title: Syncytial giant-cell hepatitis--a specific disease entity?
abstract: Syncytial giant-cell hepatitis was recently reported to be related to a paramyxovirus and carried a poor prognosis. Twelve patients with syncytial giant-cell hepatitis seen in an 8 1/2-year period in our institute were reviewed. Seven patients had an identifiable aetiological cause: two had autoimmune chronic active hepatitis, one had primary sclerosing cholangitis and autoimmune chronic active hepatitis, two presented with prolonged jaundice after acute hepatitis A and B, one had chronic Epstein-Barr virus infection and the remaining patient was seropositive for antibody to hepatitis C virus. One patient with autoimmune chronic active hepatitis who had frequent syncytial giant cells in the liver responded promptly to corticosteroid treatment and a repeated biopsy 3 years later showed histological improvement with a marked decrease in the number of syncytial giant cells. Of the remaining five patients, three ran a clinical course of fulminant hepatic failure and two had severe chronic active hepatitis. These data indicate that syncytial giant-cell hepatitis is unlikely to be related to only one single aetiological agent and that syncytial giant-cell hepatitis does not always carry an ominous prognosis.
authors.affiliation: Institute of Liver Studies, King's College Hospital School of Medicine and Dentistry, London, United Kingdom.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lau
authors.forename: G
authors.initials: G
authors.lastname: Koukoulis
authors.forename: G
authors.initials: G
authors.lastname: Mieli-Vergani
authors.forename: B C
authors.initials: BC
authors.lastname: Portmann
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D005260:Female; D015726:Giant Cells / Q000648:ultrastructure*; D006508:Hepatitis Antibodies / Q000032:analysis; D006525:Hepatitis, Viral, Human / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010252:Paramyxoviridae / Q000302:isolation & purification; D011379:Prognosis; D011863:Radioimmunoassay; D009626:Terminology as Topic; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D006508:Hepatitis Antibodies