作为肉芽肿性肝炎罕见病因的内脏利什曼病

JPGN reports Pub Date : 2024-03-26 DOI:10.1002/jpr3.12059
Dalal Ben Sabbahia, Meriem Atrassi, Halima Msaaf, Imane Chahid, A. Khoaja, Nissrine Bennani, Mehdi Karkouri, Abdelhak Abkari
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摘要

内脏利什曼病(VL)是由利什曼原虫引起的一种可能致命的感染。其特征是发热、体重减轻、贫血、脾脏和肝脏肿大。VL 引起的肝炎是肉芽肿性肝炎的病因之一,在文献中鲜有描述。它与其他病因,尤其是感染性和自身免疫性病因存在鉴别诊断问题。因此,有必要进行全面的临床、生物学和组织学评估,以确定这种疾病的病因,尤其是在像我国这样的地方病流行国家。在本病例研究中,一名 2 岁 8 个月大的男童被诊断为 VL,并接受了甲氧苄氨嘧啶治疗;2 个月后,病情发展为持续性大肝脏;实验室结果显示肝功能升高和贫血。进行了肝活检,组织学结果证实了肉芽肿性肝炎的诊断。
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Visceral leishmaniasis as a rare cause of granulomatous hepatitis
Visceral leishmaniasis (VL) is a potentially fatal infection caused by species of Leishmania. It is characterized by fever, weight loss, anemia, and enlargement of the spleen and liver. Hepatitis due to VL is one of the causes of granulomatous hepatitis rarely described in the literature. It poses a problem of differential diagnosis with other causes, notably infectious and autoimmune. Hence the need for a global clinical, biological, and histological evaluation to orientate this entity, especially in endemic countries like ours. In the present case study, a 2‐year 8‐month‐old boy was diagnosed with VL and treated with meglumine antimoniate; the evolution was marked after 2 months by the persistence of a large liver; laboratory results showed elevated liver functions and anemia. A liver biopsy was performed, and the histological findings confirmed the diagnosis of granulomatous hepatitis.
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