Abstract
Liver biopsy was performed in 38 patients with fulminant hepatitis and coma and repeated in 22. Stereological estimation of hepatocyte volume was correlated with levels of clotting factors.
Early liver biopsy allowed prognosis in 55% of the cases. All patients with a hepatocyte volume of <35% and thromboplastin time ≤10% died; all patients but two with hepatocyte volume ≥35% and thromboplastin time >10% recovered consciousness (n = 9) or at least showed evidence of marked liver regeneration (n = 2).
On serial liver biopsy a significant increase in hepatocyte volume and clotting factors was only observed in patients who recovered consciousness. The estimated liver cell mass after regeneration in patients who recovered consciousness was ≥45% and <45% in the patients who did not.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chalkley H. W., Cornfield J., Park H. A Method for Estimating Volume-Surface Ratios. Science. 1949 Sep 23;110(2856):295–297. doi: 10.1126/science.110.2856.295. [DOI] [PubMed] [Google Scholar]
- Colombi A., Thölen H., Engelhart G., Duckert F., Hecht Y., Koller F. Blutgerinnungsfaktoren als Index für den Schweregrad einer akuten Hepatitis. Schweiz Med Wochenschr. 1967 Dec 23;97(51):1716–1721. [PubMed] [Google Scholar]
- Opolon P., Hadchouel P., Del Corso A., Caroli J. Ammoniémie et équilibre acido-basique au cours de l'atrophie aiguë du foie. Ann Med Interne (Paris) 1970 Jan;121(1):1–15. [PubMed] [Google Scholar]
- Paliard P., Patricot F., Grimaud J. A. Les altérations histologiques des hépatities graves et leur évolution. A propos de 45 observations suivies par biopsie. Ann Gastroenterol Hepatol (Paris) 1972 Mar-Apr;8(2):133–150. [PubMed] [Google Scholar]
- Scotto J., Theodoropoulos G., Lageron A. Application d'une méthode stéréologique aux coupes histologiques d'hépatites aiguës graves: spéculations pronostiques. Rev Med Chir Mal Foie. 1970;45(1):61–64. [PubMed] [Google Scholar]
- Tygstrup N. Determination of the hepatic elimination capacity (Lm) of galactose by single injection. Scand J Clin Lab Invest Suppl. 1966;18:118–125. [PubMed] [Google Scholar]