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: 7.9). 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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    • "Hepatosplenomegaly can be detected in physical examination, and blood chemistry may reveal elevated transaminases. Brucellosis can lead to nonspecific hepatic inflammation, granulomatous hepatitis, and rarely to cirrhosis [7, 8]. Many different histologic patterns can be seen in hepatic involvement, but the most common histological appearance is granuloma formation in the liver parenchyma and in the periportal areas [8]. "
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    ABSTRACT: Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter). Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day) and doxycycline (200 mg/day) therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs.
    Case Reports in Medicine 05/2011; 2011(7):614546. DOI:10.1155/2011/614546
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    • "Patients with chronic brucellosis may develop splenomegaly and hepatomegaly. Additionally, multifocal granulomas with epithelioid macrophages are observed in the parenchyma of the liver and spleen in biopsy samples from infected patients [55, 56]. However, hepatic and splenic abscess were described as uncommon complication in some patients during the acute phase of Brucella sp. "
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    ABSTRACT: Brucellosis is a chronic infectious disease caused by Brucella spp., a gram-negative facultative intracellular pathogen that affects humans and animals, leading to significant impact on public health and animal industry. Human brucellosis is considered the most prevalent bacterial zoonosis in the world and is characterized by fever, weight loss, depression, hepato/splenomegaly, osteoarticular, and genital infections. Relevant aspects of Brucella pathogenesis have been intensively investigated in culture cells and animal models. The mouse is the animal model more commonly used to study chronic infection caused by Brucella. This model is most frequently used to investigate specific pathogenic factors of Brucella spp., to characterize the host immune response, and to evaluate therapeutics and vaccines. Other animal species have been used as models for brucellosis including rats, guinea pigs, and monkeys. This paper discusses the murine and other laboratory animal models for human and animal brucellosis.
    BioMed Research International 02/2011; 2011(3):518323. DOI:10.1155/2011/518323 · 2.71 Impact Factor
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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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    ABSTRACT: Hepatic involvement is frequent in human brucellosis. While different histopathological lesions have been reported in these patients, the underlying cellular and molecular mechanisms have not been addressed. This study assessed whether Brucella abortus can infect a human hepatoma cell line and induce a proinflammatory response in these cells. The bacterium not only infected the human hepatoma cell line HepG2 but also exhibited intracellular replication. The infection induced hepatoma cells to secrete IL-8, and supernatants from Brucella-infected hepatoma cells were shown to induce the migration of human neutrophils. The infection also induced the expression of the intercellular adhesion molecule ICAM-1 on hepatoma cells, and the adhesion of neutrophils to these cells was significantly higher than to uninfected hepatoma cells. ICAM-1 expression was also induced by stimulation of hepatoma cells with supernatants from Brucella-infected neutrophils. While Brucella infection did not induce the expression of matrix metalloproteinases (MMPs) in hepatoma cells, it significantly induced MMP-9 in neutrophils. Hepatoma cell apoptosis was significantly induced by B. abortus infection and also by stimulation with supernatants from Brucella-infected neutrophils. The present study provides clues regarding potential mechanisms of tissue damage during liver brucellosis.
    Journal of Hepatology 07/2010; 53(1):145-54. DOI:10.1016/j.jhep.2010.02.028 · 11.34 Impact Factor
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