Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · Nov 2008
Comparative StudyClinical, biochemical, immunological and virological profiles of, and differential diagnosis between, patients with acute hepatitis B and chronic hepatitis B with acute flare.
In areas with high or intermediate endemicity for chronic hepatitis B virus (HBV) infection, it is difficult to distinguish acute hepatitis B (AHB) from chronic hepatitis B with an acute flare (CHB-AF) in patients whose prior history of HBV infection has been unknown. The present study aimed to screen laboratory parameters other than immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) to discriminate between the two conditions. ⋯ (i) There are significant differences with respect to clinical, biochemical, immunological and virological aspects between ASL-HB and CHB-AF. (ii) Of several diagnostic combinations, IgM anti-HBc jointing HBV-DNA is most effective and most practicable in distinguishing ASL-HB from CHB-AF. (iii) A low HBeAg level is more useful than negative HBeAg in differential diagnosis between ASL-HB and CHB-AF. (iv) In those patients with a high level of IgM anti-HBc, serum AFP level >10x upper reference limit could rule out a probability of ASL-HB.
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J. Gastroenterol. Hepatol. · Nov 2008
Risks and clinical features of colorectal cancer complicating Crohn's disease in Japanese patients.
No reports on the relative risk of development of colorectal cancer (CRC) in Japanese patients with Crohn's disease (CD) have been published. The present study aimed to investigate the relative risk and the clinical features of CRC complicating CD among patients managed at Fukuoka University Chikushi Hospital, Fukuoka, Japan (a tertiary referral center for inflammatory bowel diseases). ⋯ The risk of CRC in longstanding CD in Japan was similar to that in Western countries. The necessity of surveillance in the management of CD would also need to be discussed in the near future, especially in CD patients with anal lesions or fistulae, and are particularly important in patients with a 20-year or more history of CD.