Govindarajan S, de Cock K M, Peters R L
Hum Pathol. 1985 Mar;16(3):262-7. doi: 10.1016/s0046-8177(85)80012-5.
Recent studies have indicated that some cases of fulminant hepatitis that were ostensibly type B were actually acute viral hepatitis, types B and delta, or persistent hepatitis, type B with superimposed acute delta infection. Histologic characterization of the various types has not yet been undertaken. Within ten to 37 days of the onset of initial symptoms, liver tissues from a total of 16 patients who had acute delta hepatitis with fulminant clinical courses were examined. Tissues were from biopsies in nine cases and from autopsies in seven. Based on the serologic absence of IgM hepatitis B core antibody, chronic forms of hepatitis B with acute delta infection were diagnosed in five of the 16 patients. The underlying liver disease in three of these five patients was identifiable as chronic active hepatitis with fibrosis, and that in the others was apparently persistent hepatitis B. Coded liver tissues from these seven autopsies were evaluated without the knowledge of serologic diagnosis for qualitative and quantitative light microscopic features, together with autopsy liver tissues from five patients with fulminant B hepatitis without serologic evidence of delta infection and five patients with fulminant non-A, non-B hepatitis. No specific features that would allow discrimination among these three types of hepatitis were found.
近期研究表明，一些表面上为B型的暴发性肝炎病例实际上是急性病毒性肝炎，即B型和丁型，或者是B型持续性肝炎合并急性丁型感染。目前尚未对各种类型进行组织学特征描述。在最初症状出现后的10至37天内，对总共16例具有暴发性临床病程的急性丁型肝炎患者的肝组织进行了检查。其中9例组织来自活检，7例来自尸检。基于血清学检查未发现IgM乙肝核心抗体，16例患者中有5例被诊断为慢性B型肝炎合并急性丁型感染。这5例患者中，有3例潜在的肝脏疾病可确定为伴有纤维化的慢性活动性肝炎，其他患者显然为B型持续性肝炎。对这7例尸检的编码肝组织在不知血清学诊断结果的情况下进行评估，观察其定性和定量的光学显微镜特征，并与5例无丁型感染血清学证据的暴发性B型肝炎患者以及5例暴发性非甲非乙型肝炎患者的尸检肝组织进行对比。未发现能够区分这三种类型肝炎的特异性特征。
