Volume 141, Issue 5, Pages e9 (November 2011)

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Volume 141, Issue 5, Pages 1665-1672.e9 (November 2011) Acute Hepatitis E Infection Accounts for Some Cases of Suspected Drug-Induced Liver Injury Timothy J. Davern, Naga Chalasani, Robert J. Fontana, Paul H. Hayashi, Petr Protiva, David E. Kleiner, Ronald E. Engle, Hanh Nguyen, Suzanne U. Emerson, Robert H. Purcell, Hans L. Tillmann, Jiezhun Gu, Jose Serrano, Jay H. Hoofnagle Gastroenterology Volume 141, Issue 5, Pages 1665-1672.e9 (November 2011) DOI: 10.1053/j.gastro.2011.07.051 Copyright © 2011 AGA Institute Terms and Conditions

Figure 1 Liver injury initially attributed to nevirapine (case 2) and later considered probably due to chronic HEV infection. (A) The portal area is expanded by a chronic inflammatory infiltrate with interface hepatitis indicative of chronic hepatitis. Several eosinophils are present. H&E stain; original magnification 400×. (B) There is portal fibrotic expansion with early bridging fibrosis. Ductular reaction is present at the edges of the portal areas. Masson trichrome stain; original magnification 200×. Gastroenterology 2011 141, 1665-1672.e9DOI: (10.1053/j.gastro.2011.07.051) Copyright © 2011 AGA Institute Terms and Conditions

Figure 2 Acute liver injury attributed to nevirapine (case 7) and later considered due to hepatitis E. (A) The biopsy specimen shows an acute hepatitis pattern with mild canalicular cholestasis. There is portal inflammation with many plasma cells and a few eosinophils and moderate interface hepatitis. The parenchyma shows numerous foci of lobular inflammation with acidophil bodies. H&E stain; original magnification 200×. (B) There is early periportal fibrosis and mild ductular reaction. Masson trichrome stain; original magnification 200×. Gastroenterology 2011 141, 1665-1672.e9DOI: (10.1053/j.gastro.2011.07.051) Copyright © 2011 AGA Institute Terms and Conditions