碎玻璃样夹杂物：与肝毒性相关

StephenW

Ground Glass-Like Inclusions: Associated with Liver Toxicity
Kemal Deniz  1
Affiliations
Affiliation

    1
    Department of Pathology, Erciyes University, Faculty of Medicine, KAYSERI, TURKEY.

    PMID: 33021734 DOI: 10.5146/tjpath.2020.01510

Abstract

Objective: The etiology of ground glass-like inclusions is heterogenous and the pathology has been described in various conditions including HBV infection, Lafora's disease, fibrinogen storage disease, type IV glycogenosis, and alcohol reversion therapy. Similar ground glass-like inclusions are also associated with immunosuppressed conditions and multiple medications, for which the clinical significance is still unclear. Additional cases, some with previously unreported unique etiologies, and their follow-up were described in this study.

Materials and methods: Eleven cases were examined between 2008 and 2019 for this study. The clinical data and histologic slides were reviewed. All of the cases were negative for Hepatitis B virus. None of the patients declared alcohol intake or a history of epilepsy.

Results: Liver histology showed mild lobular inflammation in most of the cases (72%). Ground glass-like hepatocytes were distributed in the patchy-panlobular, periportal, and centrizonal pattern at 55%, 27%, and 18%, respectively. Clinical history revealed medication use in nine (82%) patients including NSAIDs, steroids, and chemotherapy. Ground glass-like inclusions were related to herbal toxicity in two of the patients. Liver function tests were elevated in all of the cases. Follow-up data revealed four patients with malignancy who died of their cancer. Seven patients showed resolution of elevated liver enzymes with a median follow-up period of 37 months (range 7-132 months).

Conclusions: Medication is the most relevant etiology for the development of these inclusions. Ground glass-like inclusions may also seen in herbal toxicity. Transplantation was not an etiologic factor in our patients. Most of the patients displayed an indolent course with resolution of the elevated transaminases.

StephenW

碎玻璃样夹杂物：与肝毒性相关
凯末尔·丹尼兹1
隶属关系
联系

    1个
    土耳其埃尔塞耶斯大学医学院病理学系，土耳其开塞利。

    PMID：33021734 DOI：10.5146 / tjpath.2020.01510

抽象

目的：磨碎的玻璃状夹杂物的病因是异质的，并且已在包括HBV感染，Lafora病，纤维蛋白原贮积病，IV型糖原症和酒精逆转疗法在内的各种疾病中描述了这种病理。相似的类似毛玻璃的内含物也与免疫抑制状况和多种药物有关，其临床意义尚不清楚。这项研究描述了其他病例，其中一些以前没有报道过独特的病因，并对其随访。

材料和方法：在2008年至2019年之间检查了11例本研究的病例。回顾了临床数据和组织学幻灯片。所有病例均为乙型肝炎病毒阴性。没有患者宣布饮酒或有癫痫病史。

结果：大多数情况下，肝组织学表现为轻度小叶炎症（72％）。磨碎的玻璃样肝细胞以斑块小叶状，门静脉周围和中心状分布，分别为55％，27％和18％。临床病史显示有9名（82％）患者使用药物治疗，包括NSAID，类固醇和化疗。两名患者中，磨碎的玻璃状夹杂物与草药毒性有关。在所有情况下，肝功能检查均升高。随访数据四例恶性肿瘤患者死于癌症。七名患者表现出肝酶升高的消退，中位随访时间为37个月（7-132个月）。

结论：药物治疗是这些包涵体发展最相关的病因。磨碎的玻璃状内含物也可能对草药产生毒性。移植不是我们患者的病因。大多数患者表现出轻度病程，转氨酶升高。

StephenW

http://www.turkjpath.org/pdf/pdf_TPD_1945.pdf