title: Adenovirus ascending cholangiohepatitis.
abstract: Three children, two with liver transplants and one with acquired human immunodeficiency virus (HIV) infection, presented with hepatitis accompanied by elevated gamma glutamyl transpeptidase. Biopsies revealed cholangiohepatitis caused by adenovirus infection. There was a progressive loss of interlobular bile ducts in two of the patients. In one patient, infection of the biliary tree was marked by a necrotizing cholangitis, with adenoviral inclusions noted in the biliary epithelium. In each patient, there was evidence of adenovirus gastrointestinal infection. This is the first report of adenoviral infection of the biliary tree in humans. It is hypothesized that adenovirus cholangiohepatitis occurs as a result of ascending infection from the gastrointestinal tract to the biliary tree.
authors.affiliation: Department of Pathology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Bründler
authors.forename: Norberto
authors.initials: N
authors.lastname: Rodriguez-Baez
authors.forename: Ron
authors.initials: R
authors.lastname: Jaffe
authors.forename: Arthur G
authors.initials: AG
authors.lastname: Weinberg
authors.forename: Beverly Barton
authors.initials: BB
authors.lastname: Rogers
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D000258:Adenovirus Infections, Human / Q000150:complications*; D002675:Child, Preschool; D002761:Cholangitis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000276:immunology; D006525:Hepatitis, Viral, Human / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D009894:Opportunistic Infections / Q000150:complications*; D016896:Treatment Outcome