Gisela Gualano - Academia.edu (original) (raw)

Papers by Gisela Gualano

Research paper thumbnail of Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease

Journal of Hepatology, 2011

Research paper thumbnail of Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease

Journal of Hepatology, 2011

Research paper thumbnail of Risk factors for infection in chronic hepatitis C: A high prevalence of sexual exposure among human immunodeficiency virus-coinfected women

Research paper thumbnail of Cyproterone acetate induces a wide spectrum of acute liver damage including corticosteroid-responsive hepatitis: report of 22 cases

Liver International, 2015

Cyproterone acetate (CPA), an antiandrogenic drug for prostate cancer, has been associated with d... more Cyproterone acetate (CPA), an antiandrogenic drug for prostate cancer, has been associated with drug-induced liver injury (DILI). We aim to expand the knowledge on the spectrum of phenotypes and outcomes of CPA-induced DILI. Twenty-two males (70±8 years; range 54-83) developing liver damage due to CPA therapy (dose: 150±50 mg/day; range 50-200) were included. Severity index and causality by RUCAM were assessed. From 1993 to 2013, 22 patients were retrieved. Latency was 163±97 days. Most patients were symptomatic, showing hepatocellular injury (91%) and jaundice. Liver tests at onset were: ALT 18±13 x ULN, ALP 0.7±0.7 x ULN, and total serum bilirubin 14±10 mg/dL. International normalized ratio values higher than 1.5 were observed in 14 (66%) patients. Severity was mild in 1 case (4%), moderate in 7 (32%), severe in 11 (50%), and fatal in 3 (14%). Five patients developed ascitis, and 4 encephalopathy. One patient had a liver injury that resembled autoimmune hepatitis. Eleven (50%) were hospitalized. Nineteen patients recovered after CPA withdrawal, although 3 required steroid therapy (2 of them had high ANA titres). Liver biopsy was performed in 7 patients (2 hepatocellular collapse, 1 submassive necrosis, 2 cholestatic hepatitis, 1 cirrhosis with iron overload, and 1 autoimmune hepatitis). RUCAM category was "highly probable" in 19 (86%), "probable" in 1 (4%), and "possible" in 2 (9%). CPA-induced liver injury is severe and can be fatal, and may occasionally resemble autoimmune DILI. The benefit/risk ratio of this drug should be thoroughly assessed in each patient. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease

Journal of Hepatology, 2011

Research paper thumbnail of Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease

Journal of Hepatology, 2011

Research paper thumbnail of Risk factors for infection in chronic hepatitis C: A high prevalence of sexual exposure among human immunodeficiency virus-coinfected women

Research paper thumbnail of Cyproterone acetate induces a wide spectrum of acute liver damage including corticosteroid-responsive hepatitis: report of 22 cases

Liver International, 2015

Cyproterone acetate (CPA), an antiandrogenic drug for prostate cancer, has been associated with d... more Cyproterone acetate (CPA), an antiandrogenic drug for prostate cancer, has been associated with drug-induced liver injury (DILI). We aim to expand the knowledge on the spectrum of phenotypes and outcomes of CPA-induced DILI. Twenty-two males (70±8 years; range 54-83) developing liver damage due to CPA therapy (dose: 150±50 mg/day; range 50-200) were included. Severity index and causality by RUCAM were assessed. From 1993 to 2013, 22 patients were retrieved. Latency was 163±97 days. Most patients were symptomatic, showing hepatocellular injury (91%) and jaundice. Liver tests at onset were: ALT 18±13 x ULN, ALP 0.7±0.7 x ULN, and total serum bilirubin 14±10 mg/dL. International normalized ratio values higher than 1.5 were observed in 14 (66%) patients. Severity was mild in 1 case (4%), moderate in 7 (32%), severe in 11 (50%), and fatal in 3 (14%). Five patients developed ascitis, and 4 encephalopathy. One patient had a liver injury that resembled autoimmune hepatitis. Eleven (50%) were hospitalized. Nineteen patients recovered after CPA withdrawal, although 3 required steroid therapy (2 of them had high ANA titres). Liver biopsy was performed in 7 patients (2 hepatocellular collapse, 1 submassive necrosis, 2 cholestatic hepatitis, 1 cirrhosis with iron overload, and 1 autoimmune hepatitis). RUCAM category was "highly probable" in 19 (86%), "probable" in 1 (4%), and "possible" in 2 (9%). CPA-induced liver injury is severe and can be fatal, and may occasionally resemble autoimmune DILI. The benefit/risk ratio of this drug should be thoroughly assessed in each patient. This article is protected by copyright. All rights reserved.