Achar K N, al-Alousi S S, Patrick J P
Amiri Hospital (Teaching), Kuwait.
Br J Rheumatol. 1994 Feb;33(2):161-4. doi: 10.1093/rheumatology/33.2.161.
A 55-yr-old Palestinian man was admitted with a 1-month history of bi-temporal headache, proximal weakness and myalgia in the lower limbs. Both temporal arteries were swollen and tortuous. There was a moderate degree of cholestatic hepatic dysfunction. Temporal artery biopsy showed typical features of giant cell arteritis. Light microscopic examination of the liver showed no significant abnormality while electron microscopic (EM) examination revealed ultrastructural damage to the bile canaliculi. The patient improved dramatically on steroid therapy with normalization of cholestatic dysfunction. EM examination of a repeat liver biopsy 8 months later showed complete reversal of the biliary ultrastructural damage. The pathogenesis of the biliary injury remains uncertain.
一名55岁的巴勒斯坦男子因双侧颞部头痛、近端肌无力和下肢肌痛病史1个月入院。双侧颞动脉肿胀且迂曲。存在中度胆汁淤积性肝功能障碍。颞动脉活检显示巨细胞动脉炎的典型特征。肝脏的光镜检查未发现明显异常，而电子显微镜（EM）检查显示胆小管有超微结构损伤。患者接受类固醇治疗后病情显著改善，胆汁淤积性功能障碍恢复正常。8个月后重复肝脏活检的EM检查显示胆汁超微结构损伤完全逆转。胆汁损伤的发病机制仍不确定。
