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Bioptische und klinische Untersuchungen zum Leberschaden bei Rh-Inkompatibilität

Bioptical and clinical studies concerning liver damage in Rh-Incompatibility

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Summary

40 liver biopsies were done on 26 children with Rh-incompatibility following exchange transfusion. 11 patients showed slight clinical signs of the disease, 9 patients medium and 6 of them severe signs.

Single cell necrobioses were found most frequently, icteric cells and bile thrombi more rarely. Erythropoietic foci were not regularly seen and at most discrete. Siderosis or glycogen content showed to be of no diagnostic or prognostic importance according to the present data. None of the cases showed any signs of beginning cirrhosis. Two histological signs — single cell necrobioses and icteric cells — could be proven to correlate with the clinical signs of “anemia” and “postnatal rise in bilirubin”. The presence or number of hematopoetic foci were independ of the severity of the disease and decreased with age.

From the present data one may conclude, that the initial liver damage is reversible provided the patient receives an early exchange transfusion. The cases of liver cirrhosis following Rh-incompatibility, described in the older literature, must have been based on the longstanding effect of the antigen-antibody reaction in the absence of exchange transfusions.

the results of the present studies give rise to a discussion as to the pathogenesis of liver damage in Rh-incompatibility disease. It is held probable, that the direct antigen-antibody reaction of Rh-antibodies with the sinusendothelial cells of the liver is of basic importance.

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Authors and Affiliations

  1. Charité-Kinderklinik der Humboldt-Universität Berlin, Berlin, Deutschland

    D. Gmyrek, B. Wohlgemuth & R. Weiland

  2. Pathologisches Institut der Karl Marx-Universität Leipzig, Leipzig, Deutschland

    D. Gmyrek, B. Wohlgemuth & R. Weiland

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Gmyrek, D., Wohlgemuth, B. & Weiland, R. Bioptische und klinische Untersuchungen zum Leberschaden bei Rh-Inkompatibilität. Z. Kinder-Heilk. 103, 307–324 (1968). https://doi.org/10.1007/BF00439911

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