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Weil's disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case.
Pathol Res Pract. 2014 Dec; 210(12):1134-7.PR

Abstract

We report an autopsy case of a 60-year-old man with Weil's disease who died of fulminant hepatic failure. Ante-mortem blood culture yielded the growth of Leptospira interrogans (serovar icterohaemorrhagiae). At autopsy, the liver weighed 1210 g and showed a typical appearance of "acute yellow liver atrophy". Zone 3 (centrilobular region) showed submassive necrosis of hepatocytes accompanied by marked hemorrhage. Hepatocytes in zones 1 and 2 were well preserved, and the leptospira antigen was immunohistochemically demonstrated in several hepatocytes. Dissociation of liver cell plates was not observed. An immunohistochemical study demonstrated that CD31-positive, sinusoidal endothelial cells had almost completely disappeared in zone 3. This finding suggested that severe and selective damage to endothelial cells in zone 3 was the main cause of the submassive hepatocellular necrosis, which led to fulminant hepatic failure in the present case.

Authors+Show Affiliations

Department of Pathology, Osaka Red Cross Hospital, Japan. Electronic address: masa-s@sings.jp.Department of Rheumatology, Osaka Red Cross Hospital, Japan.Department of Pathology, Fujita Health University School of Medicine, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24997567

Citation

Shintaku, Masayuki, et al. "Weil's Disease (leptospirosis) Manifesting as Fulminant Hepatic Failure: Report of an Autopsy Case." Pathology, Research and Practice, vol. 210, no. 12, 2014, pp. 1134-7.
Shintaku M, Itoh H, Tsutsumi Y. Weil's disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case. Pathol Res Pract. 2014;210(12):1134-7.
Shintaku, M., Itoh, H., & Tsutsumi, Y. (2014). Weil's disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case. Pathology, Research and Practice, 210(12), 1134-7. https://doi.org/10.1016/j.prp.2014.05.002
Shintaku M, Itoh H, Tsutsumi Y. Weil's Disease (leptospirosis) Manifesting as Fulminant Hepatic Failure: Report of an Autopsy Case. Pathol Res Pract. 2014;210(12):1134-7. PubMed PMID: 24997567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Weil's disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case. AU - Shintaku,Masayuki, AU - Itoh,Hirotaka, AU - Tsutsumi,Yutaka, Y1 - 2014/05/16/ PY - 2014/01/08/received PY - 2014/04/18/revised PY - 2014/05/06/accepted PY - 2014/7/7/entrez PY - 2014/7/7/pubmed PY - 2015/9/9/medline KW - Selective damage KW - Sinusoidal endothelial cell KW - Submassive hepatocellular necrosis KW - Weil's disease SP - 1134 EP - 7 JF - Pathology, research and practice JO - Pathol Res Pract VL - 210 IS - 12 N2 - We report an autopsy case of a 60-year-old man with Weil's disease who died of fulminant hepatic failure. Ante-mortem blood culture yielded the growth of Leptospira interrogans (serovar icterohaemorrhagiae). At autopsy, the liver weighed 1210 g and showed a typical appearance of "acute yellow liver atrophy". Zone 3 (centrilobular region) showed submassive necrosis of hepatocytes accompanied by marked hemorrhage. Hepatocytes in zones 1 and 2 were well preserved, and the leptospira antigen was immunohistochemically demonstrated in several hepatocytes. Dissociation of liver cell plates was not observed. An immunohistochemical study demonstrated that CD31-positive, sinusoidal endothelial cells had almost completely disappeared in zone 3. This finding suggested that severe and selective damage to endothelial cells in zone 3 was the main cause of the submassive hepatocellular necrosis, which led to fulminant hepatic failure in the present case. SN - 1618-0631 UR - https://www.unboundmedicine.com/medline/citation/24997567/Weil's_disease__leptospirosis__manifesting_as_fulminant_hepatic_failure:_report_of_an_autopsy_case_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0344-0338(14)00138-1 DB - PRIME DP - Unbound Medicine ER -