UNUSUAL PULMONARY FAT-EMBOLISM CAUSED BY FULMINANT NECROTIZING DELTA-HEPATITIS

A 28-year-old drug addict who had injected intravenously died of hepat ic failure and coma caused by fulminant hepatitis (simultaneously: hep atitis A, persistent hepatitis B, hepatitis C and superinfection by de lta hepatitis). Liver histology disclosed cirrhosis with severe necrot izing hepatitis and extensive microvesicular steatosis, compatible wit h a delta virus infection. Moderate pulmonary fat embolism (grade I-II according to Falzi) was accompanied by fat deposits in alveolar macro phages. It is postulated that protracted fat mobilization from necroti zing hepatocytes may be the cause of pulmonary fat embolism; the extra vasation of fat from the vessels into the alveoli results in phagocyto sis by alveolar macrophages.