Storch V W, Frank K H, Kunze K D, Porst H, Schentke K U
Dtsch Z Verdau Stoffwechselkr. 1983;43(4):173-84.
We report immunohistological findings in liver, spleen, brain, and skeletal muscle of a 23-year-old woman with hepatitis nonA/nonB caused by contaminated anti-D-globulin. She died in a liver coma. At autopsy, a chronic liver dystrophy with cirrhosis was diagnosed. The necrotic areas of the liver showed a collapse of the reticulin framework, newly formed collagen fibres, and diffuse inflammation with immunohistological evidence of IgG, CIq, C9, and fibrinogen. C4 and C9 could be localised in bile thrombi and in the cytoplasm of pseudotubular transformed hepatocytes. In addition, C9 was found in blood vessel walls. A local distribution of HBsAg was found in the cytoplasm and/or the periphery of liver cells. HBcAg could not be detected in any of 5 different regions of the liver. A serum with antibodies to acute phase antigen of nonA/nonB hepatitis stained the cytoplasm and nuclei of (mostly intact) liver cells focally and their cell membranes diffusely. Patchy deposits of IgA and IgM were demonstrated in liver, brain und spleen. Circulating antibodies to cell nuclei and smooth muscle reacted with the patient's own liver and brain but not with spleen and skeletal muscle.--It is suggested that the manifold immunohistological findings in this patient are an expression of the vain attempt of the organism to clear away antigenic material, probably induced by different hepatitis viruses.
我们报告了一名23岁患有因抗D球蛋白污染导致的非甲非乙型肝炎的女性患者肝脏、脾脏、大脑和骨骼肌的免疫组织学检查结果。她死于肝昏迷。尸检诊断为伴有肝硬化的慢性肝营养不良。肝脏坏死区域显示网状纤维支架塌陷、新形成的胶原纤维以及弥漫性炎症，免疫组织学证据显示存在IgG、C1q、C9和纤维蛋白原。C4和C9可定位于胆栓以及假管状转化肝细胞的细胞质中。此外，在血管壁中发现了C9。在肝细胞的细胞质和/或周边发现了HBsAg的局部分布。在肝脏的5个不同区域均未检测到HBcAg。一种含有非甲非乙型肝炎急性期抗原抗体的血清局部地染色了（大多完整的）肝细胞的细胞质和细胞核，并弥漫性地染色了它们的细胞膜。在肝脏、大脑和脾脏中证实有IgA和IgM的斑片状沉积。循环抗细胞核和平滑肌抗体与患者自身的肝脏和大脑发生反应，但不与脾脏和骨骼肌发生反应。——提示该患者多种免疫组织学检查结果是机体清除可能由不同肝炎病毒诱导的抗原物质的徒劳尝试的一种表现。
