A case of syncytial giant cell hepatitis with features of a paramyxoviral infection

Claus J. Fimmel, Linsheng Guo, Richard W. Compans, Elizabeth M. Brunt, Scot Hickman, Robert R. Perrillo, Andrew L. Mason

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Adult syncytial giant cell hepatitis (GCH) is an uncommon and often fulminant form of hepatitis that may be caused by infection with a novel paramyxo-like virus. We present the case of a 69-yr-old man who presented with acute, community-acquired hepatitis and chronic lymphocytic leukemia. A liver biopsy showed the typical findings of panlobular syncytial giant cell hepatitis. Electron microscopic examination demonstrated abundant nucleocapsid-like protein material in the cytoplasm and nuclei of affected hepatocytes. These structures were similar to, but distinct from, those of known paramyxoviridae, suggesting infection with a novel, related virus. In situ hybridization studies with a probe directed against the measles fusion protein gene gave a positive signal with a hepatocyte distribution. No signal was obtained with the measles nucleocapsid protein probe, suggesting that the disease agent was genetically distinct from, but related to, the measles virus. Subsequent liver biopsies were characterized by the gradual disappearance of the giant cell changes and by the concomitant development of cirrhosis. This is a case of adult GCH that resolved spontaneously and led to cirrhosis, thus implicating GCH as a potential cause of 'cryptogenic' liver disease. Our findings provide further support for the existence of a distinct, as yet unidentified viral species as a cause of this disease.

Original languageEnglish (US)
Pages (from-to)1931-1937
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume93
Issue number10
DOIs
StatePublished - Oct 1 1998
Externally publishedYes

Fingerprint

Giant Cells
Hepatitis
Infection
Nucleocapsid Proteins
Hepatocytes
Fibrosis
Viral Fusion Proteins
Viruses
Biopsy
Paramyxoviridae Infections
Measles virus
Liver
Measles
B-Cell Chronic Lymphocytic Leukemia
In Situ Hybridization
Liver Diseases
Cytoplasm
Electrons
Genes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Fimmel, C. J., Guo, L., Compans, R. W., Brunt, E. M., Hickman, S., Perrillo, R. R., & Mason, A. L. (1998). A case of syncytial giant cell hepatitis with features of a paramyxoviral infection. American Journal of Gastroenterology, 93(10), 1931-1937. https://doi.org/10.1111/j.1572-0241.1998.00548.x

A case of syncytial giant cell hepatitis with features of a paramyxoviral infection. / Fimmel, Claus J.; Guo, Linsheng; Compans, Richard W.; Brunt, Elizabeth M.; Hickman, Scot; Perrillo, Robert R.; Mason, Andrew L.

In: American Journal of Gastroenterology, Vol. 93, No. 10, 01.10.1998, p. 1931-1937.

Research output: Contribution to journalArticle

Fimmel, CJ, Guo, L, Compans, RW, Brunt, EM, Hickman, S, Perrillo, RR & Mason, AL 1998, 'A case of syncytial giant cell hepatitis with features of a paramyxoviral infection', American Journal of Gastroenterology, vol. 93, no. 10, pp. 1931-1937. https://doi.org/10.1111/j.1572-0241.1998.00548.x
Fimmel, Claus J. ; Guo, Linsheng ; Compans, Richard W. ; Brunt, Elizabeth M. ; Hickman, Scot ; Perrillo, Robert R. ; Mason, Andrew L. / A case of syncytial giant cell hepatitis with features of a paramyxoviral infection. In: American Journal of Gastroenterology. 1998 ; Vol. 93, No. 10. pp. 1931-1937.
@article{60061cd99006458f99aa35cbc0a1cbbc,
title = "A case of syncytial giant cell hepatitis with features of a paramyxoviral infection",
abstract = "Adult syncytial giant cell hepatitis (GCH) is an uncommon and often fulminant form of hepatitis that may be caused by infection with a novel paramyxo-like virus. We present the case of a 69-yr-old man who presented with acute, community-acquired hepatitis and chronic lymphocytic leukemia. A liver biopsy showed the typical findings of panlobular syncytial giant cell hepatitis. Electron microscopic examination demonstrated abundant nucleocapsid-like protein material in the cytoplasm and nuclei of affected hepatocytes. These structures were similar to, but distinct from, those of known paramyxoviridae, suggesting infection with a novel, related virus. In situ hybridization studies with a probe directed against the measles fusion protein gene gave a positive signal with a hepatocyte distribution. No signal was obtained with the measles nucleocapsid protein probe, suggesting that the disease agent was genetically distinct from, but related to, the measles virus. Subsequent liver biopsies were characterized by the gradual disappearance of the giant cell changes and by the concomitant development of cirrhosis. This is a case of adult GCH that resolved spontaneously and led to cirrhosis, thus implicating GCH as a potential cause of 'cryptogenic' liver disease. Our findings provide further support for the existence of a distinct, as yet unidentified viral species as a cause of this disease.",
author = "Fimmel, {Claus J.} and Linsheng Guo and Compans, {Richard W.} and Brunt, {Elizabeth M.} and Scot Hickman and Perrillo, {Robert R.} and Mason, {Andrew L.}",
year = "1998",
month = "10",
day = "1",
doi = "10.1111/j.1572-0241.1998.00548.x",
language = "English (US)",
volume = "93",
pages = "1931--1937",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "10",

