RESUMO
El compromiso hepático en receptores de transplante alogénico de células progenitoras hemotopoyéticas (TCPH) es una complicación muy frecuente y es responsable de la morbimortalidad precoz. La toxicidad por fármacos la enfermedad injerto versus huésped ( EICH) , la enfermedad venooclusiva (EVO) y las infecciones fúngicas, bacterianas y virales constituyen las principales etiologias. El objetivo de este estúdio retrospectivo fue estabelecer la prevalencia y etiología de la afectación hepática, evaluar el impacto en la mortalidad y analizar el valor predictivo de las transaminasas pré TCPH en la ocurrencia de EICH agudo, cr¶nico y mortalidad. De un total de 236 pacientes transplantados, se evaluaron 82 sometidos a TCPH alogénico. El 88% de los pacientes tuvo afectación hepática: EICH agudo 40.2%, EICH cr¶nico 15.9%, de causa indeterminada 9.8% sepsis 7.3%, toxicidad por fármacos 6.1%, EVO 3.7%, hepatitis aguda y recidiva de enfermedad 2.4%. La mortalidad evaluada al año fue 36.6%. La insuficiÛncia hepática aguda (IHA) represento el 10% de las muertes. Las causas de IHA fueron: progresón de EICH agudo, recidiva de la enfermedad hematológica en el hígado, hepatitis herpética y EVO. El valor predictivo positivo de las transaminasas pré TCPH para EICH agudo, cr¶nico y mortalidad fue 0.27, 0.14 y 0.43 respectivamente. No se hallaron diferencias significativas entre pacientes con pruebas bioquímicas hepáticas pré TCPH alteradas o normales en la ocurrencia de EICH agudo, crónico o mortalidad. (AU)
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Hepatopatias/epidemiologia , Doença Enxerto-Hospedeiro/epidemiologia , Transplante de Células-Tronco Hematopoéticas , Hepatopatias/etiologia , Hepatopatias/mortalidade , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/mortalidade , Transplante de Células-Tronco Hematopoéticas/mortalidade , Estudos Retrospectivos , Valor Preditivo dos Testes , Transaminases/análise , Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/mortalidade , Argentina/epidemiologia , Falência Hepática Aguda/etiologiaRESUMO
El compromiso hepático en receptores de transplante alogénico de células progenitoras hemotopoyéticas (TCPH) es una complicación muy frecuente y es responsable de la morbimortalidad precoz. La toxicidad por fármacos la enfermedad injerto versus huésped ( EICH) , la enfermedad venooclusiva (EVO) y las infecciones fúngicas, bacterianas y virales constituyen las principales etiologias. El objetivo de este estúdio retrospectivo fue estabelecer la prevalencia y etiología de la afectación hepática, evaluar el impacto en la mortalidad y analizar el valor predictivo de las transaminasas pré TCPH en la ocurrencia de EICH agudo, crônico y mortalidad. De un total de 236 pacientes transplantados, se evaluaron 82 sometidos a TCPH alogénico. El 88% de los pacientes tuvo afectación hepática: EICH agudo 40.2%, EICH crônico 15.9%, de causa indeterminada 9.8% sepsis 7.3%, toxicidad por fármacos 6.1%, EVO 3.7%, hepatitis aguda y recidiva de enfermedad 2.4%. La mortalidad evaluada al año fue 36.6%. La insuficiência hepática aguda (IHA) represento el 10% de las muertes. Las causas de IHA fueron: progresón de EICH agudo, recidiva de la enfermedad hematológica en el hígado, hepatitis herpética y EVO. El valor predictivo positivo de las transaminasas pré TCPH para EICH agudo, crônico y mortalidad fue 0.27, 0.14 y 0.43 respectivamente. No se hallaron diferencias significativas entre pacientes con pruebas bioquímicas hepáticas pré TCPH alteradas o normales en la ocurrencia de EICH agudo, crónico o mortalidad.
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Doença Enxerto-Hospedeiro/epidemiologia , Transplante de Células-Tronco Hematopoéticas , Hepatopatias/epidemiologia , Argentina/epidemiologia , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/mortalidade , Transplante de Células-Tronco Hematopoéticas/mortalidade , Hepatopatias/etiologia , Hepatopatias/mortalidade , Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/mortalidade , Valor Preditivo dos Testes , Estudos Retrospectivos , Transaminases/análiseRESUMO
INTRODUCTION: Variceal hemorrhage occurs in 25 to 35% of cirrhotic patients and is associated with significant morbidity and mortality and elevated hospital costs. Endoscopic exploration of gastroesophageal varices (GEV) in cirrhotic patients increases costs and involves a certain degree of invasiveness and discomfort for patients. The association between the presence of GEV and spleen size, liver function and platelet count is controversial. The aim of this study was to determine the correlation between liver function, evaluated by Child-Pugh (Ch-P) classification, platelet count (PC) and spleen volume index (SVI) with the presence of GEV in patients with cirrhosis managed in the outpatient setting. PATIENTS AND METHOD: Sixty-eight patients were included. In all patients, a medical history was taken and biochemical tests, mode B and Doppler abdominal ultrasonography, and upper digestive video-endoscopy were performed. RESULTS: A total of 76.47% of the patients were men and 23.53% were women. The median age was 52.8 12.4 years. More than half (54.41%) of the patients were Ch-P grade A, 41.18% were grade B and 4.41% were grade C. The most frequent causes of cirrhosis were alcohol in 52.95% and hepatitis C virus in 17.65%. Esophageal varices (EV) were found in 85.29% of the patients. The median SVI was 50.5 9.2 and the median PC was 150 26 x 109/L. A correlation was found between the presence of EV, SVI >or= 45 and PC < or= 100 x 109/L (r = 0.327; p = 0.006). No correlation was found between the presence of EV and Ch-P grade A. In the multivariate analysis, only the presence of EV was associated with SVI >or= 45 (OR 7.4; 95% CI, 1.30-77.7; p = 0.02). CONCLUSION: The presence of EV in cirrhotic patients managed in the outpatient setting was correlated with SVI >or= 45 and PC Assuntos
Endoscopia Gastrointestinal
, Varizes Esofágicas e Gástricas/diagnóstico
, Cirrose Hepática/diagnóstico
, Varizes Esofágicas e Gástricas/etiologia
, Feminino
, Humanos
, Cirrose Hepática/complicações
, Testes de Função Hepática
, Masculino
, Pessoa de Meia-Idade
, Fatores de Risco
, Índice de Gravidade de Doença
, Fatores de Tempo
RESUMO
UNLABELLED: Drug addicts frequently have liver diseases for different reasons: alcohol abuse, the drugs themselves, but more often hepatitis B and C infections. AIDS is common in this population as well and could also affect the liver directly or in the form of hepatocellular or biliary damage. We conducted this study to determine the prevalence of liver diseases, alcoholism, hepatitis B and C infections, and HIV positivity in this population. We studied a cohort of 137 persons, all with a history of drug abuse, and investigated the quantity of alcohol intake, the kind of drug used, and he routes of drug administration. RESULTS: We found liver disease in 33.6%. The prevalence of alcoholism was 65.4%, of HCV 67.3%, and of HBV 17.3%. HDV was undetectable, whereas we found HIV at a frequency of 17.3%. HCV RNA was detected in 85.4% of HCV. The drug most often used was cocaine at 90.4%, followed by marihuana at 88.3%; LSD use occurred in 17.5%. We found parenteral drug use in 43.1%. We performed 22 liver biopsies, 21 associated with HCV, and detected histological changes consistent with chronic hepatitis in 17, with cirrhosis in 4, and with hepatocellularcarcinoma in 1.
Assuntos
Alcoolismo/complicações , Infecções por HIV/complicações , Hepatite Viral Humana/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Argentina/epidemiologia , Estudos de Coortes , Feminino , Anticorpos Anti-Hepatite/análise , Hepatite B/complicações , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/complicações , Hepatite D/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Drug addicts frequently have liver diseases for different reasons: alcohol abuse, the drugs themselves, but more often hepatitis B and C infections. AIDS is common in this population as well and could also affect the liver directly or in the form of hepatocellular or biliary damage. We conducted this study to determine the prevalence of liver diseases, alcoholism, hepatitis B and C infections, and HIV positivity in this population. We studied a cohort of 137 persons, all with a history of drug abuse, and investigated the quantity of alcohol intake, the kind of drug used, and he routes of drug administration. RESULTS: We found liver disease in 33.6%. The prevalence of alcoholism was 65.4%, of HCV 67.3%, and of HBV 17.3%. HDV was undetectable, whereas we found HIV at a frequency of 17.3%. HCV RNA was detected in 85.4% of HCV. The drug most often used was cocaine at 90.4%, followed by marihuana at 88.3%; LSD use occurred in 17.5%. We found parenteral drug use in 43.1%. We performed 22 liver biopsies, 21 associated with HCV, and detected histological changes consistent with chronic hepatitis in 17, with cirrhosis in 4, and with hepatocellularcarcinoma in 1.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Infecções por HIV/epidemiologia , Alcoolismo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Hepatite Viral Humana/complicações , Hepatite Viral Humana/epidemiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite B/complicações , Hepatite B/epidemiologia , Infecções por HIV/complicações , Alcoolismo/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Prevalência , Argentina/epidemiologia , Anticorpos Anti-Hepatite/análise , Antígenos de Superfície da Hepatite B/sangue , Hepatite D/complicações , Hepatite D/epidemiologia , Estudos de CoortesRESUMO
