May hepatic granulomas be part of the histological spectrum of chronic hepatitis C?

[Guest guest]

http://www.eurekalert.org/pub_releases/2008-12/wjog-mhg122508.php

Public release date: 29-Dec-2008

[ Print Article | E-mail Article | Close Window ]

Contact: Lin Tian

wjg@...

86-105-908-0039

World Journal of Gastroenterology

May hepatic granulomas be part of the histological spectrum of chronic hepatitis

C?

While older large series of patients with hepatic granulomas have found

sarcoidosis and tuberculosis to be the most common causes of hepatic granulomas,

recent works have noted some patients with chronic hepatic C and hepatic

granulomas and no other obvious associations. Today, patients that undergo liver

biopsy often have chronic hepatitis C that is being staged prior to possible

anti viral therapy. The age of HIV and immunosuppression for organ transplants

has also made opportunistic infections associated with hepatic granulomas more

likely.

A research article to be published on November 7, 2008 in the World Journal of

Gastroenterology addresses this question. The research team led by Ned Snyder

from the University of Texas medical branch report a retrospective study of over

4 000 liver biopsies as well as a prospective study of 240 patients with chronic

hepatitis C undergoing routine liver biopsies. They found that the most common

association for hepatic granulomas was chronic hepatitis C. In the prospective

study of patients with stable hepatitis C, almost 1% had hepatic granulomas.

In this paper, no reason for the association between granulomas and hepatitis C

was found unless granuloma formation is part of the immune response to chronic

hepatitis C. Hepatic granulomas have been associated with interferon therapy for

hepatitis C and other disorders, but only one patient in the study had received

interferon. Granulomas sometimes can develop in intravenous drug users from talc

in the injection solution, but examination of the biopsies with polarized light

revealed only one patient with crystalloid particles.

The authors concluded that granulomas are an uncommon part of the histologic

spectrum of chronic hepatitis C. When granulomas are found in the liver of a

patient with chronic hepatitis C, the clinician should be comfortable with the

association after other pertinent diseases are excluded.

A reviewer felt this paper is a very good retrospective examination of

characteristics associated with hepatogranulomas, with the added strength of the

prospective surveillance.

###

Reference: Snyder N, ez JG, Xiao SY. Chronic hepatitis C is a commonly

associated with hepatic granulomas. World J Gastroenterol 2008; 14(41):

6366-6369

http://www.wjgnet.com/1007-9327/14/6366.asp Telephone: +1-409-7721501 Fax:

+1-409-7724789

Correspondence to: Ned Snyder, MD, 301 University, Department of Internal

Medicine, Division of Gastroenterology,Galveston, Texas 77555-0764, United

States. nesnyder@...

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in

gastroenterology and hepatology, has established a reputation for publishing

first class research on esophageal cancer, gastric cancer, liver cancer, viral

hepatitis, colorectal cancer, and H pylori infection and provides a forum for

both clinicians and scientists. WJG has been indexed and abstracted in Current

Contents/Clinical Medicine, Science Citation Index Expanded (also known as

SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE

and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals,

Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and

Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a

weekly journal published by WJG Press. The publication dates are the 7th, 14th,

21st, and 28th day of every month. WJG is supported by The National Natural

Science Foundation of China, No. 30224801 and No. 30424812, and was founded with

the name of China National Journal of New Gastroenterology on October 1, 1995,

and renamed WJG on January 25, 1998.