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2 "Chronic active hepatitis"
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Case Report
Methotrexate Induced Chronic Active Hepatitis: A report of two cases.
Jee Young Han, Young Nyun Park, Chan Il Park, Chae Yoon Chon
Korean J Pathol. 1994;28(2):168-172.
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AbstractAbstract PDF
Although methotrexate(MTX) has been known to have many side effects, especially toxicity on the hemopoietic cells and the liver, it has been used as a potent anticancer drug and for the treatment of psoriasis or rheumatoid arthritis. The severity of hepatotoxicity varies from mild fatty change to chronic active hepatitis(CAH) and cirrhosis. We experienced two cases of MTXinduced CAH in patients with psoriasis, which prompted us to report in view of the absence of biopsy proven MTX hepatotoxicity in the Korean literature. Microscopically, the liver showed a distorted lobular architecture with portal fibrous expansion, piecemeal necrosis and bridging necrosis/fibrosis. The hepatic lobules revealed fatty changes of hepatocyte, focal hepatocytolysis, delicate collagen deposits along the space of Disse and the characteristically marked polyploid nuclear change of hepatocytes.
Original Article
Liver in Systemic Lupus Erythematous: Clinicopathological analysis of 8 cases.
Young Nyun Park, Chan Il Park, Yoon Sok Chung, Si Young Song, Chein Soo Hong
Korean J Pathol. 1992;26(5):445-450.
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AbstractAbstract PDF
Hepatic changes in eight cases of systemic lupus erythematosus(SLE), were studied to evaluate the nature of hepatic injury of SLE and its relation to lupoid hepatitis. Common histologic changes of the liver in SLE included intralobular necro-inflammatory activities, fatty change, canalicular bile stasis and mild perivenular and Disse space fibrosis. The fatty change and intralobular fibrosis were thought not to be due to SLE itself but associated with steroid administration or chronic alcoholic consumption. The necro-inflammatory changes were usually mild and features of chronic active hepatitis with periportal destruction occured in one case. Symptoms related to the involvement of many other organs than the liver appeared much frequently in patients with SLE than lupoid hepatitis, suggesting that the SLE involving liver and the lupoid hepatitis are different diseases.

J Pathol Transl Med : Journal of Pathology and Translational Medicine