title: Gestational alloimmune liver disease in cases of fetal death.
abstract: OBJECTIVE
  To determine whether alloimmune liver disease can be identified as a cause of fetal death.
  
  
  METHODS
  This is a retrospective examination of the autopsy tissue of 6 stillborn fetuses and 2 extreme preterm infants (gestational age, 20 to 34 weeks) drawn from families referred for suspected neonatal hemochromatosis. Thirteen appropriate nondisease controls and 8 cases of neonatal acute liver failure with known etiology were also examined. Liver sections were immunostained using anti-human C5b-9 complex.
  
  
  RESULTS
  All of the study cases had died with no preceding evidence of fetal distress. Histopathology showed findings of acute liver injury, including global hepatocyte necrosis with minimal reticulum collapse and no fibrosis. Hepatocytes in cases stained strongly positively for C5b-9 complex, suggesting premortem lgG complement-mediated liver injury. Hepatocytes in acute liver failure case controls did not demonstrate a similar mechanism of liver injury.
  
  
  CONCLUSIONS
  Alloimmune liver disease is sometimes associated with fetal death.
authors: Children's Memorial Research Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. p-whitington@northwestern.edu
authors: Peter F
authors: PF
authors: Whitington
authors: Xiaomin
authors: X
authors: Pan
authors: Susan
authors: S
authors: Kelly
authors: Hector
authors: H
authors: Melin-Aldana
authors: Padmini
authors: P
authors: Malladi