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| 1.
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論文
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Niwa, Hideki ; Sasaki, Motoko ; Haratake, Joji ; Kasai, Takahiko ; Katayanagi, Kazuyoshi ; Kurumaya, Hiroshi ; Matsuda, Shinji ; Minato, Hiroshi ; Zen, Yoh ; Uchiyama, Akio ; Miwa, Atsuo ; Saito, Katsuhiko ; Sudo, Yoshiko ; Nakanuma, Yasuni
概要:
金沢大学大学院医学系研究科がん細胞学<br />Aim: Serum antinuclear antibodies (ANA) are occasionally noted in patients with non-alcoholic st
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eatohepatitis (NASH). We examined the significance of ANA in NASH. Methods: We compared clinicopathological features in patients with ANA-positive NASH (n = 35) and ANA-negative NASH (n = 36). Inflammatory cell profiles and the distribution of oxidative stress markers were also examined immunohistochemically. Results: ANA-positive NASH was significantly associated with female gender (P = 0.005), high degree of portal inflammation (P = 0.039), interface activity (P = 0.036) and hepatocellular ballooning (P = 0.0008). In addition, ANA of high titer (320-fold or more) was significantly associated with the histological grade and stage of NASH (P = 0.02). The degree of steatosis wais rather mild in the high-titer ANA group(P = 0.01). The analysis of inflammatory cell profiles revealed that CD3-positive T cells were predominant and plasma cells were rather few in the portal area and hepatic lobules in both ANA-positive and ANA-negative groups. There was no difference in the distribution of oxidative stress markers between ANA-positive and ANA-negative groups. Conclusion: These findings suggest that the presence of ANA may be related to the progression of NASH and that a different type of autoimmune mechanism may be involved in the pathogenesis of NASH with ANA, compared to the pathogenesis of autoimmune hepatitis. © 2007 The Japan Society of Hepatology.
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| 2.
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Ogawa, Haruhiko ; Kurashima, Kazuyoshi ; Namura, Masanobu ; Kanaya, Hounin ; Kawamura, Youichi ; Ohka, Takio ; Kurumaya, Hiroshi ; Yasui, Masahide ; Fujimura, Masaki ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />An increasing number of drugs have been implicated in the etiology of eosinophilic pneumonia charact
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erized by the development of pulmonary infiltrates, and peripheral blood eosinophilia. Naproxen is a commonly used nonsteroidal anti-inflammatory drug which may be added to the growing list of pharmacologic agents associated with infiltrative pulmonary lesions. A case of eosinophilic pneumonia induced by Naproxen is described. The results of TBLB, a lymphocyte stimulation test, and a challenge test supported this diagnosis.
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論文
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Ren, Xiangshan ; Harada, Kenichi ; Yoshikawa, Seiichi ; Igarashi, Saya ; Urabe, Takeshi ; Yamada, Shinya ; Katayanagi, Kazuyoshi ; Kurumaya, Hiroshi ; Nakanuma, Yasuni
概要:
金沢大学医薬保健研究域医学系<br />We report the case of an 80-year-old female suffering from pancreatic cancer who developed severe no
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n-alcoholic steatohepatitis (NASH) resulting in fatal hepatic failure after anti-cancer chemotherapy with gemcitabine. Hepatic encephalopathy appeared 1 year after the chemotherapy, and the patient developed progressive liver failure and eventually died. Radiological examination showed severe fatty liver. Histopathological examination of a liver needle necropsy showed almost panlobular macrovesicular fatty change. Ballooning degeneration and necrosis of hepatocytes accompanying neutrophil infiltration, Mallory bodies, and a few bile plugs were found in zone 3. Marked perivenular and pericellular/perisinusoidal fibrosis and extensive bridging fibrosis were also found. Together, these findings indicated steatohepatitis at a precirrhotic stage. Because the patient had no history of drinking in excess, we made a diagnosis of NASH, in particular, chemotherapy-associated steatohepatitis (CASH). Gemcitabine is a pyrimidine nucleoside antimetabolite with anti-cancer activity. A few reports have mentioned fatal hepatotoxicity caused by gemcitabine, but, to our knowledge, this is the first report of steatohepatitis, possibly associated with gemcitabine. Physicians treating patients with this drug should be aware of the possibility of steatohepatitis. © Springer 2010.
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論文
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Ikeda, Hiroko ; Katayanagi, Kazuyoshi ; Kurumaya, Hiroshi ; Harada, Kenichi ; Sato, Yasunori ; Sasaki, Motoko ; Nakanuma, Yasuni
概要:
Hypereosinophilic syndrome (HES) is defi ned by elevation more than 1.5×109/L of presence of a peripheral blood count, e
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vidence of organ involvement, and exclusion of secondary eosinophilia such as allergic, vasculitis, drugs, or parasite infection and also clonal eosinophilia. We present the HES case with hepatic involvement. The patient is 70-year-old male. He complained fever and back pain. Blood examination showed marked peripheral eosinophilia, elevation of transaminase and biliary enzymes. Multiple irregular mass lesions of the liver were pointed out by CT and MRI. The liver biopsy was done for differentiation from malignancy. In parenchyma, hepatic necrotic lesion was observed accompanying severe eosinophilic infi ltration with Charcot-Leyden’s crystals. There was granulomatous reaction. He was diagnosed as HES and got recovery due to steroid therapy. From the review of HES article, the hepatic histology is categorized into four types as below: 1) cholangitis type; 2) chronic active hepatitis type; 3) vasculopathic type, 4) hepatic necrosis type. Our case is classifi ed in hepatic necrosis type. This type seems to be important to distinguish malignant tumor and also visceral larva migrans by liver biopsy.
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