Non-specific Reactive Hepatitis Research Articles

Copper hepatopathies in Australian dogs.

To evaluate hepatopathies in Australian dogs according to the World Small Animal Veterinary Association (WSAVA) guidelines. Specifically, to describe the prevalence and survival of dogs with copper-associated hepatopathy. Medical records from the Small Animal Specialist Hospital were reviewed to identify dogs with liver disease and liver biopsy between November 2008 and November 2021. Liver histopathology reports were reviewed with a board-certified veterinary pathologist and classified according to the WSAVA guidelines. Histopathology reports and clinical records were reviewed to ascertain the most important histological process for statistical analysis. Copper-associated hepatopathy was defined as (i) histological evidence of copper accumulation in centrilobular areas (Zone 3) associated with hepatocyte necrosis, inflammation with copper-laden macrophages and chronic hepatitis (ii) histochemical copper staining showing hepatocyte copper accumulation in the centrilobular areas and iii) hepatic copper measurement with concentrations greater than 600 μg/g dry weight of liver. Dogs with primary inflammatory parenchymal disease included dogs with copper-associated hepatopathy, idiopathic chronic hepatitis, non-specific reactive hepatitis, chronic bacterial hepatitis and immune-mediated chronic hepatitis. Descriptive statistics were performed for all dogs. Age, weight and clinicopathologic data were compared between dogs with copper-associated hepatopathy and dogs with other causes of chronic primary inflammatory parenchymal liver disease (Kruskal-Wallis test). Survival times were calculated and compared (Kaplan-Meier curves and log rank test) between dogs with copper-associated hepatopathy and dogs with other chronic primary inflammatory parenchymal liver diseases. Breed was evaluated to determine the breed most commonly affected with copper-associated hepatopathy and identify any breed in which this disease has not previously been described. Sixty-seven (43 female, 24 male) dogs with a median age of 7.8 years (quartile [Q] Q1-Q3 4.5-9.6 years) were included. Thirteen dogs had copper-associated hepatopathy, eight dogs had idiopathic chronic hepatitis, eight dogs had non-specific reactive hepatitis, seven dogs had disorders associated with portal hypertension, five dogs had chronic bacterial hepatitis and four dogs had immune-mediated chronic hepatitis. Compared with dogs with other causes of chronic primary inflammatory parenchymal liver disease, dogs with copper-associated hepatopathy tended to be younger (6.73 vs. 8.01 years, P = 0.057) and heavier (19.8 vs. 9.6 kg, P = 0.052) than dogs with other causes of primary chronic inflammatory parenchymal diseases. There was no statistically significant difference when ALT (P = 0.30), ALP (P = 0.18) and total bilirubin (P = 0.13) were compared between the two groups. The median survival time for all dogs after liver biopsy was 2010 days (CI 1321 days - not reached). There was no significant difference in survival between dogs with copper-associated hepatopathy and dogs with other causes of chronic primary inflammatory parenchymal liver disease (P = 0.5). Copper-associated hepatopathy was common among Australian dogs with chronic hepatopathies, occurring in younger and heavier dogs than other causes of primary inflammatory parenchymal liver disease. Clinical pathology is not useful for differentiating between copper-associated hepatopathy and other causes of chronic primary inflammatory parenchymal liver disease. When copper-associated hepatopathy is treated, the prognosis can be good. This is the first report of copper-associated hepatopathy in Australian Cavalier King Charles Spaniels.

Modern hepatoprotection: a narrative review of existing approaches and prospects for the use of biotechnological drugs

