Hepatic Lesion in Systemic Lupus Erythematosus: Cytoplasmic Tubules in Sinusoidal Endothelium

To the Editor.— The detection of cytoplasmic microtubules in the glomerular endothelium of patients with systemic lupus erythematosus (SLE) aroused considerable interest recently. These structures are recognizable very frequently in the kidneys of patients with SLE, and although they are not specific or pathognomonic for this disease, their demonstration has some diagnostic value in suspected cases. 1-3 The exact nature of the cytoplasmic microtubules is not known. They were believed to represent myxovirus-like particles suggesting viral cause of the disease. 1 Other authors, however, assume that they are ultrastructural manifestations of endothelial cell injury, due either to viral infection or to some other deleterious mechanism. 2,4 We found cytoplasmic microtubules in the endothelial cells of the liver sinusoids of a 20-year-old woman patient. Her illness, based on the characteristic history, and clinical and laboratory findings, was diagnosed as SLE with hepatic involvement. Liver biopsy was performed with the Menghini needle.