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Alexandra Alexopoulou

Publications and source records attributed to Alexandra Alexopoulou.

At least 19 recordsLinked to original sources
PubMed2006

Predicting utility of a model for end stage liver disease in alcoholic liver disease.

AIM: To validate the statistic utility of both the Maddrey Discriminant Function score and the Model for End-Stage Liver Disease as predictors of short term (30 d and 90 d) mortality in patients with alcoholic hepatitis and to assess prognostic factors among clinical characteristics and laboratory variables of patients with alcoholic hepatitis. METHODS: Thirty-four patients with the diagnosis of alcoholic hepatitis admitted to Hippokration University Hospital of Athens from 2000 to 2005 were assessed in the current retrospective study and a statistical analysis was conducted. RESULTS: 30- and 90-d mortality rates were reported at 5.9% (2/34) and 14.7% (5/34), respectively. Significant correlation was demonstrated for the Model for End-Stage Liver Disease (P30 = 0.094, P90 = 0.046) and the Maddrey Discriminant Function score (P30 = 0.033, P90 = 0.038) with 30- and 90-d mortality whereas a significant association was also established for alanine aminotransferase (P = 0.057), fibrin degradation products (P = 0.048) and C-reactive protein (P = 0.067) with 90-d mortality. For 30-d mortality the Area Under the Curve was 0.969 (95%CI: 0.902-1.036, P = 0.028) for the Model for End-Stage Liver Disease score and 0.984 (95%CI: 0.942-1.027, P = 0.023) for the Maddrey Discriminant Function score with the optimal cut off point of 30.5 (sensitivity 1, specificity 0.937) and 108.68 (sensitivity 1, specificity 0.969), respectively. Accordingly, for 90-d mortality the Area Under the Curve was 0.762 (95%CI: 0.559-0.965, P = 0.065) for the Model for End-Stage Liver Disease score and 0.752 (95%CI: 0.465-1.038, P = 0.076) for the Maddrey Discriminant Function score with the optimal cut off point of 19 (sensitivity 0.6, specificity 0.6) and 92 (sensitivity 0.6, specificity 0.946), respectively. The observed Kaplan Meier survival rates for different score-categories were compared with log-rank tests and higher score values were correlated with a lower survival. CONCLUSION: Equivalency of the Model for End-Stage Liver Disease and the Maddrey Discriminant Function score is implied by the current study, verified by the plotted Receiver Operative Curves and the estimated survival rates. A statistically significant utility of C-reactive protein, fibrin degradation products and alanine aminotransferase as independent predictors of 90-d mortality has also been verified.

Adult↗
PubMed2006

Acute Epstein-Barr virus infection in two elderly individuals.

Most individuals acquire Epstein-Barr virus (EBV) infection in young age. Because of uncommon presentation and misdiagnosis, clinical manifestations are less well described in older age. We present two cases of elderly patients with predominant symptoms attributed to cold agglutinin haemolytic anaemia due to acute EBV infection without fever, lymphadenopathy, pharyngitis or splenomegaly. We conclude that misleading clinical manifestations are frequent in older individuals and may lead to inappropriate diagnostic invasive procedures.

Acute Disease↗
PubMed2006

Detection of a hepatitis B surface antigen variant emerging in a patient with chronic lymphocytic leukaemia treated with fludarabine.

Fludarabine is used widely for the treatment of chronic lymphocytic leukaemia, but not as yet implicated in the emergence of hepatitis B surface antigen (HBsAg) variants following hepatitis B virus (HBV) reactivation. Such a variant was detected in a 78-year-old female who was HBsAg(-)/anti-HBc(+)/anti-HBs(+)/anti-HBe(+), and with normal ALT levels, who developed HBV reactivation after fludarabine treatment. She had high HBV-DNA levels, and became positive for HBeAg, in the absence of detectable HBsAg. HBV-DNA was extracted from serum and the HBsAg encoding region of the genome was amplified by PCR, followed by cloning and sequencing. The HBV strain appeared to be subtype adw, but had higher nucleotide homology with ayw than adw isolates, supported further by phylogenetic tree analysis. Amino-acid sequence comparisons over the alpha determinant region revealed the following substitutions: C124N, G130R, and N146S. There were also unique substitutions outside the alpha determinant. All these mutations appeared to have a profound effect on the antigenicity of this region, which resulted in failure to detect HBsAg by commercially available diagnostic assays. It is concluded that a surface variant emerged in an HBsAg(-)/anti-HBs(+) patient with chronic lymphocytic leukaemia following fludarabine treatment, with an unprecedented number of amino-acid substitutions in the alpha determinant region of HBsAg, including a subtype switch.

Aged↗
PubMed2006

Pubic osteomyelitis due to Klebsiella pneumoniae in a patient with diabetes mellitus.

