Volume 65 - 2002 - Fasc.3 - Original articles
The prevalence of autoimmune hepatitis in Hashimoto's thyroiditis in a turkish population
Purpose : Hashimoto's thyroiditis (HT) is an autoimmune thy- roid disorder. Although its etiopathogenesis is obscure, there are many findings about the relationship between other autoimmune diseases and HT. The reason for this association is a topic of inter- est, but in our study we searched for the concurrence of autoim- mune hepatitis (AH) with HT, which is a relatively new autoim- mune disorder for this association.
Methods : Forty-six patients (44 female, 2 male) with HT were included in the study. Liver function tests, viral hepatitis markers, autoantibody panels, ultrasonography and liver biopsy were per- formed in certain cases.
Results : All patients were hepatitis B negative, only two patients were hepatitis C positive (4.3%). Smooth muscle antibody (SMA) was 21.7% positive, ANA was 26% positive, Anti-Liver kidney microsomal antibody-1 (LKM-1) was 13.4% positive. Anti-mito- chondrial antibody (AMA) was not detected. Liver biopsy per- formed on six patients. Two of them had (+++) positive LKM-1 antibody titer, the other two had ANA and SMA positive results respectively and the last two had chronic hepatitis C infection. The pathology revealed AH in first four patients. We found four out of forty-six patients with HT as AH (8.69%).
Conclusion : HT patients should be searched for autoimmune diseases and AH might be one of them. (Acta gastroenterol. belg., 2002, 65, 143-145).
Influence of L-NAME and L-Arg on ischaemia-reperfusion induced gastric mucosa damage
Objective : The aim of this study was to investigate effects of L-NAME and L-Arginine on gastric mucosal injury induced by ischaemia-reperfusion.
Methods : In the experiment, 20 New Zealand rabbits were used (2700-3000 g). Celiac artery was clamped for 30 min for ischaemia and then 60 min of reperfusion followed this after all rabbits were anaesthetized. In the Sham-control group (G 1, n = 5), laparotomy was performed, and the celiac artery was prepared without clip- ping. Group 2 (Untreated, n = 5) rabbits were only subjected to ischaemia-reperfusion. Group 3 (n = 5) rabbits had L-Arginine Methyl Ester (L-Arg) 3 mg/kg/min as IV infusion during the first 15 min of the reperfusion. Group 4 (n = 5) rabbits had a nitric oxide inhibitor NG-nitro-L-arginine methyl ester (L-NAME) 100 µg/kg/min IV during the first 15 min of the reperfusion. After 60 min of reperfusion, the rabbits were killed, and their stomachs were removed for histopathologic evaluation and determination of malondialdehyde (MDA) level.
Results: After ischaemia-reperfusion, Untreated group had macroscopic necrosis involving 50 ± 6% of total gastric mucosa area and deep mucosal necrosis involving 10 ± 5% of mucosal strips. In the group treated with L-NAME, macroscopic mucosal necrosis involved 52 ± 6% of total gastric mucosa area and deep mucosal necrosis involved 11 ± 3% of mucosal strips (both p > 0.05 versus Untreated group). L-Arg treatment significantly reduced macroscopic mucosal necrosis area to 20 ± 6% and deep mucosal necrosis to 3 ± 1% (both p < 0.05 versus Untreated group and L- NAME group). MDA level in the L-Arg group was significantly lower when compared to control and L-NAME group MDA level (p < 0.05).
Conclusion : These results suggest that NO increase induced by L-Arginine injection is involved in the protection of gastric mucosa after ischaemia-reperfusion. (Acta gastroenterol. belg., 2002, 65, 150-154).
Morphological characteristics of chronic hepatitis : A comparative study on Turkish patients
Background: Chronic hepatitis caused by hepatitis B and hepatitis C viruses have characteristic histological features. We aimed to compare these histological features between two groups.
Methods : We worked on two groups each contains 50 patients, that are serologically proven, have hepatitis B and hepatitis C. These patients were analysed according to the histological features which are more often seen in chronic hepatitis C.
Results : We found higher percentage of lymphoid follicles and aggregates in portal tracts, bile duct damage or loss and lym- phoreticular reaction in patients with chronic hepatitis C than chronic hepatitis B (44% - 12%, 96% - 14%, 84% - 40%, respec- tively). We recorded most patients with severe portal tract inflam- mation were in group of chronic hepatitis C (86%). Bile duct loss wasn't observed in any patients with chronic hepatitis B , while it was present in 44% of chronic hepatitis C group. There was no significant difference between two hepatitis groups with regard to fatty change. 13 out of 14 patients, having all those above men- tioned histological findings, diagnosed with chronic hepatitis C whereas only one patient had chronic hepatitis B.
Conclusions : Aggregates and follicles forming portal inflamma- tion, lymphoreticular reaction together with bile duct damage, especially with bile duct loss strongly indicates presence of chronic hepatitis C. (Acta gastroenterol. belg., 2002, 65, 146-149).