}

TY - JOUR

T1 - A case of syncytial giant cell hepatitis with features of a paramyxoviral infection

AU - Fimmel, Claus J.

AU - Guo, Linsheng

AU - Compans, Richard W.

AU - Brunt, Elizabeth M.

AU - Hickman, Scot

AU - Perrillo, Robert R.

AU - Mason, Andrew L.

PY - 1998/10/1

Y1 - 1998/10/1

N2 - Adult syncytial giant cell hepatitis (GCH) is an uncommon and often fulminant form of hepatitis that may be caused by infection with a novel paramyxo-like virus. We present the case of a 69-yr-old man who presented with acute, community-acquired hepatitis and chronic lymphocytic leukemia. A liver biopsy showed the typical findings of panlobular syncytial giant cell hepatitis. Electron microscopic examination demonstrated abundant nucleocapsid-like protein material in the cytoplasm and nuclei of affected hepatocytes. These structures were similar to, but distinct from, those of known paramyxoviridae, suggesting infection with a novel, related virus. In situ hybridization studies with a probe directed against the measles fusion protein gene gave a positive signal with a hepatocyte distribution. No signal was obtained with the measles nucleocapsid protein probe, suggesting that the disease agent was genetically distinct from, but related to, the measles virus. Subsequent liver biopsies were characterized by the gradual disappearance of the giant cell changes and by the concomitant development of cirrhosis. This is a case of adult GCH that resolved spontaneously and led to cirrhosis, thus implicating GCH as a potential cause of 'cryptogenic' liver disease. Our findings provide further support for the existence of a distinct, as yet unidentified viral species as a cause of this disease.

AB - Adult syncytial giant cell hepatitis (GCH) is an uncommon and often fulminant form of hepatitis that may be caused by infection with a novel paramyxo-like virus. We present the case of a 69-yr-old man who presented with acute, community-acquired hepatitis and chronic lymphocytic leukemia. A liver biopsy showed the typical findings of panlobular syncytial giant cell hepatitis. Electron microscopic examination demonstrated abundant nucleocapsid-like protein material in the cytoplasm and nuclei of affected hepatocytes. These structures were similar to, but distinct from, those of known paramyxoviridae, suggesting infection with a novel, related virus. In situ hybridization studies with a probe directed against the measles fusion protein gene gave a positive signal with a hepatocyte distribution. No signal was obtained with the measles nucleocapsid protein probe, suggesting that the disease agent was genetically distinct from, but related to, the measles virus. Subsequent liver biopsies were characterized by the gradual disappearance of the giant cell changes and by the concomitant development of cirrhosis. This is a case of adult GCH that resolved spontaneously and led to cirrhosis, thus implicating GCH as a potential cause of 'cryptogenic' liver disease. Our findings provide further support for the existence of a distinct, as yet unidentified viral species as a cause of this disease.

UR - http://www.scopus.com/inward/record.url?scp=0032431526&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032431526&partnerID=8YFLogxK

U2 - 10.1111/j.1572-0241.1998.00548.x

DO - 10.1111/j.1572-0241.1998.00548.x

M3 - Article

C2 - 9772058

AN - SCOPUS:0032431526

VL - 93

SP - 1931

EP - 1937

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 10

ER -