A case of autoimmune hepatitis masquerading as acute hepatitis and accompanied by probable antiphospholipid syndrome.

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  • ZENDA Takahiro
    Department of Internal Medicine, Ishikawa Prefectural Central Hospital
  • MATSUDA Hiroto
    Department of Internal Medicine, Ishikawa Prefectural Central Hospital
  • SHIMASAKI Seikou
    Department of Internal Medicine, Ishikawa Prefectural Central Hospital
  • OHMORI Toshiaki
    Department of Internal Medicine, Ishikawa Prefectural Central Hospital
  • SHIMAZAKI Hideki
    Department of Internal Medicine, Ishikawa Prefectural Central Hospital
  • KURUMAYA Hiroshi
    Department of Pathology, Ishikawa Prefectural Central Hospital
  • MASUNAGA Takaharu
    Department of Pathology, Ishikawa Prefectural Central Hospital
  • TAKEDA Yasuo
    The Second Department of Internal Medicine, School of Medicine, Kanazawa University

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Other Title
  • 重症急性肝炎にて発症し，抗リン脂質抗体症候群の合併が疑われた自己免疫性肝炎の１例

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Abstract

A 51-year-old woman with a past history of acute obstruction of central retinal artery presented with general malaise and jaundice. In addition to severe liver dysfunction, hypergammaglobulinemia (2.8g/dl), positive of antinuclear antibody (speckled pattern ×160), biologically false positive serologic test for syphilis (slide test) and IgM anticardiolipin antibody (aCL) were also disclosed. Based on the diagnostic criteria offered by the Japanese Ministry of Welfare as well as International Autoimmune Hepatitis (AIH) Group, this case was thought of AIH masquerading as serious acute hepatitis, and accompanied by presumptive antiphospholipid syndrome (APS). Though the hepatitis became worse with hepatic encephalopathy, treatments with corticosteroid and plasma exchange produced marked improvement. Liver needle biopsy revealed acute hepatitis of confluent necrosis type. This case may raise some intriguing points concerning the deduced undesirable influence of APS on acute hepatitis, and the meaning of aCL which was detected under serious liver dysfunction.

Journal

  • Kanzo

    Kanzo 37 (12), 744-748, 1996

    The Japan Society of Hepatology

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