Summary
Sixteen human liver biopsies of patients with leptospirosis were studied both by light and electron microscopy. The sinusoidal pole of the liver cell show distortion and/or partial disappearence of the microvilli. There is hypertrophy and hyperplasia of Kupffer's cells. These data are suggestive of one or more circulating toxins. Complete cell necrosis is not prominent in human leptospirosis, this finding being in accordance with the low level of serum transaminase seen in the disease. Bile capillaries show microvilli disappearence or distortion, a non specific finding seen both in the extra and intrahepatic forms of cholestasis. No explanation for jaundice mechanism in leptospirosis was found.
Zusammenfassung
Sechzehn Leberbiopsien wurden untersucht. Der sinusoidale Pol der Leberzellen zeigt Strukturänderungen mit/oder teilweisem Verlust der Mikrovilli, die Kupfferschen Sternzellen weisen Hypertrophie und Hyperplasie auf. Diese Befunde sprechen für das Vorkommen von einem oder mehreren Toxinen. Vollständige celluläre Nekrose wurde nicht oft gefunden, was mit den niedrigen Serum-Transaminase-Werten bei dieser Krankheit übereinstimmt. Die Gallencapillaren zeigen Formveränderung bis Zerstörung der Mikrovilli, ein unspezifischer Befund der sowohl bei extraals auch intrahepatischen Formen der Cholestase gesehen wird. Es wurde keine Erklärung für den Ikterus von Leptospirosekranken gefunden.
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This work was aided by grant number DA-ARO-49-092-66-G61 of the U.S. Army Research Office and by the “Fundacao de Amparo a Pesquisa de S. Paulo”.
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de Brito, T., Machado, M.M., Montans, S.D. et al. Liver biopsy in human leptospirosis: A light and electron microscopy study. Virchows Arch. path Anat. 342, 61–69 (1967). https://doi.org/10.1007/BF00956849
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DOI: https://doi.org/10.1007/BF00956849