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Biomedical subjects

K M De Cock

Publications and source records attributed to K M De Cock.

At least 163 records · Page 9Linked to original sources
PubMed1984

Fulminant delta hepatitis in chronic hepatitis B infection.

Two male homosexual patients, one an intravenous (IV) drug abuser, had hepatitis B surface antigen-positive fulminant hepatitis. On the basis of tests for IgM antibody to hepatitis B core antigen (HBcAg) and for IgM and IgG antibodies to delta agent, acute delta hepatitis in chronic hepatitis B infection was diagnosed. The delta agent appeared to have a role in producing fulminant hepatic failure. Accurate diagnosis of fulminant hepatitis may be impossible without recourse to tests for IgM antibody to HBcAg and antibodies to delta agent. Although delta hepatitis in the United States primarily affects IV drug abusers, this infection can also occur in male homosexuals.

Acute Disease↗
PubMed1983

Portal hypertension in Nairobi, Kenya.

Previous reports have suggested that idiopathic portal hypertension, a condition quite distinct from tropical splenomegaly syndrome, occurs in Kenya. In the present study patients with oesophageal varices were allocated to diagnostic groups on the basis of liver histology and results of splenoportovenography , and these groups were then compared for prevalence of hepatitis B markers, immunoglobulin levels and results of enzyme-linked immunosorbant assay (ELISA) for S. mansoni infection. 85 patients with oesophageal varices were studied. 29.4% had histological evidence of Schistosoma mansoni infection, 20% had cirrhosis and in 25.9% liver histology was non-diagnostic and the portal vein was radiologically shown to be patent. A comparison of clinical findings, serological data and parasitological investigations suggested that this latter group was a distinct one, and did no result from failure of histological diagnosis of cirrhosis or schistosomiasis. It is likely that these patients had idiopathic portal hypertension. In 82 normal controls, the carrier rate of hepatitis B surface antigen (HBsAg) was 12.2%, 59.8% had antibody to HBsAg (anti-HBs) and 7.3% showed antibody to core antigen (anti-HBc) as the only viral marker. 58.3% of the cirrhotics and 26.7% of patients with probable idiopathic portal hypertension were HbsAg positive. The implications of these results, and limited data on hepatitis Be antigen and antibody are discussed.

Hepatitis B Surface Antigens↗
PubMed1982

Esophageal varices in Nairobi, Kenya: a study of 68 cases.

Sixty-eight patients with proven esophageal varices wer studied at Kenyatta National Hospital, Nairobi, Kenya. Of these patients, 29.4% had schistosomal portal hypertension, 22.1% cirrhosis and only 8.8% extrahepatic portal vein occlusion. One quarter of the patients had a normal liver biopsy and extrahepatic portal vein that was demonstrated to be patent. Problems relating to liver biopsy sampling resulting in underdiagnosis of specific causes of esophageal varices such as schistosomiasis are discussed. We argue that many of these patients were likely to be suffering from idiopathic portal hypertension, a condition apparently not previously recognized in Africa. Of this last group, 70.6% had suffered gastrointestinal bleeding, as had 50% of the patients with schistosomiasis. Together these two groups accounted for three-quarters of all patients who had bled. The detection of eggs of Schistosoma mansoni in stool and/or rectal snip correlated well with liver biopsy findings in both a positive and negative sense. Only 18% of patients with negative stools and snips had evidence of schistosomiasis in the liver, and positive stools or snips were found in only 14.6% of patients without schistosomal liver involvement. Of the patients in the study, 50% were of the Kamba tribe, although only 12.9% of all medical admissions to the hospital were Kamba (P less than 0.01). Luo patients were significantly more frequent within the group with schistosomiasis (P less than 0.02). Esophageal varices were attributed to tropical splenomegaly syndrome in only one patient. The implications of our results are discussed and our findings are compared with previous work from East Africa.

Adolescent↗