The liver in brucellosis.
OBJECTIVE
Brucellosis involves the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. Data on histopathology of the liver in brucellosis are scarce and contradictory. We sought to determine the liver histologic patterns present in a series of brucellosis patients and review the existing knowledge about liver involvement in this worldwide, prevalent zoonotic infection.


METHODS
Fourteen patients from 2 referral centers were retrospectively studied. They had brucellosis caused by Brucella melitensis and had undergone liver biopsy at the time of diagnosis.


RESULTS
All patients exhibited granuloma formation in the liver parenchyma and in the majority in portal spaces. Varying degrees of cellular infiltration of parenchymal tissue and portal spaces, giant cells in granulomas, parenchymal necroses, and Kupffer's cell hyperplasia were also noted. No significant epidemiological or clinical correlations with liver involvement were exhibited. Thus, liver involvement was not increased in men vs women, young vs old patients, or complicated vs uncomplicated disease.


CONCLUSIONS
The liver is involved in Brucella melitensis infection contrary to past beliefs. Different histologic patterns can be observed in liver involvement in brucellosis, the most common being granuloma formation. The pathogenetic role of brucellosis in development of liver fibrosis and cirrhosis remains limited and understudied.
Akritidis
Nikolaos
N
Internal Medicine Department, General Hospital "G. Hatzikosta" of Ioannina, Ioannina, Greece.
Tzivras
Michael
M
Delladetsima
Ioanna
I
Stefanaki
Styliani
S
Moutsopoulos
Haralampos M
HM
Pappas
Georgios
G
D000907:Antibodies, Bacterial / Q000032:analysis; D001706:Biopsy; D002002:Brucella / Q000276:immunology / Q000302:isolation & purification*; D002006:Brucellosis / Q000382:microbiology / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000382:microbiology / Q000473:pathology*; D008107:Liver Diseases / Q000382:microbiology / Q000473:pathology*; D008297:Male; D011379:Prognosis
D000907:Antibodies, Bacterial