The prevalence of acute and chronic liver diseases is increasing worldwide, which affects the quality of life and can lead to dangerous, life-threatening complications. Almost 50.0 % of all cases of acute liver failure are caused by drugs, and the overall mortality due to drug-induced liver injury reaches 5.0–11.9 %. In 2020, the hospital incidence of diseases of the digestive organs in Ukraine amounted to 430,593 cases among the adult population, of which 11,976 were fatal.
 The aim of the study: to characterize modern approaches to hepatoprotection and prospects of biological therapy based on data from open sources of information.
 Materials and methods. Publications were selected based on the PubMed, ClinicalKey Elsevier, Cochrane Library, eBook Business Collection, and Google Scholar databases, which covered information about modern approaches to the treatment of liver diseases.
 Results. Patients with chronic liver disease are at risk of extrahepatic complications related to liver cirrhosis and portal hypertension, as well as organ-specific complications of certain liver diseases. These complications can impair the quality of life and increase morbidity and mortality before and after liver transplantation. With chronic damage to the liver by toxic substances, the development of fatty dystrophy against the background of connective tissue changes in the form of nonspecific reactive hepatitis is more often observed. Hepatoprotectors are a pharmacotherapeutic group of heterogeneous drugs that prevent the destruction of cell membranes and stimulate the regeneration of hepatocytes. According to the Anatomical Therapeutic and Chemical classification of drugs (ATC classification), hepatoprotectors take their place in the group of drugs affecting the digestive system and metabolism (A), intended for the treatment of diseases of the liver and biliary tract (A05). One of the promising directions of biological therapy in patients with liver pathology is the use of means obtained from the fetoplacental complex.
 Conclusions. Cell therapy in clinically significant volumes is an actual area of modern hepatology. The most promising directions of biological therapy in clinical hepatology are the use of mesenchymal stem cells, agents obtained from the fetoplacental complex, and gene therapy.

Clinical case report of acute dinitrophenol poisoning with a fatal outcome of Udmurt Republic

Was to conduct the analysis of patient's clinical observation with acute dinitrophenol poisoning, admitted to a toxicological department of CCH №6 of Izhevsk, Udmurt Republic in 2021 yr. In this clinical case report, a 19 years old girl, who took 20 tablets of dinitrophenol, illegally obtained in online-shop, died. The fatal outcome was realized by the uncoupling of oxidative phosphorylation mechanism and cellular respiration, which in its turn led to serious dystrophic changes in all organs and tissues. Disorders of hemodynamics and blood rheological properties dominated in poisoning pathogenesis, led to congestion, stasis in microcirculatory vessels, hyperpermeability with multiple perivascular hemorrhages in organs, occurrence of piecemeal necrosis in kidneys and liver, nephrosis and nonspecific reactive hepatitis. Production ATP from ADP becomes impossible in these conditions, and respiratory energy chain completely disappears as heat, that explains the heat-increasing and fat-burning effects of dinitrophenol.

S3643 Rocky Mountain Spotted Fever Masquerading as Gastroenteritis

Introduction: Rocky Mountain spotted fever (RMSF) is a potentially lethal tick-borne illness. RMSF multiplies within blood vessels, causing endothelial damage before spreading hematologically to affect various organ. The classic triad of fever, rash, and a recent tick bite is rarely present at diagnosis. Less known, but more common initial presentations include hepatic and gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, abdominal pain, and elevated liver function tests (LFT’s). We present a case of RMSF that demonstrates the diagnostic challenges associated with this illness. Case Description/Methods: A 20-year-old male presented to the hospital with diarrhea and abdominal pain. He was tachycardic and febrile to 104oF. Blood work was remarkable for elevated LFT’s (AST 240 U/L, ALT 247 U/L, Tb 7.2 mg/dL and ALP 451 U/L). Abdominal computed tomography revealed ascites, periportal edema, and splenomegaly with infarction. The patient was empirically placed on piperacillin-tazobactam. Chronic liver disease and infectious disease work ups were unmemarkable. Over the next three days, his symptoms worsened and he had increasing leukocytosis and LFT’s. A liver biopsy was obtained revealing portal-based inflammation consisting predominantly of neutrophils, and mild bile ductular proliferation (Figure). On the fourth day, a serologic test for RMSF IgM antibodies was positive. The patient’s antibiotics were changed to doxycycline. One day after the antibiotic change his fever resolved, LFT’s decreased and GI symptoms improved. Discussion: RMSF is an uncommon disease that remains a diagnostic challenge for physicians. GI symptoms are the more prominent features in up to 80% of RMSF patients and often precedes the appearance of a rash. Liver involvement in RMSF is also common, most frequently manifesting as AST and ALT elevation, with jaundice being a poor prognostic factor. Liver biopsies reveal infection of the endothelial lining and periportal inflammation. The treatment of choice for RMSF is doxycycline and patients often experience rapid improvement within 72 hours. Delayed treatment can lead to fulminant disease with a mortality rate of 25%, thus prompt diagnosis and early administration of appropriate antibiotics is imperative. Clinicians should be educated about the early manifestation of RMSF and consider it among the differential diagnoses in a patient with fever, GI symptoms, and hepatic involvement.Figure 1.: Liver biopsy in Rocky Mountain spotted fever revealing a nonspecific reactive hepatitis with peri-portal inflammation and surrounding bile ductular inflammation and proliferation.

Неспецифічний реактивний гепатит – невідомий або забутий діагноз? (стислий огляд та запрошення до дискусії)

The purpose of the study was to analyze and summarize information from the sources of scientific literature on nonspecific reactive hepatitis. Materials and methods. Analytical and bibliosemantic methods were used in the study. The search was performed in Google Scholar, NCBI, PUBMED and Web of Science databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) recommendations. Results and discussion. Acute and chronic liver diseases rank as one of the leading places in the structure of pathology of internal organs. The consequence of these diseases in many cases is the development of cirrhosis of the liver, which ranks 11th among the leading causes of death and 15th among the causes of morbidity in the world. Among hepatopathies, nonspecific reactive hepatitis (code K75.2 for ICD-10; DB97 for ICD-11) is rarely mentioned and diagnosed – secondary hepatitis caused by several endogenous and exogenous factors that reflect the liver's response to any somatic disease. There are few publications on this problem, but there are many publications on the deviation of liver function tests: bilirubin, alanine and aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase in many pathological conditions, including in critically ill patients regardless of their trauma, cardiac and acute surgical pathology, intestinal disorders. Frequent signs of hepatic dysfunction in many diseases, along with a small number of clinical diagnoses of nonspecific reactive hepatitis, indicate a problem of underdiagnosis, which can be explained by the lack of clear clinical, laboratory and instrumental signs of this disease. Determination of biomarkers of the liver function used in routine clinical practice requires qualitative and quantitative clarification, ultrasound is not always informative, and computed tomography is not always available. This indicates the urgency of the problem of defining the concept and criteria for the diagnosis of nonspecific reactive hepatitis and the need for large-scale clinical studies, especially in critical conditions of various etiologies, in the pathogenesis of which are hemodynamic disorders and systemic inflammatory response. Conclusion. The low diagnosis of nonspecific reactive hepatitis can be explained not only by the ignorance of doctors, but also by the lack of clear diagnostic criteria. The true prevalence of nonspecific reactive hepatitis does not correspond to the frequency of pathology in clinical diagnoses

Palpebral Non-Hodgkin Lymphoma with Non-specific Reactive Hepatitis

ABSTRACT Extranodal Non-Hodgkin Lymphoma (NHL) remains an odd issue and something to discuss. Clinical evidence and guidelines on the treatment have not yet been broadly published and accessible. Here, we present a case of a thirty-eight years old woman complaining of mass on both lower lids of the eyes. The CT Scan examination showed enhancing solid masses on right-sided and left-sided palpebra inferior that press bulb oculi, suspected as bilateral malignant masses of bilateral palpebra inferior. Laboratory data revealed the surge of liver function marker. The patient was eventually diagnosed with Non-Hodgkin Lymphoma (NHL) of palpebra inferior B cell type high-grade stadium II E. Although there are still ongoing research and development of definitive treatments, R-CHOP a regiment given to this patient has shown complete favorable result with dosage adjustment due to the surge of basal liver function. The regiment was considered safe since no adverse effects reportedKeywords: extranodal, lymphoma non-hodgkin, palpebra, liver function

Immunological and pathological investigations of non-specific reactive hepatitis in shelter dogs

Abstract The aim of this study was to describe the gross, histopathological and immunohistochemical features of non-specific reactive hepatitis (NSRH) in stray dogs. To perform this study the livers of 23 dogs of different breed and sex were used. The tissue sections were stained with hematoxylin–eosin, and immunohistochemically. The results of this work showed that NSRH was characterized by the infiltration of lymphocytes and plasma cells scattered throughout the liver parenchyma and in the portal stroma, and associated with inflammatory and non-inflammatory diseases in other organ systems. The inflammatory infiltrate of NSRH was composed of CD3+ T lymphocytes and HLA-DR+ lymphocytes, as well as IgG+ plasma cells and alpha-1-antitrypsin+ macrophages in the portal spaces and hepatic sinusoids.

Study of Non-Specific Reactive Hepatitis in Stray Dogs

Study of Non-Specific Reactive Hepatitis in Stray Dogs

Morphological changes in the broiler chickens liver at use of “Karsilin” in conditions of infectious-toxic hepatitis modelling

In poultry farms, at the conditions of rapid intensification of production, a lot of stress factors, such as infectious, technological, fodder, medication and others, act on the bird organism, and the main burden is borne by the liver. Therefore, timely warning and control of liver disease is very important. One of the marker infections with a potent pathogenic toxic effect on the liver and the bird organism as a whole is pseudomonosis. Objective: study of morphological changes in the liver of broiler chickens at the use of “Karsilin” in the conditions of modeling of infectious-toxic hepatitis for the determination of hepatoprotective action. We conducted a histological examination of the liver of intact chickens (intact control); chickens infected with the strain of P. aeruginosa microorganisms (control pathology); chickens, for which the “Karsilin” or Thiotriazolin was used with preventive-therapeutic purposes at infecting P. aeruginosa. Microscopic picture of liver samples infected with P. aeruginosa chicks corresponds to moderately expressed non-specific reactive hepatitis with morphological signs: disorganization of the hepatic beams pattern, hydrocytic and fatty hepatocyte dystrophy, small foci necroses, inflammatory cellular infiltration; proliferative, stagnant processes, perivascular edema and hyperemia in the system of the hepatic triad. The use of “Karsilin” at experimental pseudomonosis reduced the intensity of pathological processes: the severity of hepatocyte dystrophy was less than 71%, and necrotic changes in hepatocytes and violations of the beam pattern were less than 75% compared with the control pathology. Feed supplement “Karsilin” demonstrates hepatoprotective effect, which is expressed by preventing or significantly reducing the intensity of the manifestation of dystrophic, necrotic, infiltrative and proliferative processes in hepatocytes and in the hepatic triad in conditions of infectious-toxic hepatitis caused by the pathological action of P. aeruginosa toxins in the body of chicken broilers. Feed supplement “Karsilin” on the activity of protective and regenerative action is not inferior, and according to many indicators, the comparison preparation Thiotriazolin prevails.

Sensitivity and Specificity of Plasma ALT, ALP, and Bile Acids for Hepatitis in Labrador Retrievers.

BackgroundBiochemical indicators for diagnosing liver disease are plasma alanine aminotransferase activity (ALT), alkaline phosphatase activity (ALP), and bile acid concentration (BA).ObjectivesTo determine the sensitivity and specificity of ALT, ALP, and BA for detecting primary hepatitis (PH) in clinically healthy Labrador retrievers and investigate whether ALT and ALP can discriminate between dogs with PH and nonspecific reactive hepatitis (RH).Animals191 clinically healthy and 51 clinically ill Labrador retrievers with hepatic histopathology.MethodsRetrospective study. Medical records were reviewed for ALT, ALP, preprandial BA, liver histopathology, and hepatic copper concentrations.ResultsIn 64% (122/191) of the clinically healthy Labrador retrievers, hepatic histology revealed inflammatory infiltrates. This frequency might be biased because part of them was included as first‐line relatives of dogs with copper‐associated hepatitis. Sensitivity of ALT, ALP, and BA in this population for detecting acute hepatitis was 45, 15, and 15%, respectively. For chronic hepatitis, sensitivity was 71, 35, and 13%, respectively. Specificity of ALT, ALP, and BA was >90% for AH, CH, and RH. When increased liver enzymes were present, median ALT was significantly higher in PH cases (312 U/L, range 38–1,369) compared to RH cases (91 U/L, range 39–139) (P < .001). There was no difference in ALP between dogs with a PH and a RH (P = .361).Conclusions and Clinical ImportanceHistopathologic abnormalities in the liver were present in the majority of apparent clinically healthy Labrador retrievers. The sensitivity of ALT, ALP, and BA for detecting acute and chronic hepatitis in this population was low. More sensitive biomarkers are needed for early detection of liver disease in apparent clinically healthy dogs.

