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Abstract
Giant cell hepatitis is common manifestation in pediatric liver diseases, but quite uncommon in adults, only about 100 cases reported in the English literature in the last two decades. Data for the present review were identified by a structured PubMed/MEDLINE search from 1963 to December 2012, using keywords postinfantile giant cell hepatitis (PIGCH), adult giant cell hepatitis, and syncytial giant cell hepatitis in adults and liver. We report a case of postinfantile giant cell hepatitis along with the review related to the etiology and respective outcome, as the literature in the last 20 years suggests. This condition is probably due to idiosyncratic or cytopathic response of individual to various hepatocytic stimuli. It is purely a histomorphological diagnosis and does not establish the etiology. Autoimmune liver diseases are most common etiology, in around 40% of cases, but various viruses, drugs, posttransplant condition, and other causes also have been reported. Prognosis depends upon the etiology. In this paper, we emphasized various causative factors of PIGCH and their respective outcome in patients affected by them. We also highlighted the possible pathogenesis and histopathological spectrum of this entity on the basis of description given in various studies and our limited experience of few cases.
Highlights
Giant cell hepatitis is a condition characterized by inflammation and large multinucleated hepatocytes in the hepatic parenchyma
postinfantile giant cell hepatitis (PIGCH) is purely a histological diagnosis which is based on morphological criteria of conspicuous presence of giant cell hepatocytes; it is a descriptive term and does not speak about the etiology in any individual case [1]
In moderate prognosis group we have put those patients who had rapid onset of cirrhosis following the diagnosis of PIGCH, and in good prognosis category, we have grouped
Summary
Giant cell hepatitis is a condition characterized by inflammation and large multinucleated hepatocytes in the hepatic parenchyma. Giant cell transformation of hepatocytes along with extramedullary hematopoiesis is a common response in the newborn liver diseases [1,2,3,4]. Postinfantile giant cell hepatitis is a rare disorder. It is an unusual regenerative or degenerative hepatocytes response to various noxious stimuli, characterized by the presence of multinucleated cells in liver with generally dismal clinical outcome [1,2,3,4]. We report a case of postinfantile hepatitis with review of the literature regarding various etiological agents and their respective prognostic outcome
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