
Department of Mechanical Engineering, University College London, London, UK; UCL Hawkes Institute, University College London, London, UK. Electronic address:
Peripheral Arteriovenous Malformations (pAVMs) are congenital vascular anomalies characterised by abnormal connections between arteries and veins that bypass the capillary network. This bypass results on a high-flow and low resistance vascular structure termed nidus. The high-flow and complex angioarchitecture of pAVMs makes treatment challenging and often suboptimal, as evidenced by high recurrence rates.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
March 2025
Department of Obstetrics and Gynecology, Herlev University Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
Obstetric anal sphincter injury (OASI) is a severe complication of vaginal delivery. Up to 50% of women with OASI will experience anal incontinence at long-term. However, it is uncertain whether an elective cesarean section (CS) in a subsequent pregnancy following OASI decreases the risk of anal incontinence.
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