Histological and immunohistochemical features in fatal acute fulminant hepatitis E

Agrawal, Vinita ; Goel, Amit ; Rawat, Amit ; Naik, Sita ; Aggarwal, Rakesh (2012) Histological and immunohistochemical features in fatal acute fulminant hepatitis E Indian Journal of Pathology & Microbiology, 55 (1). pp. 22-27. ISSN 0377-4929

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Official URL: http://www.ijpmonline.org/article.asp?issn=0377-49...

Related URL: http://dx.doi.org/10.4103/0377-4929.94849


Background: Hepatitis E is being increasingly recognized as an emerging infection in developed countries. Data on histological findings and nature of inflammatory cell infiltrate in liver in this disease are quite sparse. Aims: This study was planned to study the histological features and the type of inflammatory infiltrate in liver biopsies of patients with acute fulminant hepatitis E. Materials and Methods: We retrieved postmortem liver biopsies of 11 Indian patients with fulminant hepatitis E, and compared these with biopsies from seven patients with fulminant hepatitis B. Results : Biopsies from acute fulminant hepatitis E showed varying degrees of hepatocyte necrosis, mixed portal and lobular inflammation, accompanied by bile ductular proliferation, lymphocytic cholangitis, Kupffer cell prominence, cholestasis, apoptotic bodies, pseudo-rosette formation, steatosis, and presence of plasma cells in portal tracts. Interface hepatitis was more frequent in acute hepatitis B than in acute hepatitis E (100% vs 20%; P<0.05). These findings differ from those reported in cases with autochthonous hepatitis E in Europe. On immunohistochemistry, lymphocyte infiltrate consisted predominantly of CD3+T cells in both hepatitis E and hepatitis B; these cells contained a predominant cytotoxic (CD8+ ) cell subpopulation in 81.8% of cases with hepatitis E and in 50% of cases with hepatitis B. Conclusion: Our findings suggest that histological changes in HEV infection may vary with geographical location because of prevalent HEV genotypes, and that CD8+ lymphocytes play a role in HEV-induced liver injury.

Item Type:Article
Source:Copyright of this article belongs to Medknow Publications.
ID Code:94876
Deposited On:05 Oct 2012 11:08
Last Modified:05 Oct 2012 11:08

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