Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune disea...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2021-08-01
|
| Series: | Egyptian Liver Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43066-021-00140-5 |
| _version_ | 1818585812076331008 |
|---|---|
| author | Dina Sweed Mohamed Ramadan El Shanshory Eman Mohammed Elaskary Hassnaa Atef Hassan Enas Sweed Eman Sweed Shimaa Abdelsattar Ahmed Abdelgawad Asmaa Mosbeh Heba Abdallah Shereen El-Mashad Nermine Ehsan |
| author_facet | Dina Sweed Mohamed Ramadan El Shanshory Eman Mohammed Elaskary Hassnaa Atef Hassan Enas Sweed Eman Sweed Shimaa Abdelsattar Ahmed Abdelgawad Asmaa Mosbeh Heba Abdallah Shereen El-Mashad Nermine Ehsan |
| author_sort | Dina Sweed |
| collection | DOAJ |
| description | Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection. |
| first_indexed | 2024-12-16T08:43:01Z |
| format | Article |
| id | doaj.art-66f22e124a3b402f80cc022d231dbb2e |
| institution | Directory Open Access Journal |
| issn | 2090-6226 |
| language | English |
| last_indexed | 2024-12-16T08:43:01Z |
| publishDate | 2021-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Liver Journal |
| spelling | doaj.art-66f22e124a3b402f80cc022d231dbb2e2022-12-21T22:37:39ZengSpringerOpenEgyptian Liver Journal2090-62262021-08-011111410.1186/s43066-021-00140-5Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case reportDina Sweed0Mohamed Ramadan El Shanshory1Eman Mohammed Elaskary2Hassnaa Atef Hassan3Enas Sweed4Eman Sweed5Shimaa Abdelsattar6Ahmed Abdelgawad7Asmaa Mosbeh8Heba Abdallah9Shereen El-Mashad10Nermine Ehsan11Pathology Department, National Liver Institute, Menoufia UniversityPediatric Department, Faculty of Medicine, Tanta UniversityPediatric Department, Faculty of Medicine, Tanta UniversityPediatric Department, Faculty of Medicine, Tanta UniversityRadiology Department, Faculty of Medicine, Benha UniversityClinical Pharmacology Department, Faculty of Medicine, Menoufia UniversityClinical Pathology Department, National Liver InstituteClinical Biochemistry, and Molecular Diagnostics Department, National Liver Institute, Menoufia UniversityPathology Department, National Liver Institute, Menoufia UniversityClinical Biochemistry, and Molecular Diagnostics Department, National Liver Institute, Menoufia UniversityPathology Department, National Liver Institute, Menoufia UniversityPathology Department, National Liver Institute, Menoufia UniversityAbstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.https://doi.org/10.1186/s43066-021-00140-5Autoimmune hemolytic anemiaIntracytoplasmic globulesPathologySARS-CoV-2 |
| spellingShingle | Dina Sweed Mohamed Ramadan El Shanshory Eman Mohammed Elaskary Hassnaa Atef Hassan Enas Sweed Eman Sweed Shimaa Abdelsattar Ahmed Abdelgawad Asmaa Mosbeh Heba Abdallah Shereen El-Mashad Nermine Ehsan Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report Egyptian Liver Journal Autoimmune hemolytic anemia Intracytoplasmic globules Pathology SARS-CoV-2 |
| title | Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report |
| title_full | Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report |
| title_fullStr | Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report |
| title_full_unstemmed | Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report |
| title_short | Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report |
| title_sort | trichrome positive intrahepatic cytoplasmic globules are potential histopathological clue for covid 19 induced hepatitis a case report |
| topic | Autoimmune hemolytic anemia Intracytoplasmic globules Pathology SARS-CoV-2 |
| url | https://doi.org/10.1186/s43066-021-00140-5 |
| work_keys_str_mv | AT dinasweed trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT mohamedramadanelshanshory trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT emanmohammedelaskary trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT hassnaaatefhassan trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT enassweed trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT emansweed trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT shimaaabdelsattar trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT ahmedabdelgawad trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT asmaamosbeh trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT hebaabdallah trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT shereenelmashad trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport AT nermineehsan trichromepositiveintrahepaticcytoplasmicglobulesarepotentialhistopathologicalclueforcovid19inducedhepatitisacasereport |