Nobuyuki Yamashita

Factors contributing to ribavirin-induced anemia.

Background and Aim:  Interferon and ribavirin combination therapy for chronic hepatitis C produces hemolytic anemia. This study was conducted to identify the factors contributing to ribavirin‐induced anemia.

Occurrence of clinical depression during combination therapy with pegylated interferon alpha or natural human interferon beta plus ribavirin

Aim:  The onset of depression symptoms during pegylated interferon α plus ribavirin (PEG‐IFN/RBV) combination therapy has led to treatment discontinuation in some cases. In the present study, we conducted a questionnaire survey during treatment to determine whether natural human interferon β plus ribavirin (IFNβ/RBV) therapy is associated with a lower incidence of depression symptom onset compared with PEG‐IFN/RBV therapy.

Preventive effects of ME3738 on hepatic fibrosis induced by bile duct ligation in rats

Aim:  The aim of this study was to examine the preventive effects of ME3738 on hepatic fibrosis induced by bile duct ligation (BDL) in rats.

Interferon-beta plus ribavirin therapy can be safely and effectively administered to elderly patients with chronic hepatitis C

AIM This study aims to evaluate the efficacy and safety of interferon-beta plus ribavirin therapy in older Japanese patients. PATIENTS AND METHODS This study enrolled 132 older patients (age, ≥65 years) with chronic hepatitis C who received 24-48 weeks of interferon-beta plus ribavirin (FR; n = 66) or pegylated interferon-alpha plus ribavirin (PR; n = 66) therapy. RESULTS Patients with the ITPA genotype (CA/AA) in the PR group had significantly greater decreases in hemoglobin levels than those in the FR group at or after week 8. The proportions of patients with a dose reduction of interferon-beta and ribavirin in the FR group were significantly lower than those in the PR group. A significantly higher proportion of patients completed treatment in the FR group than in the PR group. The sustained virological response (intention-to-treat analysis) rate of naïve patients with genotype 1 was 29% (6 of 21) in the PR group and 29% (6 of 21) in the FR group. The sustained virological response (intention-to-treat) rate of those with genotype 2 was 67% (12 of 18) in the PR group and 72% (13 of 18) in the FR group. CONCLUSION Interferon-beta plus ribavirin therapy was safe in elderly patients, with lower proportions of patients with a dose reduction of interferon-beta or ribavirin and treatment discontinuation. In treatment-naïve patients, the sustained virological response rate was similar between interferon-beta plus ribavirin therapy and pegylated interferon-alpha plus ribavirin therapy, regardless of whether the patients had hepatitis C virus genotype 1 or 2.

[Hypoxemia due to pulmonary tumor microembolisms from a hepatocellular carcinoma: a case report].

We report a case of pulmonary tumor embolism due to hepatocellular carcinoma (HCC). A woman in her 60s was treated with sorafenib 800 mg daily for HCC with lymph node metastasis. Approximately 50 days after taking sorafenib, she experienced dyspnea and was admitted to the hospital on account of hypoxia. Although her oxygen saturation levels deteriorated, we could find no obvious cause for the hypoxia; despite artificial respiration and oxygenation, she died of respiratory failure on the fourth day of admission. Tissue samples revealed that the HCC cells had infiltrated her lung arterioles; therefore, we concluded that multiple tumor microembolisms from the HCC to the lungs had caused death via respiratory failure. Cases of hypoxia caused by multiple invisible embolisms from HCCs are rarely reported. We believe that infiltration into the lymphatic system may have been related to the development of pulmonary tumor microembolisms.

An inflammatory pseudotumor of the liver in a patient with reactive arthritis

A rare case of an inflammatory pseudotumor (IPT) of the liver with reactive arthritis (ReA) is herein described. A 34-year-old woman presented with post-infectious ReA in the bilateral knees and foot joints. As the primary infected site for ReA could not be determined, a systemic survey revealed an IPT in her liver, which was diagnosed histologically. The arthritis and the tumor regressed simultaneously after being treated by indomethacin farnesil 400 mg/day. Although the exact etiology of IPT or ReA still remains unknown, it is hypothesized that the same pathogenetic mechanisms may be involved in the development of IPT and ReA.