Yalcin Kendal, Tugba Tuncel Elif, Ucmak Feyzullah, Bestas Remzi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakir, Turkey.
Department of Gastroenterology, Manisa City Hospital, Manisa, Turkey.
Hepatol Forum. 2021 Sep 15;2(3):137-140. doi: 10.14744/hf.2021.2021.0038. eCollection 2021 Sep.
Brucellosis is a zoonotic infection that may involve the liver in a variety of ways, however, data on the histopathology of liver effects in brucellosis are limited. Brucellosis is generally characterized by a high fever, joint or back pain, and hepatosplenomegaly. This report illustrates a case of granulomatous hepatitis with granulomas in the liver and bone marrow in a patient who presented with non-specific symptoms, hepatomegaly, splenomegaly, digital clubbing, and laboratory signs of intrahepatic cholestasis. Granulomas were detected in the bone marrow and hepatic specimens. The diagnosis of brucellosis was based on the isolation of in a blood culture and serum agglutination titers of 1:640. Treatment for brucellosis led to improved laboratory and clinical findings. Brucellosis should be considered in regions where it is endemic in cases of an elevated transaminase level and related clinical findings. Brucellosis should also be considered in the differential diagnosis of intrahepatic cholestasis and/or granulomas in hepatic and bone marrow biopsies. This case report provides valuable histopathological features and detailed information of liver involvement in a case of brucellosis.
布鲁氏菌病是一种人畜共患感染病，可通过多种方式累及肝脏，然而，关于布鲁氏菌病肝脏病变组织病理学的数据有限。布鲁氏菌病通常表现为高热、关节或背部疼痛以及肝脾肿大。本报告阐述了一例肉芽肿性肝炎病例，该患者表现为非特异性症状、肝肿大、脾肿大、杵状指以及肝内胆汁淤积的实验室指标，其肝脏和骨髓中均有肉芽肿。在骨髓和肝脏标本中检测到了肉芽肿。布鲁氏菌病的诊断基于血培养中分离出[具体病原体未给出]以及血清凝集效价为1:640。布鲁氏菌病的治疗使实验室检查结果和临床症状得到改善。在转氨酶水平升高及有相关临床症状的布鲁氏菌病流行地区，应考虑布鲁氏菌病。在肝内胆汁淤积和/或肝脏及骨髓活检中有肉芽肿的鉴别诊断中也应考虑布鲁氏菌病。本病例报告提供了布鲁氏菌病病例中肝脏受累的有价值的组织病理学特征和详细信息。
