再生不良性貧血を併発したSyncytial giant-cell hepatitisの1例

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A 52-year-old woman developed abnormality of liver function tests on December 20, 1992. She was hospitalized until January 20, 1993, with a satisfactory clinical outcome. However, her condition deteriorated subsequently, and she was transferred to our hospital on March 15. Examination on admission revealed jaundice, ascites and edema. The results of the initial investigations were as follows: AST 753 KU, ALT 395 KU, T. Bil 29.3mg/dl, prothorombin time 26.4%, WBC 2900/mm3, platelet count 33000/mm3. The results of immunologic studies and serologic tests for viral hepatitis were all negative. She was diagnosed as having subacute hepatitis classified non-A, non-B, non-C, and aplastic anemia associated with hepatitis. Her clinical course was complicated by fungal infection, disseminated intravascular hemorrhage, and cerebral and pulmonary bleeding. She died on April 8. Liver specimen revealed submassive necrosis with prominent giant cell transformation. Electron microscopy showed structures resembling the nucleocapsids of paramyxovirus and particles. This case was concluded to be compatible with syncytial giant cell hepatitis as characterized by Phillis in 1991.
社団法人日本肝臓学会の論文