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Fibrosing cholestatic hepatitis – disease not only of transplanted patients. A report of eight cases


Authors: E. Honsová 1;  J. Šperl 2
Authors‘ workplace: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM, Praha 1;  Klinika hepatogastroenterologie, Transplantcentrum IKEM, Praha 2
Published in: Čes.-slov. Patol., 47, 2011, No. 2, p. 55-58
Category: Original Article

Overview

Fibrosing cholestatic hepatitis (FCH) is a rapidly progressive, sometimes fatal form of hepatitis B or C in patients who are under immunosuppressive treatment. This condition was originally described in hepatitis B virus-infected recipients after a liver transplantation. It is characterized clinically by cholestatic hepatic dysfunction, and pathologically by marked hepatocyte swelling, cholestasis, periportal peritrabecular fibrosis, and only mild inflammation. Here we present 8 patients with hepatitis B and C related FCH. Three patients developed FCH after liver transplantation, two of them died due to hepatic failure. One recipient of a kidney/pancreas transplant developed “de novo” hepatitis C with features of FCH. He underwent antiviral treatment and survived with good liver function, unfortunately both of his grafts failed. Four patients suffered from a reactivation of their respective hepatitis B infections after chemotherapy treated hematological malignancy. Three of them needed an urgent liver transplantation and survived with good liver function and with a remission of their hematological diseases. The last patient died due to liver failure. Although FCH is a rare variant of viral hepatitis, it should be emphasized that prompt diagnosis is important for the management of patients.

Keywords:
fibrosing cholestatic hepatitis – viral hepatitis B – viral hepatitis C


Sources

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Labels
Anatomical pathology Forensic medical examiner Toxicology
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