腹腔鏡が診断に有用であったHBVキャリアーに合併した自己免疫性肝炎の1例

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  • Diagnostic Usefulness of Laparoscopy in a Case of HBV Carrier with Autoimmune Hepatitis.

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We reported a case of HBV carrier with autoimmune hepatitis(AIH), in whom laparoscopy was useful in the diagnosis of AIH. A 39-year-old woman was referred to our hospital for further exarnination of the liver. Her liver function tests showed abnormal and HBsAg and HbeAb were positive in her laboratory data. Liver biopsy showed chronic active hepatitis. At first, she was suspected to have chronic hepatitis B due to mutant HBV and treated with strong neominophagen C. In spite of the treatment, her liver function tests fluctuated. Overlapping of AIH was suspected because of positive results for antinuclear antibody(1:320). Laparoscopy revealed coarse undulation and wide depression, which are typical findings for AIH. Indocyanine green injection showed high uptake of the dye in elevated regions. She was diagnosed to have AIH in a Hw carrier and treated with corticosteroids. Her liver function tests normalized and no reactivation of HBV has been observed. Laparoscopy was useful in the differential diagnosis between AIH and chronic viral hepatitis B.

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