mercaptopurine and Hepatitis-B

Topics: Acute Disease; Age Factors; Alcoholism; Azathioprine; Chemical and Drug Induced Liver Injury; Chronic Disease; Cortisone; Diet Therapy; Exchange Transfusion, Whole Blood; Halothane; Hepatic Encephalopathy; Hepatitis; Hepatitis A; Hepatitis B; Hepatitis B Antigens; Hospitalization; Humans; Liver Diseases; Liver Function Tests; Malabsorption Syndromes; Mercaptopurine; Prednisone; Prognosis; Pruritus

Topics: Anti-Inflammatory Agents, Non-Steroidal; Azathioprine; Digestive System; Female; Gastroenterology; Hepacivirus; Hepatitis A; Hepatitis B; Humans; Inflammatory Bowel Diseases; Male; Mercaptopurine; Sulfasalazine

In three patients with malignant disease HBsAg was detected in the serum at least 6 months before the development of acute hepatitis type B, which in each case followed a fulminant course to death. It is suggested that suppression of the normal immunological responses to hepatitis-B viral antigens by cytotoxic drug therapy permitted widespread infection of hepatocytes. Subsequently, upon withdrawal of these drugs, recovery of immunocompetence resulted in rapid destruction of all infected hepatocytes and massive liver damage. Screening for HBsAg before cytotoxic drug therapy, careful monitoring of liver function during its withdrawal, and prompt treatment with corticosteroids should abnormalities occur may prevent this unfortunate sequence of events.

Topics: Adult; Antineoplastic Agents; Chlorambucil; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Hepatitis B; Hepatitis B Antigens; Humans; Immunosuppression Therapy; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Prednisolone; Pregnancy; Substance Withdrawal Syndrome; Vincristine

A series of 21 patients with active chronic hepatit diagnosed on the basis of clinical, biochemical and histological criteria, were treated by immunosuppressive cure--a combination of Prednison or Triamcinolon with 6-Mercaptopurin. The cure lasted for at least 12 months and attempts as its interruption usually brought about exacerbation of activity requiring further treatment reaching the total of more than 3 years, in some cases lasting for all the followed period of 7 years. There were no significant side effects requiring interruption. Immunosuppressive treatment remarkably improved biochemical indicators, particularly significant was the decrease in SGPT activity and hypergammaglobulinemia. The results were likewise good in HB-Ag positive patients, 8 of which are included in the series. The prognosis of chronic active hepatitis undergoing immunosuppressive treatment was mathematically estimated. Using the mathematical solution of biological problems the authors arrived at the probable survival of 5.5 to 6.5 years for their series of patients.

Topics: Chronic Disease; Drug Therapy, Combination; Follow-Up Studies; Hepatitis; Hepatitis B; Humans; Immunosuppressive Agents; Liver Function Tests; Mercaptopurine; Prednisone; Triamcinolone

Topics: Child; Common Cold; Hepatitis B; Humans; Influenza, Human; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Mouth Diseases; Prednisone; Remission, Spontaneous; Time Factors; Ulcer; Vincristine

Topics: Adrenal Cortex Hormones; Adult; Antimetabolites; Azathioprine; Chronic Disease; Female; Hepatitis A; Hepatitis B; Humans; Male; Mercaptopurine; Middle Aged; Penicillamine; Prognosis

Topics: Acute Disease; Adult; Alanine Transaminase; Chronic Disease; Hepatitis; Hepatitis B; Humans; Liver Function Tests; Male; Mercaptopurine; Middle Aged

Topics: Glucocorticoids; Hepatitis B; Humans; Mercaptopurine