毛玻璃肝细胞内含物与多药业有关

StephenW

Ground-glass hepatocellular inclusions are associated with polypharmacy
Hsiang-Chih Lu  1 , Iván A González  1 , Kathleen Byrnes  2
Affiliations
Affiliations

    1
    Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States of America.
    2
    Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States of America. Electronic address: [email protected].

    PMID: 33836412 DOI: 10.1016/j.anndiagpath.2021.151740

Abstract

Ground-glass (GG) hepatocytes are classically associated with chronic hepatitis B (HBV) infection, storage disorders, or cyanamide therapy. In a subset of cases, an exact etiology cannot be identified. In this study, we sought to characterize the clinical, histological, and ultrastructural findings associated with HBV-negative GG hepatocytes. Our institutional laboratory information system was searched from 2000 to 2019 for all cases of ground-glass hepatocytes. Ten liver biopsies with GG hepatocellular inclusions and negative HBV serology, no known history of storage disorders, or cyanamide therapy were reviewed. Half of the patients had history of organ transplantation and/or malignancy. These patients took on average 8.1 medications (range: 3-14) with the most common medications being immunosuppressive and health supplements. Histologically, GG hepatocytes show either peri-portal or centrizonal distribution. The inclusions are PAS-positive and diastase sensitive. Electron microscopy showed intracytoplasmic granular inclusions with low electron density, consistent with unstructured glycogen. In summary, GG hepatocytes are a rare finding in liver biopsies, but are more common in patients with hepatitis B. They can also be seen in HBV-negative patients who have polypharmacy. In these cases, they are the result of unstructured glycogen accumulation putatively due to altered cell metabolism.

Keywords: Cellular inclusions; Drug-induced liver injury; Glycogen; Liver glycogen; Polypharmacy.

Copyright © 2021 Elsevier Inc. All rights reserved.

StephenW

毛玻璃肝细胞内含物与多药业有关
香芝路1，伊万·冈萨雷斯1，凯瑟琳·伯恩斯2
隶属关系
隶属关系

    1个
    美国密苏里州圣路易斯，华盛顿大学医学院病理学与免疫学系。
    2个
    美国密苏里州圣路易斯，华盛顿大学医学院病理学和免疫学系。电子地址：[email protected]。

    PMID：33836412 DOI：10.1016 / j.anndiagpath.2021.151740

抽象的

毛玻璃（GG）肝细胞通常与慢性乙型肝炎（HBV）感染，储存障碍或氰胺疗法有关。在少数情况下，无法确定确切的病因。在这项研究中，我们试图表征与HBV阴性GG肝细胞相关的临床，组织学和超微结构发现。我们从2000年至2019年对我们的机构实验室信息系统进行了搜索，以查找所有毛玻璃样肝细胞的病例。回顾了十例具有GG肝细胞内含物和HBV血清学阴性，无贮藏病史或使用氰胺疗法的肝活检。一半的患者有器官移植和/或恶性肿瘤病史。这些患者平均服用8.1种药物（范围：3-14），最常见的药物是免疫抑制剂和健康补品。组织学上，GG肝细胞显示出门周围或中心分布。内含物对PAS呈阳性，对淀粉酶敏感。电子显微镜检查显示胞浆内的颗粒内含物具有低电子密度，与非结构化糖原一致。总之，GG肝细胞在肝活检中很少见，但在乙型肝炎患者中更常见。在拥有多药店的HBV阴性患者中也可以看到它们。在这些情况下，它们可能是由于细胞代谢改变而导致的非结构化糖原积累的结果。

关键字：细胞夹杂物；药物性肝损伤；糖原肝糖原；多元药房。

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