RESUMEN
Elevated neopterin levels in blood or urine have been shown to be a marker for the activation of cell-mediated immunity in vitro and in vivo. To evaluate whether neopterin levels are elevated in patients with acute viral hepatitis, we measured urinary levels in 13 patients with hepatitis A, 26 with hepatitis B, 12 with non-A, non-B hepatitis, 8 with jaundice and/or cholestasis due to biliary and pancreatic disorders and 3 with alcoholic hepatitis and in 62 apparently healthy HBsAg carriers. Neopterin levels in patients with virus-induced hepatitis were significantly higher than those in patients with other diagnoses. Urinary neopterin levels were above normal in 49 of 51 patients with viral hepatitis and elevations during the course of hepatitis showed a pattern similar to that of the usual liver biochemical tests, suggesting that neopterin levels were related to the clinical activity of the viral disease. In patients with nonviral biliary and hepatic disorders, neopterin levels were usually normal and did not correlate with other liver biochemical tests. These findings suggest that cell-mediated immune mechanisms are activated during viral hepatitis and that neopterin measurement may be of value as an additional surrogate marker for non-A, non-B hepatitis.
Asunto(s)
Biopterinas/análogos & derivados , Hepatitis/orina , Enfermedad Aguda , Adolescente , Adulto , Enfermedades de las Vías Biliares/enzimología , Enfermedades de las Vías Biliares/orina , Biopterinas/orina , Portador Sano/enzimología , Portador Sano/orina , Femenino , Hepatitis/enzimología , Hepatitis A/enzimología , Hepatitis A/orina , Hepatitis B/enzimología , Hepatitis B/orina , Antígenos de Superficie de la Hepatitis B/análisis , Hepatitis C/enzimología , Hepatitis C/orina , Hepatitis Alcohólica/enzimología , Hepatitis Alcohólica/orina , Humanos , Masculino , Persona de Mediana Edad , Neopterin , Enfermedades Pancreáticas/enzimología , Enfermedades Pancreáticas/orinaRESUMEN
This case report deals with a description of the first case of AIDS in Tirol. Our patient was an intravenous drug abuser and presented with both opportunistic infections (candidiasis, interstitial pneumonia due to Pneumocystis carinii) and with Kaposi's sarcoma. He died within 4 weeks as a result of staphylococcal septicaemia refractory to intensive chemotherapy.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/etiología , Adulto , Austria , Dependencia de Heroína/complicaciones , Humanos , Masculino , Derrame Pericárdico/diagnóstico , Neumonía por Pneumocystis/etiología , Sarcoma de Kaposi/etiología , UltrasonografíaRESUMEN
Case reports of patients with acute viral hepatitis of the Medical Department of the Innsbruck University Medical School were evaluated in regard to prognosis. The following results were obtained: 1. Hepatitis B in the acute phase runs a severe course in more cases than non B hepatitis. 2. Disappearance of the HBs-antigen from the serum seems to be a reliable indicator for complete recovery; persistence of the antigen on the other hand indicates a chronic clinical course of the disease. 3. A difference in prognosis as to a chronic course of acute hepatitis B and non B hepatitis could not be found. Transition to a chronic stage seems to occur in about 3-15% of both forms of the disease together.