Impact of Biliary Calculi on the Liver

Gallstone is implicated for hepatocellular injury due to chronic extra hepatic large bile duct obstruction with or without repeated episodes of cholangitis. To study the liver changes in patients undergoing operative procedure for gallstone disease and to determine the relationship between severity of these changes with position of biliary calculus in biliary tree. Sixty patients who underwent operative procedure for gallstone disease between October 2013 and September 2015 were evaluated. The Liver Function Test (LFT) was done preoperatively and postoperatively. Intraoperative liver biopsy was taken. The histopathological changes of liver and their severity were noted. The most commonly observed liver function abnormality both in cholelithiasis (12.8%) and choledocholithiasis patients (50%) was increased alkaline phosphatase. Most commonly observed liver histology changes in patients with cholelithiasis was nonspecific reactive hepatitis (46.9%) and in choledocholithiasis was chronic cholestasis (50%). Patient with choledocholithiasis showed significant changes (p<0.001) in liver histopathology and LFT as compared to cholelithiasis. Patients with gallstone diseases developed significant functional as well as structural hepatic changes. Though the change was more significant in patient with choledocholithiasis compared to cholelithiasis, early operative procedure is recommended in all gallstone disease patients to prevent potential liver damage, irrespective of position of biliary calculi in biliary tree to prevent morbidities associated with it.

The Relationships between Respiratory Virus Infection and Aminotransferase in Children.

PurposeWe sought to examine the relationship between the clinical manifestations of nonspecific reactive hepatitis and respiratory virus infection in pediatric patients.MethodsPatients admitted to the pediatric unit of Konyang University Hospital for lower respiratory tract disease between January 1, 2014 and December 31, 2014 and who underwent reverse transcriptase polymerase chain reaction tests were examined. The patients were divided into those with increased levels of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) and those with normal ALT or AST levels. Further, patients with increased ALT and AST levels were individually compared with patients in the normal group, and the blood test results were compared according to the type of respiratory virus.ResultsPatients with increased ALT or AST levels had one more day of hospital stay, on average, compared with patients in the normal group (5.3±3.1 days vs. 4.4±3.0 days, p=0.019). Patients in the increased ALT level group were younger and had a longer mean hospital stay, compared with patients in the normal group (p=0.022 and 0.003, respectively). The incidences of increased ALT or AST were the highest in adenovirus infections (6/24, 25.0%), followed by enterovirus (2/11, 18.2%) and respiratory syncytial virus A (21/131, 16.0%) infections.ConclusionNonspecific reactive hepatitis is more common among patients with adenovirus, enterovirus and respiratory syncytial virus infection, as well as among those infected at a younger age. Compared with AST levels, ALT levels are better indicators of the severity of nonspecific reactive hepatitis.

Liver involvement in pediatric celiac disease.

Celiac disease (CD) is an intestinal inflammatory disease that manifests in genetically susceptible individuals when exposed to dietary gluten. It is a common chronic disorder, with a prevalence of 1% in Europe and North America. Although the disease primarily affects the gut, the clinical spectrum of CD is remarkably varied, and the disease can affect many extraintestinal organs and systems, including the liver. The hepatic dysfunction presenting in CD ranges from asymptomatic liver enzyme elevations or nonspecific reactive hepatitis (cryptogenic liver disorders), to chronic liver disease. In this article, we review the clinical presentations and possible mechanisms of CD-related liver injury to identify strategies for the diagnosis and treatment of these disorders in childhood.

Hepatoprotective Effects of B-1,3-(D)-Glucan on Bortezomib-Induced Liver Damage in Rats

The aim of this study was to evaluate the effects of β -1,3-(D)-glucan as an antioxidant and tissue protective agent and study the biochemical, histopathologic, and immunohistochemical effects of first therapeutic proteasome inhibitor bortezomib on the liver for treating relapsed multiple myeloma. The experiment included 36 adult male rats, which were divided into four treatment groups: control (healthy); bortezomib-treated; β-1,3-D-glucan-treated; and bortezomib + β-1,3-(D)-glucan-treated. Each group was subdivided into two subgroups based on time of sacrifice (48 or 72 h). After the experiments, superoxide dismutase (SOD) activity and lipid peroxidation (LPO) amounts were determined, and immunohistochemical and histopathological changes were examined in all rat liver tissues. β -1,3-(D)-Glucan treatment normalized changes of LPO and stimulated an over activity of endogenous SOD. The results of the histopathologic parameters showed that treatment with β -1,3-(D)-Glucan in the bortezomib group ameliorated the development of non-specific reactive hepatitis (NSRH) and Kupffer cell activation via NF-kB. Administration of β -1,3-(D)-Glucan is effective in reversing tissue damage induced by bortezomib in rat livers.

