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Dadun > Depósito Académico > CIMA (Centro de Investigación Médica Aplicada) > Área de Terapia génica y Hepatología > Oncobiología > DA - CIMA - Terapia génica y Hepatología - Oncobiología - Artículos de revista >

Pathological and virological findings in patients with persistent hypertransaminasaemia of unknown aetiology
Authors: Berasain, C. (Carmen)
Betes, M.T. (María Teresa)
Panizo, A. (Ángel)
Ruiz, J. (Juan)
Herrero, J.I. (José Ignacio)
Civeira, M.P. (María Pilar)
Prieto, J. (Jesús)
Keywords: Cryptogenic liver disease
Cryptogenic hepatitis
Hepatitis B virus
Hepatitis C virus
Hepatitis G virus
Non-alcoholic steatohepatitis
Issue Date: 2000
Publisher: BMJ Publishing Group
Publisher version: http://gut.bmj.com/content/47/3/429
ISSN: 1468-3288
Citation: Berasain C, Betes M, Panizo A, Ruiz J, Herrero JI, Civeira MP, et al. Pathological and virological findings in patients with persistent hypertransaminasaemia of unknown aetiology. Gut 2000 Sep;47(3):429-435.
Abstract
BACKGROUND: The histopathological spectrum and role of hepatitis viruses in cases of hypertransaminasaemia of unknown aetiology have not been correctly analysed in a sufficiently large number of patients. METHODS: We studied 1075 consecutive patients referred for liver biopsy because of elevation of alanine aminotransferase (ALT) levels for more than six months. From this population we selected those cases in whom the aetiology could not be defined from clinical, biochemical, and serological data obtained before biopsy. In these patients liver biopsies were reviewed, and hepatitis B virus (HBV)-DNA and hepatitis C virus (HCV)-RNA were assayed in serum by polymerase chain reaction (PCR). Serum hepatitis G virus (HGV)-RNA was determined by PCR in 74 patients. RESULTS: Of 1075 patients studied, the cause of the increased serum ALT levels remained elusive after appropriate testing in 109 patients (10.1%). Liver biopsies from these patients showed non-specific changes in 32.7% of cases, non-alcoholic steatohepatitis (NASH) in 15.8%, and chronic hepatitis or cirrhosis in 51.5%. HBV-DNA and/or HCV-RNA was detected more frequently in cryptogenic liver disease than in healthy blood donors (26.7% v 3.4%; p<0.001). HGV-RNA was found in only one patient. The proportion of cases with detectable HBV-DNA or HCV-RNA was 14.3% in patients with non-specific changes or NASH, 30.7% in patients with chronic hepatitis, and 61.5% in patients with cirrhosis. Cirrhosis was found more frequently in patients with positive HBV-DNA and/or HCV-RNA in serum than in those who tested negatively (p=0.005). CONCLUSIONS: In our series, patients in whom biochemical and serological data did not determine the aetiology of the disease represented 10% of all cases referred for liver biopsy for persistent elevation of serum transaminases. Approximately 50% of patients had chronic hepatitis or cirrhosis and the remainder had NASH or non-specific changes. Occult viral infections were found in a high proportion of cases in the first group and in a low percentage of patients in the second.
Permanent link: http://hdl.handle.net/10171/23324
Appears in Collections:DA - CIMA - Terapia génica y Hepatología - Oncobiología - Artículos de revista

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