title: Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South-West France.
abstract: 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.
authors.affiliation: Service d'Hépato-Gastro-Entérologie, CHU Purpan and INSERM U-531, Université Paul Sabatier, Toulouse, 31400, France. peron.jm@chu-toulouse.fr
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Peron
authors.forename: Marie
authors.initials: M
authors.lastname: Danjoux
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Réda
authors.initials: R
authors.lastname: Missoury
authors.forename: Hélène
authors.initials: H
authors.lastname: Poirson
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Vinel
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Mansuy
authors.forename: Christophe
authors.initials: C
authors.lastname: Bureau
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Pierre
authors.initials: P
authors.lastname: Brousset
authors.forename: Janick
authors.initials: J
authors.lastname: Selves
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral