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Giant cell hepatitis associated with systemic lupus erythematosus
1Department of Histopathology, Manchester Royal Infirmary.
Journal of Clinical Pathology
|February 1, 1996
Summary
Giant hepatocytes in adults, though rare, may indicate systemic lupus erythematosus (SLE). This case highlights the importance of considering SLE when liver biopsy shows giant cells and neuropathy is present.
Area of Science:
- Hepatology
- Neurology
- Rheumatology
Background:
- Giant hepatocytes are typically observed in neonatal and infantile liver diseases.
- Their presence in adult liver disease is uncommon.
Observation:
- A 42-year-old woman presented with sensory polyneuropathy and abnormal liver function.
- Investigations revealed gallstones but were otherwise unremarkable, except for positive IgG anti-double stranded DNA antibodies.
- A diagnosis of systemic lupus erythematosus (SLE) with axonal sensory polyneuropathy was made.
Findings:
- Liver biopsy demonstrated extensive giant cell transformation.
- The patient's neuropathy was confirmed via sural nerve biopsy.
- Treatment with corticosteroids led to improved liver function over two years.
Implications:
- Extensive giant cell transformation in adult liver biopsies warrants consideration of SLE.
- The co-occurrence of giant cells and neuropathy may be a significant indicator for SLE diagnosis.