Diel R, Krüger C
Abteilung Innere Medizin, Evangelischen Krankenhauses Alten Eichen, Universität Hamburg.
Dtsch Med Wochenschr. 1988 Sep 16;113(37):1433-6. doi: 10.1055/s-2008-1067831.
A 67-year-old woman with marked intrahepatic cholestasis died of acute liver failure with multiple organ failure six weeks after the first onset of jaundice. A primary generalized amyloidosis was unexpectedly found at necropsy. It had taken an unusual clinical course due to the terminal loss of liver function. Extensive serological and imaging tests had not provided a uniform diagnosis which could have been made in life only by an early liver biopsy. As icteric amyloidosis of the liver is invariably fatal within a few months, this disease, though rare, should be considered in the differential diagnosis of unclear intrahepatic cholestasis.
一名67岁女性,患有明显的肝内胆汁淤积症,在黄疸首次出现六周后死于急性肝衰竭伴多器官衰竭。尸检时意外发现原发性全身性淀粉样变性。由于肝功能最终丧失,其临床过程不同寻常。广泛的血清学和影像学检查未能提供统一诊断,而这一诊断在生前只有通过早期肝活检才能做出。由于肝脏黄疸型淀粉样变性在几个月内必然致命,这种疾病虽然罕见,但在不明原因的肝内胆汁淤积症的鉴别诊断中应予以考虑。