The Liver in Brucellosis

Internal Medicine Department, General Hospital "G. Hatzikosta" of Ioannina, Ioannina, Greece.
Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association (Impact Factor: 6.53). 09/2007; 5(9):1109-12. DOI: 10.1016/j.cgh.2006.08.010
Source: PubMed

ABSTRACT Brucellosis involves the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. Data on histopathology of the liver in brucellosis are scarce and contradictory. We sought to determine the liver histologic patterns present in a series of brucellosis patients and review the existing knowledge about liver involvement in this worldwide, prevalent zoonotic infection.
Fourteen patients from 2 referral centers were retrospectively studied. They had brucellosis caused by Brucella melitensis and had undergone liver biopsy at the time of diagnosis.
All patients exhibited granuloma formation in the liver parenchyma and in the majority in portal spaces. Varying degrees of cellular infiltration of parenchymal tissue and portal spaces, giant cells in granulomas, parenchymal necroses, and Kupffer's cell hyperplasia were also noted. No significant epidemiological or clinical correlations with liver involvement were exhibited. Thus, liver involvement was not increased in men vs women, young vs old patients, or complicated vs uncomplicated disease.
The liver is involved in Brucella melitensis infection contrary to past beliefs. Different histologic patterns can be observed in liver involvement in brucellosis, the most common being granuloma formation. The pathogenetic role of brucellosis in development of liver fibrosis and cirrhosis remains limited and understudied.

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    • "Intriguingly, there also have been speculations about a possible causal relationship between Brucella abortus infection and cirrhosis , which has not been definitively established [3]. In spite of several histopathological descriptions of liver brucellosis, the cellular and molecular mechanisms underlying the hepatic lesions have not been addressed. "
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    • "S. L. Yingst and others almost no chance that a biopsy would be taken early in the course of infection because hepatic enlargement or changes notable on ultrasound are not reported to occur early in the course of exposure (Akritidis et al., 2007). Based on the limited information available, our data are consistent with reports of liver histology in human brucellosis, i.e. that parenchymal necrosis and lymphocytic infiltration are common. "
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