Liver disease in brucellosis. A clinical and pathological study of 40 cases.

Among 82 patients with brucellosis, physical and/or biochemical abnormalities suggesting liver disease were found in 40 cases. A soft and tender liver enlargement was present in 65% of them, and the spleen was palpable in 52%. The most frequent biochemical abnormalities were a slight increase of serum transaminases and alkaline phosphatase. Liver biopsy showed a non-specific reactive hepatitis in 90% of patients, and minimal changes in the remaining 10%. Non-caseating granulomas were present in 28 patients, always associated with reactive hepatitis. No differences were found when comparing clinical and biochemical features in patients with and without granulomas. However, statistically significant differences were obtained when the duration of the process was related to the type of alteration found in the liver biopsy; the finding of granulomas was practically constant when the duration of the disease before liver biopsy was under 100 days, but was infrequent after this time.