Hepatoprotective Effects of B-1,3-(D)-Glucan on Bortezomib-Induced Liver Damage in Rats

The aim of this study was to evaluate the effects of β -1,3-(D)-glucan as an antioxidant and tissue protective agent and study the biochemical, histopathologic, and immunohistochemical effects of first therapeutic proteasome inhibitor bortezomib on the liver for treating relapsed multiple myeloma. The experiment included 36 adult male rats, which were divided into four treatment groups: control (healthy); bortezomib-treated; β-1,3-D-glucan-treated; and bortezomib + β-1,3-(D)-glucan-treated. Each group was subdivided into two subgroups based on time of sacrifice (48 or 72 h). After the experiments, superoxide dismutase (SOD) activity and lipid peroxidation (LPO) amounts were determined, and immunohistochemical and histopathological changes were examined in all rat liver tissues. β -1,3-(D)-Glucan treatment normalized changes of LPO and stimulated an over activity of endogenous SOD. The results of the histopathologic parameters showed that treatment with β -1,3-(D)-Glucan in the bortezomib group ameliorated the development of non-specific reactive hepatitis (NSRH) and Kupffer cell activation via NF-kB. Administration of β -1,3-(D)-Glucan is effective in reversing tissue damage induced by bortezomib in rat livers.

Non-specific reactive hepatitis in dolphins stranded in the Canary Islands

This paper describes the features of non-specific reactive hepatitis (NSRH) in dolphins stranded on the coast of the Canary Islands (Spain). The histological appearance of NSRH was marked by the proliferation of Kupffer cells and the presence of granulocytes, plus lymphocytes and plasma cells scattered throughout the liver parenchyma and in the portal or perivenular stroma, without or with minimal evidence of hepatocyte necrosis. NSRH was composed of inflammatory infiltration of CD3+ T-lymphocytes and IgG+ plasma cells in the portal spaces and hepatic sinusoids. The anti-S100 protein polyclonal antibody reacted with a variable number of lymphocytes from the portal areas and hepatic sinusoids and with Kupffer cells and the epithelial cells of the bile ducts.

Evaluation of fluorescence in situ hybridization for the detection of bacteria in feline inflammatory liver disease.

The etiopathogenesis of feline inflammatory liver disease (ILD) is unclear. Therefore, we sought to determine the presence and distribution of bacteria within the livers of cats with ILD using eubacterial fluorescence in situ hybridization (FISH). Histopathology from 39 cats with ILD and 19 with histologically normal livers (C) were classified using World Small Animal Veterinary Association guidelines. Hepatic sections were examined by 16 and 23S ribosomal RNA FISH. Antibodies against cytokeratins and factor VIIIa were used to distinguish bile ducts and vascular structures. Histopathologic findings included non-specific reactive hepatitis (12), neutrophilic cholangitis (NC; 12), lymphocytic cholangitis (seven), cholestasis/obstruction (three), probable lymphoma (three) and acute hepatitis (two). Bacteria were observed in 21/39 ILD and 3/19 C (P = 0.0054). In 8/39 ILD and 2/19 C bacteria were restricted to the outer liver capsule (P = 0.29) and may represent contaminants. The prevalence of intrahepatic bacteria was higher (P = 0.008) in ILD (13/31) than C (1/17). Bacteria in ILD were more frequently (P <0.0001) localized to portal vessels, venous sinusoids and parenchyma (12/13) than bile duct (1/13). Bacterial colonization was highest in Escherichia coli-positive NC cats. Concurrent non-hepatic disease, predominantly pancreatic and intestinal (8/10 cats biopsied), was present in all 13 cats with intrahepatic bacteria. Bacterial culture was positive (predominantly E coli and Enterococcus species) in 11/23 (48%) samples, and concurred with FISH in 15/23 cases. The presence of intrahepatic bacteria in 13/31 (41%) cats with ILD suggests a role in etiopathogenesis. The distribution of bacteria within the liver supports the possibility of colonization via either enteric translocation or hematogenous seeding.

