Fibrosing cholestatic hepatitis – disease not only of transplanted patients. A report of eight cases

Česká verze

Authors: E. Honsová ¹; J. Šperl ²
Authors place of work: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM, Praha ¹; Klinika hepatogastroenterologie, Transplantcentrum IKEM, Praha ²
Published in the journal: Čes.-slov. Patol., 47, 2011, No. 2, p. 55-58
Category: Původní práce

Summary

Fibrosing cholestatic hepatitis (FCH) is a rapidly progressive, sometimes fatal form of hepatitis B or C in patients who are under immunosuppressive treatment. This condition was originally described in hepatitis B virus-infected recipients after a liver transplantation. It is characterized clinically by cholestatic hepatic dysfunction, and pathologically by marked hepatocyte swelling, cholestasis, periportal peritrabecular fibrosis, and only mild inflammation. Here we present 8 patients with hepatitis B and C related FCH. Three patients developed FCH after liver transplantation, two of them died due to hepatic failure. One recipient of a kidney/pancreas transplant developed “de novo” hepatitis C with features of FCH. He underwent antiviral treatment and survived with good liver function, unfortunately both of his grafts failed. Four patients suffered from a reactivation of their respective hepatitis B infections after chemotherapy treated hematological malignancy. Three of them needed an urgent liver transplantation and survived with good liver function and with a remission of their hematological diseases. The last patient died due to liver failure. Although FCH is a rare variant of viral hepatitis, it should be emphasized that prompt diagnosis is important for the management of patients.

Keywords:
fibrosing cholestatic hepatitis – viral hepatitis B – viral hepatitis C

Zdroje

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