Drug addicts frequently have liver diseases for different reasons: alcohol abuse, the drugs themselves, but more often hepatitis B and C infections. AIDS is common in this population as well and could also affect the liver directly or in the form of hepatocellular or biliary damage. We conducted this study to determine the prevalence of liver diseases, alcoholism, hepatitis B and C infections, and HIV positivity in this population. We studied a cohort of 137 persons, all with a history of drug abuse, and investigated the quantity of alcohol intake, the kind of drug used, and he routes of drug administration. RESULTS: We found liver disease in 33.6
. The prevalence of alcoholism was 65.4
, of HCV 67.3
, and of HBV 17.3
. HDV was undetectable, whereas we found HIV at a frequency of 17.3
. HCV RNA was detected in 85.4
of HCV. The drug most often used was cocaine at 90.4
, followed by marihuana at 88.3
; LSD use occurred in 17.5
. We found parenteral drug use in 43.1
. We performed 22 liver biopsies, 21 associated with HCV, and detected histological changes consistent with chronic hepatitis in 17, with cirrhosis in 4, and with hepatocellularcarcinoma in 1.
RESUMO
Drug addicts frequently have liver diseases for different reasons: alcohol abuse, the drugs themselves, but more often hepatitis B and C infections. AIDS is common in this population as well and could also affect the liver directly or in the form of hepatocellular or biliary damage. We conducted this study to determine the prevalence of liver diseases, alcoholism, hepatitis B and C infections, and HIV positivity in this population. We studied a cohort of 137 persons, all with a history of drug abuse, and investigated the quantity of alcohol intake, the kind of drug used, and he routes of drug administration. RESULTS: We found liver disease in 33.6%. The prevalence of alcoholism was 65.4%, of HCV 67.3%, and of HBV 17.3%. HDV was undetectable, whereas we found HIV at a frequency of 17.3%. HCV RNA was detected in 85.4% of HCV. The drug most often used was cocaine at 90.4%, followed by marihuana at 88.3%; LSD use occurred in 17.5%. We found parenteral drug use in 43.1%. We performed 22 liver biopsies, 21 associated with HCV, and detected histological changes consistent with chronic hepatitis in 17, with cirrhosis in 4, and with hepatocellularcarcinoma in 1.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Alcoolismo/epidemiologia , Infecções por HIV/epidemiologia , Hepatite Viral Humana/complicações , Hepatite Viral Humana/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Alcoolismo/complicações , Argentina/epidemiologia , Estudos de Coortes , Infecções por HIV/complicações , Anticorpos Anti-Hepatite/análise , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/complicações , Hepatite B/epidemiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite D/complicações , Hepatite D/epidemiologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Fifty heterosexual partners out of 50 patients (index cases) without confirmed or probable risk factors of parenteral transmission by HCV were studied from 1/1997 to 1/2001. The index cases were HCV Ab (+) (EIA 3rd Abbott and PCR + by RT-nested PCR). The couples with probable or confirmed risk factors of parenteral transmission were strictly excluded. No case of HCV infection was found, suggesting that sexual via wouldnt be a direct transmission of HCV (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Hepatite C/transmissão , Doenças Virais Sexualmente Transmissíveis/virologia , Argentina/epidemiologia , Hepatite C/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , Comportamento Sexual , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Cônjuges , Fatores de RiscoRESUMO
Fifty heterosexual partners out of 50 patients (index cases) without confirmed or probable risk factors of parenteral transmission by HCV were studied from 1/1997 to 1/2001. The index cases were HCV Ab (+) (EIA 3rd Abbott and PCR + by RT-nested PCR). The couples with probable or confirmed risk factors of parenteral transmission were strictly excluded. No case of HCV infection was found, suggesting that sexual via wouldn't be a direct transmission of HCV
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hepatite C , Doenças Virais Sexualmente Transmissíveis , Argentina , Hepatite C , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis , CônjugesRESUMO
UNLABELLED: It is accepted that the practice of odontology implies a risk of BBV and HCV transmission but the study of does not. This work tries to determine the prevalence of HBv Ac and HCV Ac (by ELISA) in odontology students and whether there is any relation to the year of study and/or the presence of other risk factors. 188 students in their last three years of studies were investigated, all the participants filled out a clinical epidemiological form. 89 women (47.3%) and 99 men (52.7%), x age was 24.8. 50 (26.7%) had other risk factors. 160 (85.1%) fulfilled biosecurity norms and 40 (21.2%) had a labour accident. RESULTS: None of the analyzed sera were positive for HCV Ac (0%) and 1 was positive for HbcAc. CONCLUSION: The prevalence of HBv Ac and HCV Ac is extremely low with no relation to the year of study or any other risk factors.
