Hepatic lesions in the congenital rubella syndrome

The hepatic alterations of 12 patients with congenital rubella were reviewed and, in 4 specimens, studied by electron microscopy and enzyme histochemistry. The spectrum of hepatic lesions included hyalinization and swelling of hepatocytes, bile statis, hemopoiesis, and, in some cases, multinucleated giant cells. Many giant cells contained heavy glycogen deposits and showed marked activity of several hydrolytic and oxidative enzymes. The fine structure of the cytoplasmic organelles in both multinuclear and mononuclear hepatocytes was relatively normal except for cholestasis. The canaliculi adjacent to the giant cells appeared reduced in number but it is unlikely that this alone caused the bile stasis. The histological, histochemical, and fine structural changes in these cases were identical to those seen in idiopathic neonatal hepatitis.