Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France.
Hepatitis E virus is a ribonucleic acid (RNA) enterically transmitted virus that causes both epidemics and sporadic cases of acute hepatitis E in many countries of Asia and Africa. Domestically acquired (non-travel-associated) hepatitis E has been reported recently in many industrialized countries including the USA, Europe, and Japan. There is little information available on liver histology in these patients. We report a series of 11 patients with sporadic acute hepatitis E and needle liver histology in South-West France. Hepatitis E was diagnosed based on elevated transaminases (>10 upper limit normal) and the presence of specific serum antibodies (immunoglobulin-G class, present in all 11 patients) and/or viral RNA detection in serum and/or stools. Acute hepatitis lesions were observed in all cases with marked necro-inflammatory activity in nine patients. Confluent necrosis was present in five cases. Anisocaryosis and Kupffer's cell aggregates with siderosis were observed in most of the 11 patients. Cholangitis was frequent (9/11 cases). Cholestasis was observed in eight cases. Pseudo-glandular pattern was present in only one case but without zonal repartition. Characteristic pathological signs of acute hepatitis E were severe intralobular necrosis, polymorph inflammation, and acute cholangitis with numerous neutrophils.
Peron
Jean-Marie
JM
Service d'Hépato-Gastro-Entérologie, CHU Purpan and INSERM U-531, Université Paul Sabatier, Toulouse, 31400, France. peron.jm@chu-toulouse.fr
Danjoux
Marie
M
Kamar
Nassim
N
Missoury
Réda
R
Poirson
Hélène
H
Vinel
Jean-Pierre
JP
Mansuy
Jean-Michel
JM
Bureau
Christophe
C
Izopet
Jacques
J
Brousset
Pierre
P
Selves
Janick
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D005602:France; D016751:Hepatitis E / Q000097:blood / Q000473:pathology*; D016752:Hepatitis E virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008099:Liver / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000235:genetics
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral