Characteristics and outcome of primary Budd-Chiari syndrome due to Behçet's syndrome

BACKGROUND AND AIM

Behçet's syndrome (BS) is a known cause of Budd-Chiari syndrome (BCS). We aimed at identifying the prevalence of BS in patients with BCS, analyzing different clinical presentations, treatment modalities and outcome of these patients.

METHODS

We conducted a retrospective cohort study, in which all medical records of patients who were presented to Tropical Medicine Department, Ain Shams University with a confirmed diagnosis of primary BCS from May 2005 to December 2016 were collected and analyzed.

RESULTS

In total, 271 patients had a confirmed diagnosis of primary BCS, included Group I: 232 (85.6%) patients with BCS without BS and Group II: 39 patients (14.4%) with BCS due to BS. Male gender (P=0.000), oral ulcers, genital ulcers, Prominent abdominal veins, lower limb swellings, lower extremity deep venous thrombosis (P=0.000) and jaundice (P=0.003) were more frequent in group II patients. The presence of intrahepatic collaterals (P=0.004) and IVC thrombosis (P=0.000) was significant in group II. Medical treatment alone in the form of immunosuppressive drugs and anticoagulation (66.7% vs. 24.1%)±IVC stenting (23% vs. 1.3%) (P=0.000) were the main treatment modalities for BCS related to BS. The frequency of HCC in BS was significantly higher (10.26% vs. 2.59%) (P=0.013).

CONCLUSIONS

The prevalence of BS in Egyptian patients with BCS is considerably high. The clinical presentation of these patients was different from those without BS. Besides, the incidence of HCC was higher in patients with BS, whereas the mortality did not differ between the two groups.

Circulating microRNA-155 is associated with insulin resistance in chronic hepatitis C patients

BACKGROUND AND STUDY AIM

Hepatitis C represents a potential public health problem worldwide. Insulin resistance (IR) and type 2 diabetes (T2D) are among the serious metabolic complications for chronic hepatitis C virus (HCV) infection. MicroRNAs (miRNAs) are a group of small non-coding RNAs which are implicated in the modulation of almost all biological processes. The objective of this study was to investigate the levels of both miR-155 and miR-34a in sera of chronic HCV patients with or without T2D.

PATIENTS AND METHODS

In this study, we investigated the expression of both miR-155 and miR-34a in 80 subjects (20 HCV, 19 HCV/T2D, 21 T2D and 19 healthy controls), using quantitative real-time PCR.

RESULTS

Our results revealed significantly higher levels of both miR-155 and miR-34a in chronic HCV patients compared to healthy control subjects. However, only circulating miR-155 levels showed significant decline in diabetic HCV patients compared to non-diabetic HCV group. Intriguingly, the circulating levels of miR-155 were inversely correlated with HOMA-IR, fasting blood glucose and HbA1c levels.

CONCLUSION

Our findings indicate that the insulin resistance and T2D in HCV are strongly related to miR-155. This may suggest a role for miR-155 in the pathogenesis of IR caused by HCV. However, further large-scale studies are required to confirm our findings.