الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. Egypt is one of the most prevalent countries in the world in hepatitis C virus (HCV) infection. The overall prevalence of HCV antibody in the general population ranges between 15 and 20%.
Interstitial pneumonitis and alveolar pulmonary diseases occur rarely as a complication in active HCV infection by direct and indirect effects on the lung. The direct effects include initiation or exacerbation of preexisting COPD and also occur as a side-effect of HCV combination treatment (interferon) that has been associated with a plethora of pleuropulmonary complications ranging from mild asthma exacerbation to acute respiratory distress syndrome (ARDS) and death. Onset of pneumonitis can be at any stage of HCV treatment, supporting the idiosyncratic nature of this side-effect.
High resolution CT (HRCT), nowadays usually performed with spiral CT, is very often able to make the correct diagnosis of diffuse parenchymal and interstitial lung disease, especially when typical CT patterns of this disease are present, a reason why lung biopsy may be avoided. However, when CT signs are atypical, a diagnosis may only be possible after thorough clinic radiologic correlation.
Accordingly, the aim of this study is to evaluate the role of HRCT in diagnosis interstitial and alveolar pulmonary disease in active hepatitis patients.
This study was carried out on 25 patients with active hepatitis who were presented to the outpatient clinics at Alexandria main university hospital.
Non-enhanced HRCT of the chest examination was done in all patents. Reconstruction algorithm including 3D (three dimensional) MIP, Min IP (Minimal intensity projection), whenever needed. Further non radiological work up including either: Pulmonary function test including measurements of (FVC). BAL (cellular percentage and (CD4-CD8 immunophenotyping) and Trans bronchial core needle biopsy.
A total of 25 patients, 56% of patients were males and 44% of patients were females. Their age ranged from 20 to 74 years old (mean :56.88 ± 10.77). 92% of patients had positive HCV and 8% had autoimmune hepatitis. Presentencing with symptom of pneumonitis.
Pulmonary investigations among studied patients. Mean FVC in the studied group was 46.33 12.8 . Mean BAL lymphocyte percentage was 71.63 8.1 .BAL CD4-CD8 immunophenotyping , In cases of (NSIP), the mean was 3.70 ± 0.14. In cases of (COP) the mean was 0.60 ± 0.14. In case of sarcoidosis the mean was 4.0. Trans bronchial Biopsy was done in one patient, revealed non caseating lesion (sarcoidosis).
In this study, there were significant positive correlations between the HRCT findings and (patient complaints, FVC and BAL results). Regarding HRCT (Mosaic changes) 76% of patients had ground glass opacities .24% had Mosaic perfusion