Hepatic Dysfunction in Sickle Cell Disease: A New System of Classification Based on Global Assessment Philip A. Berry, Timothy J.S. Cross, Swee Lay Thein,

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Presentation transcript:

Hepatic Dysfunction in Sickle Cell Disease: A New System of Classification Based on Global Assessment Philip A. Berry, Timothy J.S. Cross, Swee Lay Thein, Bernard C. Portmann, Julia A. Wendon, John B. Karani, Michael A. Heneghan, Adrian Bomford Clinical Gastroenterology and Hepatology Volume 5, Issue 12, Pages 1469-1476 (December 2007) DOI: 10.1016/j.cgh.2007.08.009 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Photomicrograph of liver biopsy specimen (original magnification 200×), hematoxylin-eosin stained, demonstrating features of cholangitis and severe cholestasis. Clinical Gastroenterology and Hepatology 2007 5, 1469-1476DOI: (10.1016/j.cgh.2007.08.009) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 CT scan of patient with sickle hepatopathy demonstrating asymmetric liver enlargement. Left lobe appears more bulky than right lobe. Clinical Gastroenterology and Hepatology 2007 5, 1469-1476DOI: (10.1016/j.cgh.2007.08.009) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 Photomicrograph of liver biopsy specimen (original magnification 400×), hematoxylin-eosin stained, demonstrating sequestration of sickled erythrocytes within dilated sinusoids. Clinical Gastroenterology and Hepatology 2007 5, 1469-1476DOI: (10.1016/j.cgh.2007.08.009) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Photomicrograph of liver biopsy specimen (original magnification 150×), hematoxylin-eosin stained, demonstrating bile plugging and hepatocyte cholestasis adjacent to an area of necrosis (far left). There is also evidence of advanced fibrosis. Clinical Gastroenterology and Hepatology 2007 5, 1469-1476DOI: (10.1016/j.cgh.2007.08.009) Copyright © 2007 AGA Institute Terms and Conditions

Figure 5 Magnetic resonance cholangiogram demonstrating subtle, generalized abnormality of second and third order bile ducts with areas of stenosis and dilatation. Clinical Gastroenterology and Hepatology 2007 5, 1469-1476DOI: (10.1016/j.cgh.2007.08.009) Copyright © 2007 AGA Institute Terms and Conditions