Assuntos
Anticorpos Anti-Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Estudantes de Odontologia , Adulto , Argentina , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Fatores de Risco , Estudos SoroepidemiológicosRESUMO
It is accepted that the practice of odontology implies a risk of BBV and HCV transmission but the study of does not. This work tries to determine the prevalence of HBv Ac and HCV Ac (by ELISA) in odontology students and whether there is any relation to the year of study and/or the presence of other risk factors. 188 students in their last three years of studies were investigated, all the participants filled out a clinical epidemiological form. 89 women (47.3%) and 99 men (52.7%), x age was 24.8. 50 (26.7%) had other risk factors. 160 (85.1%) fulfilled biosecurity norms and 40 (21.2%) had a labour accident. RESULTS: None of the analyzed sera were positive for HCV Ac (0%) and 1 was positive for HbcAc. CONCLUSION: The prevalence of HBv Ac and HCV Ac is extremely low with no relation to the year of study or any other risk factors (AU)
Assuntos
Humanos , Masculino , Feminino , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Estudantes de Odontologia , Hepatite B/transmissão , Hepatite C/transmissão , Prevalência , Fatores de Risco , Transmissão de Doença Infecciosa do Paciente para o Profissional , Ensaio de Imunoadsorção Enzimática , Anticorpos Anti-Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Estudos Soroepidemiológicos , Argentina/epidemiologiaRESUMO
It is accepted that the practice of odontology implies a risk of BBV and HCV transmission but the study of does not. This work tries to determine the prevalence of HBv Ac and HCV Ac (by ELISA) in odontology students and whether there is any relation to the year of study and/or the presence of other risk factors. 188 students in their last three years of studies were investigated, all the participants filled out a clinical epidemiological form. 89 women (47.3%) and 99 men (52.7%), x age was 24.8. 50 (26.7%) had other risk factors. 160 (85.1%) fulfilled biosecurity norms and 40 (21.2%) had a labour accident. RESULTS: None of the analyzed sera were positive for HCV Ac (0%) and 1 was positive for HbcAc. CONCLUSION: The prevalence of HBv Ac and HCV Ac is extremely low with no relation to the year of study or any other risk factors
Assuntos
Humanos , Masculino , Feminino , Hepatite B , Hepatite C , Estudantes de Odontologia , Argentina , Ensaio de Imunoadsorção Enzimática , Hepatite B , Anticorpos Anti-Hepatite B , Hepatite C , Anticorpos Anti-Hepatite C , Transmissão de Doença Infecciosa do Paciente para o Profissional , Prevalência , Fatores de Risco , Estudos SoroepidemiológicosRESUMO
Fifty heterosexual partners out of 50 patients (index cases) without confirmed or probable risk factors of parenteral transmission by HCV were studied from 1/1997 to 1/2001. The index cases were HCV Ab (+) (EIA 3rd Abbott and PCR + by RT-nested PCR). The couples with probable or confirmed risk factors of parenteral transmission were strictly excluded. No case of HCV infection was found, suggesting that sexual via wouldn't be a direct transmission of HCV.
Assuntos
Hepatite C/transmissão , Doenças Virais Sexualmente Transmissíveis/virologia , Adulto , Idoso , Argentina/epidemiologia , Feminino , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis/epidemiologia , CônjugesRESUMO
It is accepted that the practice of odontology implies a risk of BBV and HCV transmission but the study of does not. This work tries to determine the prevalence of HBv Ac and HCV Ac (by ELISA) in odontology students and whether there is any relation to the year of study and/or the presence of other risk factors. 188 students in their last three years of studies were investigated, all the participants filled out a clinical epidemiological form. 89 women (47.3
) and 99 men (52.7
), x age was 24.8. 50 (26.7
) had other risk factors. 160 (85.1
) fulfilled biosecurity norms and 40 (21.2
) had a labour accident. RESULTS: None of the analyzed sera were positive for HCV Ac (0
) and 1 was positive for HbcAc. CONCLUSION: The prevalence of HBv Ac and HCV Ac is extremely low with no relation to the year of study or any other risk factors.
