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LIVER INVOLVEMENT IN “Q” FEVER
Author(s) -
POWELL O. W.
Publication year - 1961
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1961.10.1.52
Subject(s) - alkaline phosphatase , thymol , cholesterol , gastroenterology , medicine , liver function tests , jaundice , liver biopsy , bilirubin , transaminase , elevated alkaline phosphatase , pathology , lesion , biopsy , chemistry , biochemistry , enzyme , chromatography , essential oil
Summary In 72 consecutive cases of “Q” fever, hepatomegaly occurred in 47, and jaundice in three. Abnormal results for serum cephalin‐cholesterol flocculation, thymol turbidity or serum alkaline phosphatase activity were found in 61 cases. The test that most commonly produced an abnormal result was the cephalin‐cholesterol flocculation test (56 cases); this was followed by the serum alkaline phosphatase estimation (26 cases) and the thymol turbidity test (25 cases). During the first four weeks, the serum alkaline phosphatase level was related to the degree of cephalin‐cholesterol flocculation. Positive cephalin‐cholesterol flocculation commonly persisted for several months. Increased serum alkaline phosphatase levels were frequently the first, and occasionally the only, biochemical evidence of liver involvement. Quite high values were seen at times. Serum transaminase activity was only moderately increased, even in jaundiced patients. Liver biopsy was performed on 13 patients of the series, and on an additional jaundiced patient admitted to hospital subsequently. The predominant histological pattern was one of focal inflammation. This was of all grades, from small collections of mixed inflammatory cells to frank granulomas with central necrosis and fibroblastic reaction. In one patient a focal inflammatory lesion was found in the liver 17 weeks after the onset of the illness.