Non-specific reactive hepatiti

Concomitant hepatic lesions can occur as a consequence of a number of viral, bacterial, parasitic and mycotic infections as well as due to toxic effects. Owing to their ambiguity, however, these lesions do not allow closer aetiological specification. Therefore, the term non-specific reactive hepatitis is not actually considered to be a pathological entity in its own right. 

Fig. 21.1 Non-specific reactive hepatitis in sepsis due to cervical l)mph node abscess sparse single cell necrosis and periportal inflammation...

Liver involvement is reflected in moderately elevated transaminases, histologically detected monohistiocytic granulomas and miliary microabscesses (frequently with gram-positive rods) as well as occasional evidence of non-specific reactive hepatitis. (91, 93) (s. fig. 24.13)... 

The intestinal disease with fever and arthralgia caused by Campylobacter colitis may show findings corresponding to non-specific reactive hepatitis in terms of laboratory parameters and histology. (124, 125)... 

In early infancy, liver involvement manifests as giantcell hepatitis (s. fig. 22.5) or non-specific reactive hepatitis. (s. fig. 21.1) Furthermore, granulomas (s. p. 398) may develop, sometimes with marked density. Transaminases are elevated cholestasis is also frequently detectable. (43, 44, 46, 48)... 

In children and adults, signs of non-specific reactive hepatitis have also been observed. (42, 47) Acidophilic liver cell necrosis occasionally develops, depending on the type of red corpuscles. The endothelial cells are distended, the portal zones show inflammatory infiltration and granulomas or retothelial nodules are frequently found, (s. fig. 25.4) The pathogens can be demonstrated in the liver. Cirrhosis may develop, especially after the destruction of the lobular architecture as a sequela of extensive parenchymal necrosis. There are various serological tests available, including the Sabin-Feldmann... 

Cellular infiltration may vary in its degree, depending on the extent of the parenchymal lesion as well as on the type and duration of the toxic effect. A more severe inflammatory reaction corresponds to non-specific reactive hepatitis, (s. p. 392) (s. figs. 21.1 29.8)... 

Histology shows deposits of needle-like porphyrins and large-droplet fatty changes in the hepatocytes, moderate iron deposits in the hepatocytes and Kupffer cells as well as signs of non-specific reactive hepatitis, (s. fig. 31.18)... 

Adjacent tissue often shows local, non-specific reactive hepatitis (activation of Kupffer cells, small round-cellu-... 

The liver shows vasculitis with necrotizing epithelioid cell granulomas. Non-specific reactive hepatitis is also present. Therapy is with cyclophosphamide (1-2 mg/kg BW/day). We have given an extensive description of this clinical picture based on 132 cases in the literature as well as on our own experience. (84)... 

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