RESUMO
Fifty heterosexual partners out of 50 patients (index cases) without confirmed or probable risk factors of parenteral transmission by HCV were studied from 1/1997 to 1/2001. The index cases were HCV Ab (+) (EIA 3rd Abbott and PCR + by RT-nested PCR). The couples with probable or confirmed risk factors of parenteral transmission were strictly excluded. No case of HCV infection was found, suggesting that sexual via wouldnt be a direct transmission of HCV.
RESUMO
In order to ascertain the clinical and epidemiological features of acute liver failure (ALF), we analyzed the clinical histories of 22 patients from La Plata city, with the diagnosis of ALF (prothrombin level or factor V below 50%) seen between November 1996 and November 2000. Age, sex, hepatic encephalopathy, reason for consultation, etiology, hepatic biochemical tests, serum creatinine, glycemia, digestive hemorrhage, course and treatment variables were analyzed. What is remarkable is the high frequency of the toxic etiology and of infection by HDV, as well as the high prevalence of ascites and the low incidence of hepatic encephalopathy. We think that the high survival rate we found is due to the early diagnosis and early referral of the patients to the intensive care unit and to centers with programs for liver transplantation.
Assuntos
Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Fator V/análise , Feminino , Humanos , Falência Hepática Aguda/etiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Protrombina/análise , Estudos RetrospectivosRESUMO
Se analizaron las historias clínicas de 22 pacientes con IHA (Protrombina y/o factor V menor de 50 por ciento). La ictericia fue el motivo de consulta más frecuente (54.5 por ciento). Doce pacientes (54.5 por ciento) presentaron EH, sólo dos de los cuales la teníam en el momento del ingreso. Doce (54.5 por ciento) presentaron ascitis en algún momento de la evolución. Etiología desconocida en 6 (27.2 por ciento), fármacos 6 (27.2 por ciento), HBV 5 (22.7 por ciento) 2 de los cuales teníam además HDV y 3 (13.6 por ciento) autoimmune. Se halló una alta tasa de sobrevida. (Au)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Falência Hepática Aguda/fisiopatologia , Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/etiologia , Protrombina/análise , Fator V/análise , Estudos Retrospectivos , Prognóstico , Idoso de 80 Anos ou maisRESUMO
In order to ascertain the clinical and epidemiological features of acute liver failure (ALF), we analyzed the clinical histories of 22 patients from La Plata city, with the diagnosis of ALF (prothrombin level or factor V below 50
) seen between November 1996 and November 2000. Age, sex, hepatic encephalopathy, reason for consultation, etiology, hepatic biochemical tests, serum creatinine, glycemia, digestive hemorrhage, course and treatment variables were analyzed. What is remarkable is the high frequency of the toxic etiology and of infection by HDV, as well as the high prevalence of ascites and the low incidence of hepatic encephalopathy. We think that the high survival rate we found is due to the early diagnosis and early referral of the patients to the intensive care unit and to centers with programs for liver transplantation.
RESUMO
Se analizaron las historias clínicas de 22 pacientes con IHA (Protrombina y/o factor V menor de 50 por ciento). La ictericia fue el motivo de consulta más frecuente (54.5 por ciento). Doce pacientes (54.5 por ciento) presentaron EH, sólo dos de los cuales la teníam en el momento del ingreso. Doce (54.5 por ciento) presentaron ascitis en algún momento de la evolución. Etiología desconocida en 6 (27.2 por ciento), fármacos 6 (27.2 por ciento), HBV 5 (22.7 por ciento) 2 de los cuales teníam además HDV y 3 (13.6 por ciento) autoimmune. Se halló una alta tasa de sobrevida.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Falência Hepática Aguda , Idoso de 80 Anos ou mais , Fator V , Falência Hepática Aguda , Prognóstico , Protrombina , Estudos RetrospectivosRESUMO
Diphenylhydantoin is a anticonvulsivant and antiarrhythmic drug. We reported a less frequent case of diphenylhydantoin associated acute hepatotoxicity in a 18-year old woman who immediately after child birth presented generalized tonic-clonic seizures secondary to arachnoid cyst in the left temporal-lobe. The patient developed a mononucleosis like coinciding with previous descriptions. Histological features observed in the liver biopsy specimen showed compatible changes with toxic acute liver failure (ALF). In the few cases published of ALF for Diphenylhydantoin is not specifically pointed out the absence of hepatic encephalopathy as it happened to our patient.