Chronic Active Hepatitis Associated With Eosinophilia And Coombs'-Positive Hemolytic Anemia

Panush, Richard S.; Wilkinson, Lee; Fagin, Ronald R.

doi:10.1016/s0016-5085(73)80015-0

Cited by 30 publications

(10 citation statements)

References 20 publications

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“…Eosinophils and their secretory proteins are known to play important roles in necroinflammatory processes in human beings, especially in hypersensitivity reactions (1-4). Eosinophilic infiltration of the liver portal tracts is reported to occur in several kinds of hepatobiliary diseases, such as drug-induced hepatitis, autoimmune hepatitis, primary sclerosing cholangitis and human hepatic allograft rejection (5)(6)(7)(8)(9)(10). The role of eosinophils as effector cells in liver tissue injury has recently been postulated in human hepatic allograft rejection and eosinophil-induced CAH in the idiopathic hypereosinophilic syndrome (10,11).…”

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confidence: 99%

Eosinophilic infiltration of the liver in primary biliary cirrhosis: A morphological study

et al. 1993

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Eosinophils and their secretory proteins are important in necroinflammatory processes. In this study we surveyed eosinophilic infiltration of the liver in 176 liver biopsy specimens from patients with primary biliary cirrhosis. A considerable number of eosinophils were found in the portal tracts in 51 of these specimens (29%), whereas this finding occurred in only 2 of 50 (4%) specimens from patients with viral chronic active hepatitis. Eosinophilic infiltration of the portal tracts was focal. These eosinophils were immunohistochemically shown to contain the secreted form of eosinophilic cationic protein. Grades of eosinophilic infiltration of the portal tracts were higher in those livers with higher grades of lymphoplasmacytic infiltration, granulomas and florid duct lesion in the portal tracts, and they were lower in those livers with higher grades of bile duct disappearance and orcein-positive granuoles in hepatocytes. In the livers of patients with primary biliary cirrhosis, eosinophils were abundant around the damaged bile ducts, around the portal vein branches and at the marginal regions, and they were scattered in the portal tracts, whereas only the last pattern was seen in viral chronic active hepatitis. Peripheral blood eosinophils tended to be increased in primary biliary cirrhosis patients with higher grades of eosinophilic infiltration of the portal tracts. Eosinophilic infiltration of the portal tracts may play a role in immunological injuries of the interlobular bile ducts in primary biliary cirrhosis.

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Eosinophilic infiltration of the liver in primary biliary cirrhosis: A morphological study

et al. 1993

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“…Chronic hepatitis, hypereosinophilia, and autoimmune hemolytic anemia in one patient who was treated by longstanding systemic corticosteroids was described by Panush et al Flare-ups of the hepatitis were reported twice without hemolysis or peripheral eosinophilia noted, suggesting that these abnormalities were more readily and continuously suppressed by small amounts of steroids than was the hepatic inflammation 8. The occurrence of these three processes together in one patient suggests that they may be related to abnormal host-immune responses 8…”

Section: Discussionmentioning

confidence: 76%

Long-term Follow-up of Severe Eosinophilic Hepatitis: A Rare Presentation of Hypereosinophilic Syndrome

Awadie

Khoury

Zohar

et al. 2019

Rambam Maimonides Med J

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Idiopathic hypereosinophilic syndrome (HES) is a rare, heterogeneous disorder characterized by a strikingly high eosinophil count (>1,500 cells/μL), over a long period of time (>6 months), with end organ damage. We present a 60-year-old patient with idiopathic HES with isolated liver involvement, a rare systemic disease and a rare solid organ involvement. The patient had a thorough investigational work up until HES was established, including liver biopsy. He needed intensive immunosuppressive treatment at first with steroids, then with azathioprine in conjunction with a low dose of steroids. After 16 years of follow-up, the patient showed no evidence of liver dysfunction. To the best of our knowledge, this is the longest follow-up for a patient with HES-associated chronic hepatitis. Our observation suggests that, with appropriate treatment, liver involvement in HES may be well controlled without deterioration to advanced liver failure.

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“…21 Thrombocytopenia now appears to be an additional man¬ ifestation in a spectrum of immune alterations. Further studies will be required to determine whether patients with chronic liver disease have autoimmune platelet reactions (involving platelet glycoproteins, other platelet-specific antigens, or antigens that cross-react with hepatic tissue) or predominantly nonspecific reactions governed by platelet absorption of immunoglobulin or immune com¬ plexes via platelet Fc receptors.…”

Section: Resultsmentioning

confidence: 99%

Immune Thrombocytopenia and Response to Splenectomy in Chronic Liver Disease

Skootsky¹

1986

Arch Intern Med

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Chronic Active Hepatitis Associated With Eosinophilia And Coombs'-Positive Hemolytic Anemia

Cited by 30 publications

References 20 publications

Eosinophilic infiltration of the liver in primary biliary cirrhosis: A morphological study

Eosinophilic infiltration of the liver in primary biliary cirrhosis: A morphological study

Long-term Follow-up of Severe Eosinophilic Hepatitis: A Rare Presentation of Hypereosinophilic Syndrome

Immune Thrombocytopenia and Response to Splenectomy in Chronic Liver Disease

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