Reviewer's report
Title:Anastrozole-related acute hepatitis with autoimmune features: a case
report.
Version: 1Date:8 December 2010
Reviewer: James H Lewis
Reviewer's report:
Major Revisions:
1) the authors fail to provide any baseline liver tests prior to the patient starting
the drug - are any pre-treatment LFTs available? Also, no pre-treatment
autoantibodies are available - since the ANA was low titer - and disappeared, can
it truly be linked to the drug if no baseline values are available. The apparent
positive De-challenge cannot be verified.
2) The word "flogistic" does not appear in any dictionary I consulted - did the
biopsy have any features that are accepted as autoimmune hepatitis-like, such
as plasma cell infiltrate, rosetting or interface hepatitis? Mild steatosis is
nonspecific.
3) did the authors apply any standard causality assessment methodology to the
case report such as RUCAM ; and given the possiblity of autoimmune injury , did
they attempt to apply the international autoimmune hepatitis scoring system to
the case? If so, what values did they get? And would those scores allow
classification of the case of at least "probably related" ? Anything less than
probably related does not warrant publication as a case report and should be
relegated to a letter to the editor or some other hypothesis -generating medium.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare I have no competing interests
Reviewer's report
Title:Anastrozole-related acute hepatitis with autoimmune features: a case
report.
Version: 1Date:8 December 2010
Reviewer: James H Lewis
Reviewer's report:
Major Revisions:
1) the authors fail to provide any baseline liver tests prior to the patient starting
the drug - are any pre-treatment LFTs available? Also, no pre-treatment
autoantibodies are available - since the ANA was low titer - and disappeared, can
it truly be linked to the drug if no baseline values are available. The apparent
positive De-challenge cannot be verified.
2) The word "flogistic" does not appear in any dictionary I consulted - did the
biopsy have any features that are accepted as autoimmune hepatitis-like, such
as plasma cell infiltrate, rosetting or interface hepatitis? Mild steatosis is
nonspecific.
3) did the authors apply any standard causality assessment methodology to the
case report such as RUCAM ; and given the possiblity of autoimmune injury , did
they attempt to apply the international autoimmune hepatitis scoring system to
the case? If so, what values did they get? And would those scores allow
classification of the case of at least "probably related" ? Anything less than
probably related does not warrant publication as a case report and should be
relegated to a letter to the editor or some other hypothesis -generating medium.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Anastrozole-related acute hepatitis with autoimmune features: a case
report.
Version: 1Date:8 December 2010
Reviewer: James H Lewis
Reviewer's report:
Major Revisions:
1) the authors fail to provide any baseline liver tests prior to the patient starting
the drug - are any pre-treatment LFTs available? Also, no pre-treatment
autoantibodies are available - since the ANA was low titer - and disappeared, can
it truly be linked to the drug if no baseline values are available. The apparent
positive De-challenge cannot be verified.
2) The word "flogistic" does not appear in any dictionary I consulted - did the
biopsy have any features that are accepted as autoimmune hepatitis-like, such
as plasma cell infiltrate, rosetting or interface hepatitis? Mild steatosis is
nonspecific.
3) did the authors apply any standard causality assessment methodology to the
case report such as RUCAM ; and given the possiblity of autoimmune injury , did
they attempt to apply the international autoimmune hepatitis scoring system to
the case? If so, what values did they get? And would those scores allow
classification of the case of at least "probably related" ? Anything less than
probably related does not warrant publication as a case report and should be
relegated to a letter to the editor or some other hypothesis -generating medium.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare I have no competing interests
assistant