Lau J Y, Koukoulis G, Mieli-Vergani G, Portmann B C, Williams R
Institute of Liver Studies, King's College Hospital School of Medicine and Dentistry, London, United Kingdom.
J Hepatol. 1992 May;15(1-2):216-9. doi: 10.1016/0168-8278(92)90039-r.
Syncytial giant-cell hepatitis was recently reported to be related to a paramyxovirus and carried a poor prognosis. Twelve patients with syncytial giant-cell hepatitis seen in an 8 1/2-year period in our institute were reviewed. Seven patients had an identifiable aetiological cause: two had autoimmune chronic active hepatitis, one had primary sclerosing cholangitis and autoimmune chronic active hepatitis, two presented with prolonged jaundice after acute hepatitis A and B, one had chronic Epstein-Barr virus infection and the remaining patient was seropositive for antibody to hepatitis C virus. One patient with autoimmune chronic active hepatitis who had frequent syncytial giant cells in the liver responded promptly to corticosteroid treatment and a repeated biopsy 3 years later showed histological improvement with a marked decrease in the number of syncytial giant cells. Of the remaining five patients, three ran a clinical course of fulminant hepatic failure and two had severe chronic active hepatitis. These data indicate that syncytial giant-cell hepatitis is unlikely to be related to only one single aetiological agent and that syncytial giant-cell hepatitis does not always carry an ominous prognosis.
近期有报道称，多核巨细胞性肝炎与一种副粘病毒有关，且预后较差。我们回顾了本研究所在8年半时间里收治的12例多核巨细胞性肝炎患者。7例患者有明确的病因：2例患有自身免疫性慢性活动性肝炎，1例患有原发性硬化性胆管炎合并自身免疫性慢性活动性肝炎，2例在甲型和乙型肝炎急性期后出现长期黄疸，1例患有慢性EB病毒感染，其余1例丙肝病毒抗体呈阳性。1例自身免疫性慢性活动性肝炎患者肝脏中出现大量多核巨细胞，对皮质类固醇治疗反应迅速，3年后重复活检显示组织学改善，多核巨细胞数量显著减少。其余5例患者中，3例出现暴发性肝衰竭临床过程，2例患有严重慢性活动性肝炎。这些数据表明，多核巨细胞性肝炎不太可能仅与单一病因相关，且多核巨细胞性肝炎并不总是预后不良。
