Liver injury in protein-calorie malnutrition: an electron microscopic study

Nutritional liver injury was studied in 14 patients with protein-calorie malnutrition which included 4 children and 10 adults. Hepatomegaly was present in six patients. Liver function tests were normal in all. Light microscopic studies of liver biopsies revealed only mild and nonspecific alterations. Ultrastructure studies revealed organelle pathology of hepatocytes in all the patients. RER was dilated to form vesicles or was fragmented. Mitochondria were of bizarre shape and variable size and some contained filamentous inclusion bodies. Widening of the intercellular spaces was commonly seen and often sheets of collagen bundles were present in perisinusoidal space. Glycogen was apparently increased. Seven patients had repeat studies after recovery from protein-calorie malnutrition, ultrastructural abnormalities of the liver were almost completely reversed to normal.