Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jan 2023
ReviewVariants of autoimmune liver diseases: how to diagnose? how to treat?
Autoimmune liver diseases (AILDs), such as autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and primary biliary cholangitis (PBC), are classified as rare diseases, but their incidence is increasing. In this review, we present the characteristics of AILDs in adults, and mainly focus on their variants in terms of diagnosis and management. The classic AILDs have been well defined in clinical guidelines, but a proportion of patients with a single AILD tend to show features of other AILDs. ⋯ However, treating these patients is challenging, even for experienced clinicians. Progression to end‑stage liver disease is, unfortunately, not a rare course, despite combined and second‑line therapies, particularly for AIH‑PSC variants. Thus, studies based on prospective registers are necessary to elaborate upon widely accepted guidelines, to offer better care to these patients, and to improve their prognosis.
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Pol. Arch. Med. Wewn. · Jan 2023
Antiviral prophylaxis, male gender and killer immunoglobulin-like receptor KIR2DL3 as markers for stratifying the risk of BK polyomavirus-associated nephropathy in kidney transplant recipients.
The risk of polyomavirus‑associated nephropathy (PyVAN) currently ranges from 1% to 10%, and the risk of graft loss is 10% to 50% within 2 years post‑diagnosis. There is currently no specific antiviral therapy against BK polyomavirus (BKPyV), and no therapeutic approach has been proven superior. Natural killer cells play a key role in the defense against viral infections. ⋯ Our findings confirm that the KIR/HLA genotype plays a significant role in the development of PyVAN and suggest the contribution of both environmental and genetic factors to the incidence of BKPyV infection after kidney transplantation.
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Pol. Arch. Med. Wewn. · Jan 2023
Clinical outcomes of therapy-related acute myeloid leukemia: over 20 years long single center retrospective analysis.
Therapy‑related acute myeloid leukemia (t‑AML), a life‑threatening complication of cytotoxic therapy, represents an emerging challenge of modern oncology. ⋯ Our study revealed that prognosis of t‑AML varies. Hence, the treatment strategy should include performing alloHCT as soon as possible in the patients with an adverse genetic profile.
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Pol. Arch. Med. Wewn. · Jan 2023
Ultrasound and biomarker based assessment of hepatic steatosis in patients with severe obesity.
Nonalcoholic fatty liver disease (NAFLD) is a common liver abnormality, but its noninvasive diagnosis in patients with severe obesity remains difficult. ⋯ Our study confirmed the usefulness of only 2 out of 3 techniques, the HRI and the NAFLD logit score for the diagnosis of NAFLD in patients with severe obesity. The methods designed for the general population require different cutoff values to achieve accurate performance in patients with severe obesity.