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[一例经肝活检诊断为酒精性肝炎并经皮质类固醇治疗成功治愈的病例]

[A case of alcoholic hepatitis diagnosed by a liver biopsy and successfully treated by corticosteroid therapy].

作者信息

Taniguchi Hideaki, Shibagaki Koutaro, Seshimo Ken, Kobayashi Keita

机构信息

Department of Internal Medicine (Gastroenterology), Tottori Municipal Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2012 Apr;109(4):630-7.

Abstract

A 50-year-old man with a history of alcohol intake exceeding 80 g/day was admitted because of severe liver dysfunction and high fever. A rapid increase of transaminase with remittent high fever was observed several days after admission. Abdominal CT scan demonstrated a 22×20 mm mass in segment 8, highly suggestive of hepatocellular carcinoma. However, because the etiology of the liver dysfunction was still unknown, we performed a liver biopsy on the sixth day. Histological examination of the liver specimen showed marked granulocyte infiltration, Mallory bodies, and hepatocyte ballooning, all consistent with alcoholic hepatitis. We made a final diagnosis of alcoholic hepatitis and successfully treated him with corticosteroids. This case suggests that a liver biopsy has diagnostic value in alcoholic hepatitis, especially in cases in which the diagnosis is uncertain.

摘要

一名50岁男性,有每日酒精摄入量超过80克的病史,因严重肝功能不全和高热入院。入院几天后观察到转氨酶迅速升高并伴有弛张热。腹部CT扫描显示肝8段有一个22×20毫米的肿块,高度提示肝细胞癌。然而,由于肝功能不全的病因仍不清楚,我们在第六天进行了肝活检。肝标本的组织学检查显示有明显的粒细胞浸润、马洛里小体和肝细胞气球样变,均符合酒精性肝炎。我们最终诊断为酒精性肝炎,并成功地用皮质类固醇对他进行了治疗。该病例表明肝活检对酒精性肝炎具有诊断价值,尤其是在诊断不确定的情况下。

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