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The case begins with a 23 year old woman who presents to her

The case begins with a 23 year old woman who presents to her

The

The presence of multinucleated giant cells on liver biopsy is the distinguishing diagnostic feature of giant cell hepatitis. There are often other non-specific findings consistent with inflammation or cirrhosis such as fibrosis, bile stasis, portal edema, and infiltration of inflammatory cells. 18

Giant cells are frequently present in neonatal and infantile liver disease, but are rare in the adult population. In infants, giant cell formation is thought to be a response of immature hepatocytes to a variety of insults, most commonly cholestasis. In adults, the formation of giant cells is thought to be an idiosyncratic regenerative response of hepatocytes. Giant cell hepatitis has been associated with viral infection (including paramyxovirus, HIV, Epstein-Barr virus, and hepatitis A, B, and C); drugs, chemicals, and herbals; as well as autoimmune diseases such as inflammatory bowel disease, systemic lupus, and Graves disease. Giant cell hepatitis is therefore a nonspecific reaction pattern rather than a distinct disease process. Other drugs: clomethacin, p-aminosalicylic acid Other diseases: sickle cell, hypoparathyroidism 19

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Mr. P is a 76 year old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy.
Mr. P is a 76 year old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy.
Mr. P is a 76 year old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy.
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