Osteomyelitis of the pubic symphysis or pubic osteomyelitis is a rare entity that is encountered in certain groups of people such as athletes, intravenous drug users, patients with pelvic malignancy, and patients who have undergone surgical manipulations of the genitourinary system. The most frequent causative organism is Staphylococcus aureus. K pneumoniae is a common pathogen in diabetic patients, but pubic osteomyelitis due to K pneumoniae has not previously been described. We present a diabetic patient with pubic osteomyelitis caused by K pneumoniae without known predisposing factors.

Anti-Bacterial Agents↗
PubMed2005

Aneurysmal dilatation of the portal vein: a rare cause of portal hypertension.

Aneurysmal dilatation of the portal vein (ADPV) is a rare cause of portal hypertension. We described a case of ADPV in a female patient who presented with ascites. Imaging studies revealed tortuosity and dilatation of the main portal vein with turbulent flow. Endoscopy revealed oesophageal varices. A liver biopsy showed no abnormalities in liver histology. This is the first case of ascites as a complication of ADPV in the absence of liver cirrhosis, arteriovenous fistula or documented portal vein thrombosis. Hyperdynamic circulation and increased portal vein flow could be implicated in the pathogenesis of ascites in this setting.

Aneurysm↗
PubMed2005

Poststreptococcal reactive arthritis with thoracic spine involvement in an adult.

It is controversial whether poststreptococcal reactive arthritis (PSReA) is an entity separate from acute rheumatic fever (ARF) or is a forme fruste of ARF. Although there are many case series of PSReA in children, this entity is not common in adults. We describe an adult patient with polyarthritis and thoracic spine involvement attributed to PSReA.

Anti-Bacterial Agents↗
PubMed2004

Acute chest syndrome in sickle-cell trait; Two case reports in persons of Mediterranean origin and review of the literature.

Sickle-cell trait has been characterized as a benign condition. However, life-threatening complications sometimes develop. Acute chest syndrome (ACS) is usually described in homozygous sickle cell disease, but it rarely develops in individuals with sickle-cell trait. Two cases of ACS in patients with sickle-cell trait are reported here. Factors such as advanced age at the time of presentation and absent past medical and family history can be misleading. Although ACS in sickle-cell trait has thus far only been reported in persons of Afro-American origin, persons of Mediterranean origin can, on rare occasions, also experience the syndrome.

Journal Article↗
PubMed2004

Hepatitis B surface antigen variant with multiple mutations in the a determinant in an agammaglobulinemic patient.

A patient with agammaglobulinemia developed acute hepatitis that progressed to chronic liver disease with high levels of hepatitis B virus (HBV) DNA in the absence of detectable HBsAg. Sequencing of the a determinant region of HBsAg revealed multiple amino acid substitutions that, unusually, also included a substitution at position 122 that defines subtype specificity. All of these mutations had a profound effect on the antigenicity of this region, which led to the complete failure of variant detection by commercially available routine diagnostic assays or laboratory-based monoclonal antibody assays.

Agammaglobulinemia↗
PubMed2003

A fatal case of postinfantile giant cell hepatitis in a patient with chronic lymphocytic leukaemia.

Postinfantile giant cell hepatitis has been associated with various aetiologies, including drug taking, autoimmune diseases and viral infections. We present a fatal case of giant cell hepatitis in a patient with chronic lymphocytic leukaemia. No liver biopsy was available ante-mortem. The patient was treated with corticosteroids and aciclovir for suspected autoimmune hepatitis and reactivation of Epstein-Barr virus in the context of his haematological malignancy. Post-mortem liver biopsy showed severe giant cell hepatitis while the study of liver tissue by electron microscopy revealed paramyxo-like viral particles in the cytoplasm of the affected hepatocytes similar to those observed in previous reports of giant cell hepatitis. This case illustrates that the diagnosis of the underlying cause of giant cell hepatitis may be complicated because a heterogeneous group of different aetiologies needs to be investigated. The identification of the causative agent is essential before commencing any kind of therapy. A few sporadic case reports of paramyxo-like virus related, postinfantile giant cell hepatitis have shown that ribavirin was quite effective treatment but further clinical evaluation is needed.

Aged↗
PubMed2003

Acute neutrophilic meningitis treated successfully with corticosteroids.

This report describes a cocaine user who presented with polymorphonuclear pleocytosis in cerebrospinal fluid mimicking bacterial meningitis. Thorough investigation of the cerebrospinal fluid did not reveal evidence of bacteria or fungi. Clinical deterioration was observed in spite of empiric treatment with antibiotics. The patient had a favorable outcome after corticosteroid treatment.

Acute Disease↗
PubMedDate not supplied

A case of liver sarcoidosis mimicking cirrhosis.

Although autopsy series report liver granulomas in up to 70% of patients, computed tomography detection of hepatic and splenic lesions is described in 5% and 15% of sarcoidosis cases, respectively. A rather rare case of liver sarcoidosis mimicking macronodular cirrhosis is presented by this current article. Imaging findings in our patient were in compliance with the diagnosis of liver cirrhosis, although liver biopsy findings eventually revealed sarcoid granulomas located in the portal and lobular areas without fibrotic lesions. Histological and imaging modalities in liver sarcoidosis are discussed.

Contrast Media↗