One hundred and seventy-two livers from Egyptian children and adults were studied by biopsy for fatty change, inflammatory cell infiltration and fibrosis. Sixty children, seven of whom had visceral forms of schistomiasis were included. Besides fatty changes and inflammatory cells in excess of normal, 32 per cent of the children showed varying degrees of fibrosis, but over 76 per cent of the children with schistosomiasis or signs of malnutrition showed excess fibrous tissue deposition. Abrupt changes in fatty metamorphosis observed about the age of puberty are attributed to marked dietary changes instituted at this age.
Of the adults, 78 per cent had schistosomiasis, and this had a profound effect upon fibrosis of the liver, producing both nodular and smooth types. But again, as in the children, malnutrition, whether sustained or interrupted, was probably the most important etiological agent responsible for fibrosis in the absence of schistosomiasis. Factors other than parasitism and malnutrition are believed to be unimportant.
Present address: U. S. Naval Medical School, National Naval Medical Center, Bethesda 14, Maryland.