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Difference between revisions of "Medical liver disease"
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→Other: Added a casepf PSS
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=Other= | =Other= | ||
==Primary Systemic Sclerosis== | |||
[[File:5 05168051 sl 1.png |Primary systemic sclerosis in the liver]] | |||
[[File:5 05168051 sl 2.png |Primary systemic sclerosis in the liver]] | |||
[[File:5 05168051 sl 3.png |Primary systemic sclerosis in the liver]] | |||
[[File:5 05168051 sl 4.png |Primary systemic sclerosis in the liver]] | |||
[[File:5 05168051 sl 5.png |Primary systemic sclerosis in the liver]] | |||
[[File:5 05168051 sl 6.png |Primary systemic sclerosis in the liver]] | |||
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Primary systemic sclerosis in a 67 year old White, non-Hispanic man who had undergone renal transplantation for idiopathic nodular glomerusclerosis, which had recurred in 2013. He had been scheduled to receive a second transplantation, but had not yet received one. The patient had a positive anti-nuclear antigen study, with a positive scleroderma antibody (SCL-70), a high SCL-70 antibody index of 3.9, and negative DNA, Chromatin, Anti-Riboscomal P, SS-A, SS-B, anti Smith, RNP, JO-1, anticentromere antibody and rheumatoid factor serologic studies. Hepatitis A, B, and C serologic studies were negative. Liver function tests showed normal albumin and total bilirubin levels with alkaline phosphatase of 712 IU/L (35-129 normal range), alanine aminotransferase 59 IU/L (5-41 normal range), and aspartate aminotransferase 68 IU/L (5-37 normal range). This case provisions many of the features known to be present in primary systemic sclerosis as seen in the skin. A. At low power, triads appear almost as white ghosts against a relatively normal set of hepatocyte lobules. B. Closer examination reveals some triads to be expanded, with peripheral bile ductular proliferation and modest associated chronic inflammation without interface hepatitis. C. Portal arterioles had thick walls; inflammation included lymphocytes and occasional plasma cells. D. Trichrome failed to stain the material in the triads blue, but did show space of Disse collagenization. E. PAS with diastase showed positive staining of the material with emphasis on the arteriole walls. F. Hemosiderosis was seen on iron stain. | |||
==Budd-Chiari syndrome== | ==Budd-Chiari syndrome== | ||
*[[AKA]] ''hepatic vein obstruction''. | *[[AKA]] ''hepatic vein obstruction''. | ||