SUBACUTE HEPATITIS

Report of Two Cases

Abstract

Clinical patterns and pathological futures of two fatal patients with subacute hepatitis (Tisdale, 1963) were described.
Case 1. A housewife, aged 39, was first seen on March 6, 1968 with two weeks' history of relapsed jaundice. Five months previously she had abnormal liver function tests lasted two months and enlarged liver. On admission she had deep jaundice, slight enlarged liver, palpable spleen, marked elevation of serum transaminase (S-GOT>S-GPT), γ-globulinemia, and negative LE-cells. Administration of corticosteroid for fourtysix days failed to release progressive jaundice, malaise, anorexia or weakness. Necropsy was performed on May 6, 1968. Liver histology revealed extensive necrosis of liver cells in centralobular areas, heavy lymphocyte infiltration and marked reticular fibrosis in the portal zones.
Case 2. A male massagist, aged 40, was admitted on May 29, 1968 with two months' history of jaundice, anorexia, and ascites. On admission he had deep jaundice, moderate pyrexia, marked ascites, liver edge 5cm below the costal margin, elevated S-GOT and marked γ-globulinemia. Jaundice, malaise and ascites persisted until death supervened from terminal hepatic coma on June 20, 1968. Liver histology revealed irregular and submassive depletion of liver cells, proliferation of bile ducts in portal zones, and reformation of lobular architecture with collagenization. These findings indicated partial transition from subacute hepatic necrosis to postnecrotic cirrhosis.