Cervantes F, Bruguera M, Carbonell J, Force L, Webb S
Postgrad Med J. 1982 Jun;58(680):346-50. doi: 10.1136/pgmj.58.680.346.
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.
在82例布鲁氏菌病患者中，40例发现有提示肝脏疾病的体格检查和/或生化异常。其中65%有肝脏柔软且有压痛的肿大，52%可触及脾脏。最常见的生化异常是血清转氨酶和碱性磷酸酶轻度升高。肝活检显示90%的患者为非特异性反应性肝炎，其余10%变化极小。28例患者有非干酪样肉芽肿，均与反应性肝炎相关。比较有肉芽肿和无肉芽肿患者的临床及生化特征时未发现差异。然而，当病程持续时间与肝活检中发现的改变类型相关时，获得了具有统计学意义的差异；肝活检前疾病持续时间在100天以下时，肉芽肿的发现几乎是恒定的，但在此之后则很少见。
