[Cut-off period of subclassification and pathological features of severe hepatitis based on clinical and pathological analyses].
BACKGROUND
To explore the cut-off period of subclassification and pathological features of severe hepatitis (SH).


METHODS
Based on combined clinical and pathological analyses, the complete clinical and biopsy or autopsy liver tissues data from 196 cases of patients with severe hepatitis were investigated. Meanwhile, proliferative hepatocytes, cholangioepithelia and collagens were identified by a panel of monoclonal antibodies such as those against albumin, cytokeratin 18,19 and collagen I, III with immunohistochemical method.


RESULTS
The clinical and pathological analyses indicated the cut-off periods of acute, subacute and chronic SH (ASH,SSH and CSH) were (13.4+/-7.2) d, (77.4+/-69.3) d and (80.5+/-63.2) d, respectively. Among all SH cases, one case of ASH patient presented clinical manifestation and pathological changes of ASH for 21 days, however, one patient with SSH was demonstrated 12 day course by histological examination. The time of cut-off period between ASH and SSH in child cases was shorter than that in adult cases. Histologically, ASH liver tissues showed massive and/or submassive necrosis caused by one attack, with congestive sinusoid frameworks and proliferative cholangioepithelium-like hepatocytes, while SSH liver tissues presented combined fresh and old submassive or massive necrosis caused by multiple attacks, accompanied by obviously proliferative bile ducts and sinusoid framework collapse.However, the pathological changes of CSH showed ASH- or SSH-like lesions on the background of chronic liver injury.


CONCLUSIONS
Our data indicated that the cut-off period between ASH and SSH is in accordance with the Scheme of Viral Hepatitis Prevention and Therapy, China, published in 2000, but excluded a part of child SH cases. In our study, the authors found a few pathological features in ASH and SSH.
Sun
Yan-ling
YL
Department of Pathology, The No. 302 Hospital of PLA, Beijing 100039, China.
Zhao
Jing-min
JM
Zhou
Guang-de
GD
Wang
Song-shan
SS
Li
Wen-shu
WS
Meng
Er-hong
EH
Zhang
Tai-he
TH
Zhang
Ling-xia
LX
Chen
Ju-mei
JM
Zhu
Chuan-lin
CL
Pu
Yu-shan
YS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003094:Collagen / Q000378:metabolism; D005260:Female; D006505:Hepatitis / Q000145:classification* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D053530:Keratins, Type I / Q000378:metabolism; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D053530:Keratins, Type I; D003094:Collagen