Intranuclear particles in the hepatocytes of patients with non-A, non-B hepatitis and acute intermittent porphyria

Abstract

Dear Sir: We’ read with great interest the report “Nuclear Changes in Hepatocytes of Patients with Non-A, Non-B Hepatitis” by Cabral et al. (1). We examined by electron microscope liver biopsy specimens of 21 patients with non-A, non-B (NANB) hepatitis, and detected intranuclear viruslike particles measuring 25 + 3 nm in diameter (Figure 1A) in 2 patients. These particles were observed in 2%-3% of hepatocytic nuclei examined (2). The particles resembled “the first type of particles, 25 2 2 nm in diameter” (1) in size, appearance, and incidence. Unexpectedly we detected aggregates of 35-nm particles that were similar to “the third type particles” (1) in the hepatocytic nuclei of a patient with acute intermittent porphyria (AIP). The cluster of particles was observed in only 0.5% of hepatocytic nuclei examined (Figure IB). This patient had no evidence of known hepatitis virus infection, exposure to hepatotoxic agents, and no history of blood-transfusion or hepatitis. The appearance of these particles in AIP suggests the following three possibilities: (a) this patient with AIP may be a NANB hepatitis virus carrier (3); (b) the particles may be one of AIP-related structures; (c) this structure may be a nonspecific alteration due to liver injury. We failed to demonstrate convincingly the presence of “the second type of particles” (1) in patients with NANB hepatitis and AIP. With regard to intracytoplasmic tubular structures in the hepatocytes of chimpanzees with experimentally infected NANB hepatitis (4, 51, we could not detect them in the hepatocytic cytoplasm of 21 NANB hepatitis patients or of an AIP patient as reported (1). We feel, therefore, that these cytoplasmic tubular structures may be alterations species-specific to chimpanzees infected with one type of NANB hepatitis virus(es).