Zafrani E S, Bernuau D, Feldmann G
Hum Pathol. 1984 Dec;15(12):1166-70. doi: 10.1016/s0046-8177(84)80311-1.
In addition to hypertrophy of Ito cells and perisinusoidal fibrosis, previously unrecognized ultrastructural abnormalities of the hepatic sinusoids were observed in three patients with chronic hypervitaminosis A: 1) large areas of communication between the sinusoidal lumina and the perisinusoidal spaces, allowing extravasation of blood cells; 2) marked dilation of the perisinusoidal spaces; and 3) swelling and clarification of endothelial cells. Most of these changes, along with some other sinusoidal barrier alterations previously reported in chronic hypervitaminosis A (i.e., bleb formation on the sinusoidal membrane of the hepatocytes and the presence of multiple cellular layers lining the sinusoids), are strikingly similar to those observed in peliosis hepatis. The present findings suggest that sinusoidal barrier abnormalities might constitute a major event in the pathophysiology of vitamin A-induced liver injury as well as of peliosis hepatis.
除了肝星状细胞肥大和窦周纤维化外，在3例慢性维生素A过多症患者中还观察到以前未被认识的肝血窦超微结构异常：1）血窦腔与窦周间隙之间存在大面积连通，使血细胞外渗；2）窦周间隙明显扩张；3）内皮细胞肿胀和透明度增加。这些变化中的大多数，连同先前报道的慢性维生素A过多症中其他一些血窦屏障改变（即肝细胞血窦膜上形成泡状突起以及血窦内衬有多层细胞），与肝紫癜中观察到的变化极为相似。目前的研究结果表明，血窦屏障异常可能是维生素A诱导的肝损伤以及肝紫癜病理生理学中的一个主要事件。
