Hepatic fibrosis in fetal alcohol syndrome. Pathologic similarities to adult alcoholic liver disease.

The light- and electron-microscopic changes in a biopsy of the liver obtained at age 17 mo from a child with fetal alcohol syndrome were studied. At the time of biopsy, hepatomegaly and raised serum transaminases were present as well as neurologic and growth defects and the typical facial anomalies seen in this syndrome. Light microscopy of the liver biopsy specimen revealed parenchymal fat with portal and perisinusoidal fibrosis. Ultrastructurally, perisinusoidal spaces contained deposits of intermediate-size and large collagen fibers, myofibroblasts and occasional Ito cells, and subendothelial basement membrane-like material. These changes resemble those seen in adult human and baboon alcoholic liver disease and suggest that hepatic fibrosis in fetal alcohol syndrome has a similar pathogenesis.