Children's Memorial Research Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
J Pediatr. 2011 Oct;159(4):612-6. doi: 10.1016/j.jpeds.2011.03.048. Epub 2011 May 17.
To determine whether alloimmune liver disease can be identified as a cause of fetal death.
This is a retrospective examination of the autopsy tissue of 6 stillborn fetuses and 2 extreme preterm infants (gestational age, 20 to 34 weeks) drawn from families referred for suspected neonatal hemochromatosis. Thirteen appropriate nondisease controls and 8 cases of neonatal acute liver failure with known etiology were also examined. Liver sections were immunostained using anti-human C5b-9 complex.
All of the study cases had died with no preceding evidence of fetal distress. Histopathology showed findings of acute liver injury, including global hepatocyte necrosis with minimal reticulum collapse and no fibrosis. Hepatocytes in cases stained strongly positively for C5b-9 complex, suggesting premortem lgG complement-mediated liver injury. Hepatocytes in acute liver failure case controls did not demonstrate a similar mechanism of liver injury.
Alloimmune liver disease is sometimes associated with fetal death.
确定同种免疫性肝病是否可作为胎儿死亡的原因。
这是对 6 例死胎和 2 例极早产儿（胎龄 20 至 34 周）尸检组织的回顾性检查，这些胎儿来自疑似新生儿血色素沉着症的家族。还检查了 13 例适当的非疾病对照和 8 例已知病因的新生儿急性肝衰竭病例。使用抗人 C5b-9 复合物对肝组织切片进行免疫染色。
所有研究病例均无胎儿窘迫的先前证据而死亡。组织病理学显示急性肝损伤的发现，包括伴有最小网状塌陷的全肝细胞坏死和无纤维化。C5b-9 复合物染色强烈阳性的病例中的肝细胞表明存在生前 IgG 补体介导的肝损伤。急性肝衰竭病例对照中的肝细胞未显示出类似的肝损伤机制。
同种免疫性肝病有时与胎儿死亡有关。
