Syncytial Giant-Cell Hepatitis

Phillips, M. James; Blendis, Laurie; Poucell, S; offterson, J; Petric, Martin; Roberts, Eve A.; Levy, Gary; Superina, Riccardo; Greig, Paul D.; Cameron, Ross

doi:10.1056/nejm199102143240705

Cited by 226 publications

(48 citation statements)

References 36 publications

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“…These cases can be heterogeneous in terms of their clinical, serological, and histological features [1, 3]. PIGCH is purely a histological diagnosis which is based on morphological criteria of conspicuous presence of giant cell hepatocytes; therefore, it is a descriptive term and does not speak about the etiology in any individual case [1].…”

Section: Methodsmentioning

confidence: 99%

Postinfantile Giant Cell Hepatitis: An Etiological and Prognostic Perspective

Bihari

Rastogi

Sarin

2013

Hepatitis Research and Treatment

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Giant cell hepatitis is common manifestation in pediatric liver diseases, but quite uncommon in adults, only about 100 cases reported in the English literature in the last two decades. Data for the present review were identified by a structured PubMed/MEDLINE search from 1963 to December 2012, using keywords postinfantile giant cell hepatitis (PIGCH), adult giant cell hepatitis, and syncytial giant cell hepatitis in adults and liver. We report a case of postinfantile giant cell hepatitis along with the review related to the etiology and respective outcome, as the literature in the last 20 years suggests. This condition is probably due to idiosyncratic or cytopathic response of individual to various hepatocytic stimuli. It is purely a histomorphological diagnosis and does not establish the etiology. Autoimmune liver diseases are most common etiology, in around 40% of cases, but various viruses, drugs, posttransplant condition, and other causes also have been reported. Prognosis depends upon the etiology. In this paper, we emphasized various causative factors of PIGCH and their respective outcome in patients affected by them. We also highlighted the possible pathogenesis and histopathological spectrum of this entity on the basis of description given in various studies and our limited experience of few cases.

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Section: Methodsmentioning

confidence: 99%

Postinfantile Giant Cell Hepatitis: An Etiological and Prognostic Perspective

Bihari

Rastogi

Sarin

2013

Hepatitis Research and Treatment

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“…The possibility of chronicity after acute disease demonstrated in our study, the recurrence of the disease after liver transplantation, as well as some peculiar clinical, histological, and epidemiological features, indicate that at least 1 putative viral agent is implicated in acute and chronic hepatitis of unknown etiology. [35][36][37][38][39] …”

Section: Discussionmentioning

confidence: 99%

Acute sporadic non-A, non-B hepatitis in Northeastern Brazil: Etiology and natural history

Bahia¹,

Vitvitski

Andrade

et al. 1999

Hepatology

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In a 4-year follow-up study, patients with acute sporadic non-A, non-B (NANB) hepatitis were evaluated to determine the etiology and natural history of the disease. Acute hepatitis C virus (HCV) was detected in 13 of 43 (30%) of patients, anti-hepatitis E virus (HEV) IgG in 5 (12%), and 25 (58%) were considered non-A-E. The HCV RNA was detected in all HCV patients but none of the non-A-E cases. The initial clinical and biochemical presentation of the HCV and non-A-E cases was quite similar, although 2 of the non-A-E patients had severe disease. The 5 patients who were found to be anti-HEV IgG-reactive recovered within 6 months of follow-up. Of the 13 HCV cases, alanine transaminase (ALT) levels returned to normal in 7 (53.8%), while 6 (46.2%) continued to show abnormal ALT after 6 months of follow-up. However, 9 (69.2%) of them remained HCV-RNApositive, denoting virological/biochemical dissociation. Longterm follow-up showed a reappearance of HCV RNA in 2 of the 4 patients who were in virological remission performing 84% of chronicity rate. Acute non-A-E hepatitis patients were less likely to evolve toward chronicity, as compared with acute HCV cases (16% vs. 84%; P ‫؍‬ .0001). Only 4 (16%) of the non-A-E patients were hepatitis G virus (HGV)-RNA-positive. Concerning risk factors for acquiring parenterally transmitted viruses, tattooing was the only one that could be associated with HCV transmission (P ‫؍‬ .002). No risk factors could be identified for putative non-A-E virus transmission. Liver biopsies performed for chronic HCV patients showed a variable degree of inflammation, while the non-A-E patients presented less severe histological disease. (HEPATOLOGY 1999;30:289-293.)

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“…Multinucleated giant cell hepatitis has been reported to be associated with a particularly poor prognosis. 30 This is had persisted for a longer period of time in these patients. In LKM-1 positive patients the histological findings, with a not confirmed in our series, where eight of 11 patients with multinucleated giant cells had a clinical course similar to higher frequency of multiacinar collapse, suggest a more recent liver injury.…”

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confidence: 99%

Autoimmune Hepatitis in Childhood: A 20–Year Experience

et al. 1997

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between the ages of 10 and 20 and 45 and 70 years and has To determine the clinical, biochemical, and histologia relatively benign course at least in adults, 3 whereas LKMcal features, and outcome of childhood autoimmune 1 positive patients have a more severe disease with progreshepatitis (AIH), we reviewed the medical records of 52 sion to cirrhosis despite immunosuppressive treatment. gest that ANA/SMA positive AIH has two peaks of incidence median age: 10.5, range 2.3-14.9 years). At presentation, four children were positive for ANA alone (titer range: 1:80-1:320), 10 for SMA alone (titer range: 1:40-1:2560) and 14 for both ANA (titer range: 1:20-1:5120) and SMA (titer range: 1:40-1:1280). In two paAbbreviations: AIH, autoimmune hepatitis; ANA/SMA, nuclear and/or smooth muscle

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Syncytial Giant-Cell Hepatitis

Abstract: Although further virologic studies will be required for precise classification, we believe that paramyxoviruses should be considered in patients with severe sporadic hepatitis.

Cited by 226 publications

References 36 publications

Postinfantile Giant Cell Hepatitis: An Etiological and Prognostic Perspective

Postinfantile Giant Cell Hepatitis: An Etiological and Prognostic Perspective

Acute sporadic non-A, non-B hepatitis in Northeastern Brazil: Etiology and natural history

Autoimmune Hepatitis in Childhood: A 20–Year Experience

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