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Abstract The work was perfor.ed on 5~ patients selected ,from those attending the tropical Imedicine department of Benha University also equivalent 20 control subjects. Patients were grouped accordingto their clinical state \ and pathological picture of the liver as follows: Grgyp I COllprised 23 patients with pure hepatosplenollegaly with or without cOllpensated liver. glAu9 II Comprised 10 patients with acute viral hepatitis type B. CJJ9YP III Comprised 11 patients with pure chronic active hepatitis. Qlppp IV Comprised 10 patients ”with mixed schlstosoll8l post viral hepatitishepatospleno_galy. Comprised a 20 norll8l subjects. They were clinically free and .had negative ·intrader_l test for schistosomiasis and negative ”BsAg in their sera. All studied cases were subjected to the following studies. Complete history taking and full clinical examination. Urine and stool analysis. sigmoidoscopic examination with rectal snip which was examined by transparency technique for schistosoma ova. Intradermal test for schistosomiasis. Liver function tests. Total serum proteins• .Serum glutamic oxaloacetic transaminase (SOOT). Serum glutamic pyruvic transaminase (SGPT)• .Berum bilirubin. Reversed passive haemagglutinatlon test for detection of .HBsAg in serum. Liver biopsy stained by ordinary haematoxYlin and Basin stains and special orcein stain which staines ”BsAg in liver cells• .Ind.irect i_unofluorescence test to detect and :enu_rate total and subpopulationg’ofT-lymphocytes usinCjmonoclonal..antibodies. Results of the Work Can be Summerized as: 1- SYlI\pt:omsand signs of liver cell failure were most marked in group I and IV. 2- Urine, stools and rectal snips examination reve;t1ed that active cases of schistosomiasis were more in group I and group IV. 3- Intradermal test for schistosomiasis was posit ive .in patients of group I and IV. 4- Liver Function Test. a- Total serum proteins showed significant decrease. in group I and IV. b- Serum glutamic oxaloacetic transaminase (SnOT) was increased in group I and III. c- Serum bilirubin was incr’eased specially in group II and group IV which was highly significant and increased in group III also. ” As regards results of HHsAg in the serum. All cases of group I were negative HBsAg in their sera. Some cases of group III and group IV were positive, all cases of group II were positive. As regards pathologically examination of liver biopsies, in ,group I chosen with pure schistosomal l~fection hepatic architecture was preserved, but lohular patter was destorted in variable degrees due to the increased amount of fibrosis in the thickned portal tracts. It was formed of histocytes, lymphocytes, plasma cells and’ some eosinophils. Liver pathology with negative orcein stain. The diagnosis of schistosomal hepatic affection was based on the detection of schistosomaI ova and the presence of blackish schistosomal pigments inside kupffer cells. In group III cases chosen with chronic active hepatitis or chronic persistant hepatitis liver biopsy showed picture of chronic active hepatitis presented by reaction in thickned portal tracts was formed of fibrous tissues. Irregular septae of fine fibrous tissue infiltrated by lymphocytes extend in between lJ.ver cells. Piecemeal mecrosis of some liver cells adjacent to the fibrous septae was seen in some cases. Orce:Lnstain was positive. In group IV liver pathology showed active hepatitis and schistosomiasis Orcein stain. milced chronic with positive In group II no liver biopsies were done in the acute stage. |