New perspectives on the fatty liver of kwashiorkor - abstract

ABSTRACT

Samples of liver were examined from eight patients who died from protein-calorie malnutrition, and compared with biopsies taken at various stages of recovery from seven other patients. All specimens were taken from patients admitted to the Tropical Metabolism Research Unit, at Mona. Liver samples for electron microscopy were obtained within one hour of death, fixed in 2.5 per cent glutaraldehyde, passed through 1 per cent osmium tetroxide, dehydrated through graded ethanols, and embedded in Maraglas. Sections for electron microscopy were stained with lead citrate. The cells from recovering patients showed normal organization, apart from some increase in residual bodies, and prominent intramitochondrial swelling, and influx of calcium into the matrix. There were also canalicular and intracytoplasmic cholestasis, abundant lipid droplets, loss of glycogen reserves, scanty endoplasmic reticulum and Golgi membranes, focal cytoplasmic degradation, and depletion of peroxisomes. The depletion of peroxisomes may be an important factor in the accumulation of lipids, as they normally carry out beta-oxidation on long-chain fatty acids. They also contribute to cellular defences against free radicals. The disorganisation of cellular organelles is consistent with free radical damage and terminal anoxia (AU)