A clinicopathological study of acute hepatitis in heavy drinkers, unrelated to hepatitis A, B, or C viruses.
BACKGROUND
There are six histological classifications of alcoholic liver disease (ALD) in Japan. However, it is unclear whether all cases of the disease conform to these criteria. This study investigated the clinicopathological features of eight histologically unusual cases of ALD.


METHODS
The characteristic features of alcohol drinking behavior, subjective and objective symptoms, laboratory data on admission, and progress after admission were analyzed for eight patients with acute-onset hepatitis.


RESULTS
The eight patients showed histologically acute hepatitis, with much spotty necrosis that contained granular ceroid pigment by Kupffer cells, which indicated acute parenchymal damage of the liver, but with no Mallory bodies and unremarkable intrasinusoidal neutrophilic infiltration. The only etiological factor for all the cases was habitual alcohol consumption, with increased consumption just before the onset of symptoms. In five cases that were tested, the patients were negative for hepatic viral markers, which included hepatitis G virus RNA and TT virus DNA.


CONCLUSIONS
Some cases of ALD may not conform to the current histological classifications in either Japan or Western countries. It seems natural to consider that these cases are developed by other, unknown causes that overlap with ALD rather than as a result of damage from alcoholic overload.
Miyano
S
S
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Maeyama
S
S
Iwaba
A
A
Ogata
S
S
Koike
J
J
Kishi
M
M
Uchikoshi
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D016174:Hepacivirus; D006515:Hepatitis B virus; D006519:Hepatitis, Alcoholic / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D006507:Hepatovirus; D006801:Humans; D007728:Kupffer Cells / Q000473:pathology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis
D000431:Ethanol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase