栀子苷类药物引起SD大鼠胆红素沉着的案例分析

Case Report of Geniposide Induced Bilirubin Pigmentation in Sprague-Dawley Rat

目的鉴别诊断栀子苷类药物引起的大鼠肝肾中细微的色素颗粒。方法对经口灌胃给予栀子苷类药物SD大鼠的肝脏和肾脏进行大体解剖观察,常规HE染色镜检,结合临床血液生化及尿液指标进行分析,并利用特殊染色方法进行鉴别诊断。结果与对照组相比,各剂量组SD大鼠肝脏和肾脏均出现灰绿色改变,血清总胆红素(TB)和γ-谷氨酰转移酶(GGT)显著升高。并且,剂量组大鼠尿液中尿胆素原(URO)和尿液胆红素(BIL)含量呈剂量相关性增加。组织病理学检查见所有剂量组大鼠的肝脏和肾脏出现与受试物相关的微小棕黄色色素颗粒。这些色素颗粒对Fouchet染色呈阳性反应,而对Perls blue染色呈阴性。结论确诊了栀子苷类药物引起的大鼠肝肾中沉着的色素为胆红素,阐释了肝肾的组织病理改变与临床病理学的联系,为今后毒性病理工作中色素鉴别诊断提供理论及方法。

Objective Fine pigment granules in livers and kidneys of SD rat induced by geniposide were differentially diagnosed in this report. Methods A gross observation was performed on liver and kidney of SD rats which were administrated geniposide by oral gavage, and routine HE staining slides for microscopic analysis was carried out. In addition, the blood biochemical and urine index in clinical pathology were analyzed, and special staining was used for differential diagnosis. Result Compared to the control group, livers and kidneys of SD rats in each dose group were found discoloration of gray green, as well as the serum TB and GGT was increased significantly（P〈0.05）. The contents of urine URO and BIL in dose group were increased with dose-relation. Microscopically, liver and kidneys in all dose group animals were found tiny brown-yellow pigment droplets which were test material related.These pigment particles were positive for Fouchet staining but negative for Perls blue. Conclusion In this case, the bilirubin pigmentation was definitely diagnosed by using clinical pathology data combination with histopathological examination. In addition, the relationship between histopathologic changes of livers and kidneys and clinical pathology was explained. This can provide theory and method on pigmentation differential diagnosis for future toxicologic pathology work.