Ischemic hepatitis

T. E. Bynum, J. K. Boitnott, W. C. Maddrey

Research output: Contribution to journalArticlepeer-review

138 Scopus citations

Abstract

Seven patients with cardiovascular disease had clinical episodes and marked transaminase elevations that suggested viral hepatitis, but all had morphologic evidence (from liver biopsy or autopsy specimens) that documented centrilobular necrosis (ischemic hepatitis) with no evidence of viral or drug injury. Several also had moderate or marked passive congestion of the liver so the liver biopsies of 15 additional patients were retrospectively reviewed. In this latter group congestion alone was associated with normal or minimal elevation in transaminases while all patients with notable (>5 times normal) transaminase elevations had centrilobular necrosis. Congestion alone, no matter how severe or prolonged, seems to do little if any damage to the liver. Centrilobular necrosis, or ischemic hepatitis, correlates with significant hypertransaminasemia, appears to result from failure of hepatic perfusion (with or without preceding hypotension), and presents with clinical and laboratory manifestations that suggest viral hepatitis.

Original languageEnglish (US)
Pages (from-to)129-135
Number of pages7
JournalDigestive Diseases and Sciences
Volume24
Issue number2
DOIs
StatePublished - Feb 1 1979

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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