title: A fatal case of postinfantile giant cell hepatitis in a patient with chronic lymphocytic leukaemia.
abstract: Postinfantile giant cell hepatitis has been associated with various aetiologies, including drug taking, autoimmune diseases and viral infections. We present a fatal case of giant cell hepatitis in a patient with chronic lymphocytic leukaemia. No liver biopsy was available ante-mortem. The patient was treated with corticosteroids and aciclovir for suspected autoimmune hepatitis and reactivation of Epstein-Barr virus in the context of his haematological malignancy. Post-mortem liver biopsy showed severe giant cell hepatitis while the study of liver tissue by electron microscopy revealed paramyxo-like viral particles in the cytoplasm of the affected hepatocytes similar to those observed in previous reports of giant cell hepatitis. This case illustrates that the diagnosis of the underlying cause of giant cell hepatitis may be complicated because a heterogeneous group of different aetiologies needs to be investigated. The identification of the causative agent is essential before commencing any kind of therapy. A few sporadic case reports of paramyxo-like virus related, postinfantile giant cell hepatitis have shown that ribavirin was quite effective treatment but further clinical evaluation is needed.
authors.affiliation: Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Alexopoulou
authors.forename: Melanie
authors.initials: M
authors.lastname: Deutsch
authors.forename: Johanna
authors.initials: J
authors.lastname: Ageletopoulou
authors.forename: Johanna K
authors.initials: JK
authors.lastname: Delladetsima
authors.forename: Evangelos
authors.initials: E
authors.lastname: Marinos
authors.forename: Nikiforos
authors.initials: N
authors.lastname: Kapranos
authors.forename: Spyros P
authors.initials: SP
authors.lastname: Dourakis
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D015726:Giant Cells / Q000648:ultrastructure*; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology; D022781:Hepatocytes / Q000648:ultrastructure; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008099:Liver / Q000648:ultrastructure; D008297:Male