Hepatic pseudotumor associated with Strongyloides infection: A case report.

BACKGROUND: Strongyloides sterocoralis is a parasitic infection caused by a roundworm that is transmitted through soil contaminated with larvae. It can infrequently cause hepatic abscesses in immunocompromised patients and is rarely reported to form hepatic lesions in immunocompetent hosts. CASE SUMMARY: We present a case study of a 45-year-old female who presented with right upper quadrant abdominal pain and constitutional symptoms for several weeks. Cross-sectional imaging identified several malignant-appearing liver masses. Further investigation, including serological testing and histopathologic examination, revealed the presence of serum Strongyloides antibodies and hepatic granulomas with extensive necrosis. Following treatment with ivermectin for 2 wk, there was complete resolution of the liver lesions and associated symptoms. CONCLUSION: This case highlights the importance of considering parasitic infections, such as Strongyloides, in the differential diagnosis of hepatic masses. Early recognition and appropriate treatment can lead to a favorable outcome and prevent unnecessary invasive procedures. Increased awareness among clinicians is crucial to ensure the timely diagnosis and management of such cases.

Clinical and biologic importance of F-actin autoantibodies in HCV monoinfected and HCV-HIV coinfected patients.

The purpose of this study was to evaluate the relationship between serum filamentous (F)-actin antibody titers and severity of hepatitis present in hepatitis C virus (HCV)-infected patients. Liver biopsy samples from 18 HCV monoinfected and 20 HCV-HIV coinfected patients were graded with respect to the degree of hepatitis activity and intensity of plasma cell infiltration using MUM-1 and CD138 immunostains. Of the 38 HCV-infected patients, 6 (16%) had F-actin antibody titers in excess of 30 enzyme-linked immunosorbent assay units. We found a positive trend between serum F-actin antibody levels and the mean number of plasma cells present in the portal tracts of patients with HCV infection (r = 0.31; P = .06) and a significant association between these factors in HCV-HIV coinfected patients (r = 0.64; P = .002). Our data suggest that elevated serum F-actin antibody titers are commonly encountered in HCV-infected patients and may reflect more active inflammation in liver biopsy samples, similar to autoimmune hepatitis.

Diabetic microangiopathy in the liver: an autopsy study of incidence and association with other diabetic complications.

Diabetic hepatosclerosis (DH) is a recently described form of diabetic microangiopathy with hepatic sinusoidal fibrosis and basement membrane deposition without cirrhosis. The objective was to investigate the frequency of DH and its correlation with other diabetic microangiopathic complications. Complete autopsies from 57 adults with diabetes were reviewed for liver pathology and other diabetic complications. Basement membrane deposition in the liver was highlighted using laminin and type IV collagen immunostains. Only 1 case of DH was identified. Other diabetic end-organ damage in this case included nodular glomerulosclerosis and hepatic hyaline arteriolosclerosis, which were the most severe in the series. DH is an uncommon pattern of liver disease in patients with diabetes and is associated with severe end-organ damage. This study supports the presumed vascular etiology of DH, confirms the rarity of the lesion, and supports the suggestion that it is usually accompanied by other end-organ damage.

Clinical resolution of glycogenic hepatopathy following improved glycemic control.

Glycogenic hepatopathy is an underrecognized complication of long-standing poorly controlled diabetes mellitus. It is characterized by abnormal glycogen accumulation in hepatocytes, elevated liver enzymes and hepatomegaly. This is a distinct entity from other causes of hepatomegaly and elevated liver enzymes in diabetics such as nonalcoholic fatty liver disease. It is important to distinguish this entity as it has the potential for resolution following improved glycemic control as described by this case report.