HIV/TB co-infection: Liver biopsy findings

Abstract Background: Human immunodeficiency virus and tuberculosis (HIV/TB) co-infection in an individual constitutes a serious diagnostic and therapeutic challenge. Objective: To determine liver pathology in patients with HIV and TB co-infection. Methods: Postmortem liver biopsy was done on patients with HIV/TB co-infection. The tissues were subjected to routine histological processing. The sections were stained with haematoxylin and eosin, including special stains. Results: Sixty-seven biopsies from 67 patients (33 men and 34 women) were analysed. Thirty-nine (58.2%) had pulmonary tuberculosis (PTB) while 26 (38.8%) had disseminated tuberculosis (DTB). Two (3%) had tuberculous meningitis (TBM). Fourteen (36%) patients with PTB, 10 (38%) with DTB and one (50%) with TBM had hepatic granuloma with caseation. Histologically granuloma 25 (37.4%), chronic hepatitis 13 (19.4%), nonspecific reactive hepatitis (NSRH) 11(16.4%), steatosis nine (13.4%) and cirrhosis seven (10.4%) were found. Conclusion: This study...

Primary Hepatitis in Dogs: A Retrospective Review (2002–2006)

Little is known about etiology, disease progression, treatment outcome, survival time, and factors affecting prognosis in dogs with primary hepatitis (PH). To review retrospectively different forms of hepatitis in a referral population, by the World Small Animal Veterinary Association Standardization criteria. One-hundred and one dogs examined for histologically confirmed PH between 2002 and 2006. Dogs with nonspecific reactive hepatitis were excluded. Retrospective study. Medical records were reviewed for prevalence, signalment, clinical and clinicopathologic manifestation, outcome, survival time, and prognostic factors for shortened survival. PH occurred in 0.5% of dogs in this referral population. Acute (AH) and chronic hepatitis (CH) were diagnosed in 21 and 67 dogs, respectively. Progression from AH to CH occurred in 5/12 of the repeatedly sampled dogs. CH was idiopathic in 43 (64%) dogs, and was associated with copper accumulation in 24 (36%) dogs. Median survival time was longer in dogs with AH than in dogs with CH (either idiopathic or copper associated), and dogs with lobular dissecting hepatitis had the shortest survival time. Prognostic factors predicting shortened survival were associated with decompensated liver function and cirrhosis at initial examination. The majority of PH in dogs is CH. Previous studies appear to have underestimated the etiologic role of copper in both AH and CH. Prognosis is reduced in dogs with hepatic cirrhosis or cirrhosis-related clinical findings. Further research into etiology and treatment effectiveness in all PH forms is needed.

Ultrastructural aspects of liver injury with special reference to small bile ducts in patients with ulcerative colitis.

Liver tissue specimens taken at colectomy from 29 patients with chronic ulcerative colitis were studied by electron microscope. The fine-structural alterations were correlated with light microscopy and with biochemical liver function tests. The purpose was to identify ultrastructural features which could explain the pathogenesis of sclerosing cholangitis. Severely injured bile-duct epithelial cells were seen in three out of the eight light-microscopically diagnosed cholangitis cases, in the two cases of non-specific reactive hepatitis, and in the two fatty livers. Four cholangitis cases had, in heavily thickened bile-duct basement membranes, translucent areas containing bile-like material. Bile-duct microvilli were often blunted, and reduced in number. Intracanalicular bile thrombi and bile inclusions in hepatocytes were seldom seen, mostly but not exclusively in cholangitis. The fine-structural alterations apparently represent various stages of liver injury. These findings do not appear to be specific, but their prominence seems to correlate with the progression of the disease, at least in the case of histological parameters, but also in serum enzyme activities indicative of cholestasis. The bile-like electron-dense material found in proliferating basement membranes, very possibly regurgitated into the injured bile-duct wall after epithelial injury, could enhance the development of periductal fibrosis, leading to progression of sclerosing cholangitis.