Granulomatous involvement of the liver in patients with AIDS

• Published in: Gut Vol. 26; no. 11; pp. 1220 - 1225
• Main Authors: Orenstein, M S, Tavitian, A, Yonk, B, Dincsoy, H P, Zerega, J, Iyer, S K, Straus, E W
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.11.1985; BMJ; BMJ Publishing Group LTD
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - pathology; Adult; AIDS/HIV; Biological and medical sciences; Female; Granuloma - complications; Granuloma - pathology; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Liver - pathology; Liver Diseases - complications; Liver Diseases - pathology; Male; Medical sciences; Mycobacterium Infections, Nontuberculous - complications; Mycobacterium Infections, Nontuberculous - pathology; Tuberculosis, Hepatic - complications; Tuberculosis, Hepatic - pathology; Human; Pathology; Granuloma; Immunopathology; Liver; Digestive diseases; AIDS; Hepatobiliary disease
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.26.11.1220

During a one month period liver biopsy was carried out on eight patients with established acquired immune deficiency syndrome (AIDS) and two suspected of having AIDS to evaluate raised liver enzymes or unexplained fever and weight loss. Each of the 10 patients were found to have hepatic granulomas. Appropriate staining techniques showed acid-fast bacilli in seven of the liver specimens. One specimen contained numerous Cryptococcal organisms. Two biopsies showed granulomas but no organisms. Liver biopsy was found to be a high yield and rapid diagnostic procedure in patients with AIDS. Our results suggest that hepatic mycobacterial infection may be more common in the syndrome than previously recognised and that liver biopsy specimens should be examined routinely for the presence of acid-fast bacilli.