Related Experiment Videos
Endotheliitis-like changes in chronic hepatitis C
1Institute of Pathology of the University, Berne, Switzerland.
Insights
Endotheliitis-like changes, characterized by inflammation of vein walls, are significantly more common in chronic hepatitis C than in chronic hepatitis B. This finding suggests endotheliitis may aid in diagnosing chronic hepatitis C.
Area of Science:
- Hepatology
- Pathology
- Virology
Background:
- Liver biopsies in hepatitis C often reveal bile duct damage, lymphoid follicles, and steatosis.
- While these histological features are indicative, their diagnostic specificity for hepatitis C is uncertain.
- Endotheliitis-like changes have been observed in various liver diseases, including viral hepatitis.
Purpose of the Study:
- To investigate the prevalence and severity of endotheliitis-like changes in chronic hepatitis C.
- To compare these changes in chronic hepatitis C versus chronic hepatitis B.
- To assess the potential diagnostic utility of endotheliitis-like changes in chronic hepatitis C.
Main Methods:
- Systematic analysis of liver biopsies from 50 patients with chronic hepatitis C and 48 with chronic hepatitis B.
- Definition of endotheliitis-like changes included lymphocytic infiltration, subendothelial accumulation, adherence, and endothelial damage.
- Grading of severity (borderline/questionable; slight to moderate; severe) in small portal and central veins.
Main Results:
- Endotheliitis-like changes were significantly more frequent in chronic hepatitis C (41.5%) compared to chronic hepatitis B (6.9%) (p < 0.05).
- In chronic hepatitis C, these changes predominantly affected small portal veins, with involvement of small hepatic veins in 27% of cases.
- The severity of endotheliitis-like changes varied, with a notable presence in chronic hepatitis C patients.
Conclusions:
- Endotheliitis-like changes are significantly more prevalent in chronic hepatitis C than in chronic hepatitis B.
- These histological alterations, particularly in small portal veins, may serve as a valuable diagnostic marker for chronic hepatitis C.
- Further research could elucidate the specific role of endotheliitis in the pathogenesis of chronic hepatitis C.
Abstract:
Liver biopsies in hepatitis C frequently show bile duct damage, lymphoid follicles, large and small droplet fat, hepatocyte multinucleation. Mallory body-like material, and activation of sinusoidal inflammatory cells. Even though these lesions are useful parameters in the diagnosis of hepatitis C, their specificity remains uncertain. Endotheliitis-like changes of small portal veins have been described for various liver diseases, including viral hepatitis. The aim of the present study was to investigate the prevalence and severity of endotheliitis-like changes in chronic hepatitis C in comparison with chronic hepatitis B. For this purpose, liver biopsies of 50 patients with chronic hepatitis C and 48 patients which chronic hepatitis B were systematically analyzed for the presence of endotheliitis-like changes. Endotheliitis-like changes were defined as lymphocytic infiltration of venous walls, subendothelial lymphocyte accumulation, adherence of lymphocytes to the endothelium, and endothelial cell damage. Endotheliitis-like change severity was graded (borderline/questionable; slight to moderate; severe), and endotheliitis-like changes were analyzed in small portal veins and in central veins. Endotheliitis-like changes were significantly more frequent in chronic hepatitis C than in chronic hepatitis B (41.5% vs. 6.9%; p < 0.05). In chronic hepatitis C, endotheliitis-like changes predominated in small portal veins, but 27% of small hepatic veins were involved as well. The findings indicate that endotheliitis-like changes may represent a useful histological parameter in the diagnosis of chronic hepatitis C.