Liver & intrahepatic bile ducts

Viral hepatitis

Adenovirus hepatitis

Topic Completed: 1 November 2015

Minor changes: 22 September 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Adenovirus hepatitis[TIAB]

Rifat Mannan, M.D.
Songyang Yuan, M.D., Ph.D.
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Cite this page: Mannan A.A.S.R. Adenovirus hepatitis. website. Accessed November 29th, 2021.
Definition / general
  • Adenovirus is major cause of morbidity and mortality in immunocompromised patients and may result in severe diseases, such as pneumonia, nephritis, hepatitis, encephalitis, pancreatitis or disseminated disease
  • In patients with allogenic hematopoietic stem cell transplantation (HSCT), adenovirus is the third most common viral infection, after herpes simplex and cytomegalovirus (Arch Pathol Lab Med 2003;127:e246)
  • In HSCT recipients, adenovirus infection can result in fulminant hepatitis / fulminant hepatic failure (Intern Med 2006;45:975, Intern Med 2012;51:405)
Case reports
Microscopic (histologic) description
  • Adenovirus hepatitis is characterized by small or large areas of coagulative necrosis, with no particular zonal distribution (Arch Pathol Lab Med 2003;127:e246)
  • Inflammatory response is usually sparse or absent
  • Intranuclear viral inclusions are characterized by smudgy appearance and chromatin margination
  • May have random areas of bland coagulative necrosis
  • Nuclear inclusions are either large and basophilic or bubbly and vesicular, with smudgy nuclei and chromatin margination
  • Adenovirus immunostaining is important for confirming the diagnosis, particularly because of high incidence of coinfection with other viruses (especially herpes simplex and cytomegalovirus) in transplant recipients (Bone Marrow Transplant 2000;26:1333)
Microscopic (histologic) images

Case #354
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Adenovirus immunostain

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