Gestational alloimmune liver disease in cases of fetal death

Peter F. Whitington*, Xiaomin Pan, Susan Kelly, Hector Melin-Aldana, Padmini Malladi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Objective: To determine whether alloimmune liver disease can be identified as a cause of fetal death. Study design: This is a retrospective examination of the autopsy tissue of 6 stillborn fetuses and 2 extreme preterm infants (gestational age, 20 to 34 weeks) drawn from families referred for suspected neonatal hemochromatosis. Thirteen appropriate nondisease controls and 8 cases of neonatal acute liver failure with known etiology were also examined. Liver sections were immunostained using anti-human C5b-9 complex. Results: All of the study cases had died with no preceding evidence of fetal distress. Histopathology showed findings of acute liver injury, including global hepatocyte necrosis with minimal reticulum collapse and no fibrosis. Hepatocytes in cases stained strongly positively for C5b-9 complex, suggesting premortem lgG complement-mediated liver injury. Hepatocytes in acute liver failure case controls did not demonstrate a similar mechanism of liver injury. Conclusions: Alloimmune liver disease is sometimes associated with fetal death.

Original languageEnglish (US)
Pages (from-to)612-616
Number of pages5
JournalJournal of Pediatrics
Volume159
Issue number4
DOIs
StatePublished - Oct 1 2011

Keywords

  • ALF
  • Acute liver failure
  • GALD
  • Gestational alloimmune liver disease
  • MAC
  • Membrane attack complex
  • NH
  • Neonatal hemochromatosis
  • TCC
  • Terminal complement cascade

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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