title: [An unusual form of a pulmonary fat embolism in fulminant viral hepatitis].
abstract: A 28-year-old drug addict who had injected intravenously died of hepatic failure and coma caused by fulminant hepatitis (simultaneously: hepatitis A, persistent hepatitis B, hepatitis C and superinfection by delta hepatitis). Liver histology disclosed cirrhosis with severe necrotizing hepatitis and extensive microvesicular steatosis, compatible with a delta virus infection. Moderate pulmonary fat embolism (grade I-II according to Falzi) was accompanied by fat deposits in alveolar macrophages. It is postulated that protracted fat mobilization from necrotizing hepatocytes may be the cause of pulmonary fat embolism; the extravasation of fat from the vessels into the alveoli results in phagocytosis by alveolar macrophages.
authors.affiliation: Gerichtsärztlicher Dienst der Behörde für Arbeit, Gesundheit und Soziales, Hamburg.
authors.forename: F
authors.initials: F
authors.lastname: Schulz
authors.forename: K
authors.initials: K
authors.lastname: Püschel
mesh_terms: D000328:Adult; D004620:Embolism, Fat / Q000473:pathology*; D005234:Fatty Liver / Q000473:pathology; D006501:Hepatic Encephalopathy / Q000473:pathology*; D006525:Hepatitis, Viral, Human / Q000473:pathology*; D006801:Humans; D016676:Macrophages, Alveolar / Q000473:pathology; D008297:Male; D011650:Pulmonary Alveoli / Q000473:pathology; D011655:Pulmonary Embolism / Q000473:pathology*
vernacular_title: Ungewöhnliche Form einer Lungenfettembolie bei fulminanter Virushepatitis.