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Acute cholestatic HEV hepatitis
Haematoxylin & Eosin (H&E)
52 years
A 52- year-old man is admitted to hospital because of fatigue, icterus, dark urine and marked increase of cholestatic parameters and transaminases. At ultrasonography no evidence of mechanical obstruction. The patient suffered since 12 years of multiple sclerosis treated with Gilenya (Fingolimid, a sphingosine-1-phosphate receptor modulator). The patient did not travel recently, and had no personal history or risk factors for liver disease
Liver Biopsies exhibiting lobular disarray with severe lobular mononuclear Inflammation and single cell necrosis. There is also a bilirubinostasis and a mild acute choalngitis to see. No significant portal fibrosis
Immunohistochemistry was positive for HEV
Epidemiologically, hepatits E virus concerns mostly men and people in contact with raw meat (e.g. Butchers)
Hepatitis e virus detection in liver tissue from patients with suspected drug-induced liver injury.
Chijioke O, Bawohl M, Springer E, Weber A.
Michaƫl Huguenin, University of Basel
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