Krech R H, Geenen V, Maschek H, Högemann B
Pathologisches Institut, Städt. Kliniken Osnabrück.
Pathologe. 1998 May;19(3):221-5. doi: 10.1007/s002920050277.
The occurrence of plasmodial giant cells in the liver is probably a morphological reaction pattern with the most diverse causes. In babies and infants, these changes occur in particular in neonatal hepatitis and intrahepatic and extrahepatic bile duct atresia. Viral infections and/or autoimmune reactions are discussed etiologically in giant cell hepatitis in adults (adult gaint cell hepatitis, AGCH), which is much rarer. In some of the cases, there were conspicuously high titers against paramyxoviruses. Giant cell hepatitis can occur in the course of HIV infection. These both indicate an infectious cause. However, the disease cannot be transmitted to chimpanzees. Apart from our case, only one further case is described in the literature in which a completed hepatitis A infection could be demonstrated serologically. In addition, the titer of antinuclear antibodies was raised in our patient. This autoimmune phenomenon is probably of crucial pathogenetic significance in our patient, especially since a hepatitis A infection on its own does not afford an adequate etiological explanation for the form of chronic and active hepatitis with consecutive cirrhotic transformation observed here.
肝内疟原虫巨细胞的出现可能是一种由多种原因引起的形态学反应模式。在婴儿和幼儿中，这些变化尤其发生在新生儿肝炎以及肝内和肝外胆管闭锁中。在成人巨细胞肝炎（成人巨细胞性肝炎，AGCH）中，病因学上讨论了病毒感染和/或自身免疫反应，这种情况较为罕见。在一些病例中，针对副粘病毒的滴度显著升高。巨细胞肝炎可发生在HIV感染过程中。这两者都表明存在感染性病因。然而，该疾病不能传染给黑猩猩。除了我们的病例外，文献中仅描述了另一例病例，其中血清学检测可证实甲型肝炎感染已痊愈。此外，我们的患者抗核抗体滴度升高。这种自身免疫现象在我们的患者中可能具有关键的致病意义，特别是因为仅甲型肝炎感染并不能为这里观察到的慢性活动性肝炎并伴有连续性肝硬化转变的形式提供充分的病因解释。
