A case report of primary hepatic carcinoma with prolonged HB virus infection and mono-clonal gammopathy

Transient monoclonal gammopathy in a patient with Bartonella quintana endocarditis

Monoclonal gammopathy has been reported rarely in association with infectious diseases. Viral infection has been the most frequently reported. We report a case of Bartonella quintana endocarditis in a 45-year-old homeless male associated with a monoclonal IgG kappa gammopathy. The gammopathy disappeared after 8 months of antibiotics while the Bartonella antibody titre was decreasing. This correlation suggests a causative role for B. quintana for the monoclonal gammopathy. To the best of our knowledge, this the first report of monoclonal gammopathy in the course of B. quintana infection.

Monoclonal and biclonal gammopathy in two patients infected with Bartonella henselae

Two immunocompetent patients with cat-scratch disease due to infection with Bartonella henselae developed monoclonal and biclonal gammopathy. Neither patient had evidence of any other known cause of plasma cell dyscrasia, and antibiotic eradication of Bartonella henselae infection resulted in the prompt disappearance of the gammopathy. Hence, cat-scratch disease should be added to the list of possible underlying disorders in individuals presenting with monoclonal and biclonal gammopathy.

Follow-up study in chronic active hepatitis after therapies with immunosuppressive drugs and tiopronin

Follow-up studies were conducted in the patients with chronic active hepatitis treated 10 years ago with tiopronin (TP) or corticosteroids (CS). HB surface antigen (HBsAg) was measured in previously collected paraffin embedded liver sections by enzyme-labelled antibody technique. Of 72 cases examined, 15 cases were treated with TP only (8 cases) and combination with CS (7 cases), 38 cases with CS and 19 cases not treated with TP or CS (control group). Two deaths occurred in TP group (each 1 case in the single and combination treatments) in the 9th year due to bleeding of oesophageal varices in a chronic aggressive hepatitis (2B type) with HBsAg diffusely distributed in liver tissue. Two deaths were found in CS group and 4 in the control group. No significant difference as noted in the rehabilitation rate in HBsAg negative cases of TP group and CS group versus the control group. In the positive cases, the rehabilitation rate was found to be 66.7% in the CS group compared with 0% in the non-CS group, and each 3 cases out of 5 rehabilitated by the single and combination treatments with TP respectively.