Arias F, Mancilla-Jimenez R
N Engl J Med. 1976 Sep 9;295(11):578-82. doi: 10.1056/NEJM197609092951102.
To investigate if fibrin (or fibrinogen), immunoglobulins and complement were present in the liver of patients with toxemia of pregnancy, we performed immunofluorescence studies on needle biopsies of pre-eclamptic women. Fibrin (or fibrinogen) outlining the hepatic sinusoids was found in all 12 cases; in two of them there were also large nodular deposits of fibrin (or fibrinogen) and to a lesser extent of IgG, IgM and C3 in areas of necrosis. Immunofluorescence study of 13 control liver biopsies, six from pregnant women, was negative. Our findings suggest that the factors involved in glomerular and hepatic injury are similar. To explain the predominant involvement of liver and kidney, we propose that in these organs, the vasospasm characteristic of toxemia is more severe; this enhanced severity, in the presence of a systemic yet mild blood hypercoagulability, would create adequate local conditions for the precipitation of fibrin-fibrinogen.
为了研究妊娠毒血症患者的肝脏中是否存在纤维蛋白（或纤维蛋白原）、免疫球蛋白和补体，我们对先兆子痫女性的肝脏穿刺活检组织进行了免疫荧光研究。在所有12例患者中均发现有纤维蛋白（或纤维蛋白原）勾勒出肝血窦；其中2例在坏死区域还存在大量纤维蛋白（或纤维蛋白原）的结节状沉积，以及程度较轻的IgG、IgM和C3沉积。对13例对照肝脏活检组织（其中6例来自孕妇）进行的免疫荧光研究结果为阴性。我们的研究结果表明，肾小球和肝脏损伤所涉及的因素相似。为了解释肝脏和肾脏为何受累更为明显，我们提出，在这些器官中，妊娠毒血症特有的血管痉挛更为严重；在全身性但程度较轻的血液高凝状态下，这种增强的严重程度会为纤维蛋白 - 纤维蛋白原的沉淀创造足够的局部条件。
