title: [Chronic active hepatitis: recurrence after long-term immunosuppressive therapy in spite of normal liver histology].
abstract: We report the case of a patient with liver-kidney microsomal antibody (LKM) positive chronic active hepatitis (CAH) which was followed-up for 12 years. Besides LKM the patient's serum was positive for thyroid microsomal antibodies, but negative for antinuclear, liver membrane and smooth muscle antibodies as well as hepatitis B virus markers. The patient was HLA B 8 negative. The disease of the 23 year old female patient began as an acute hepatitis which progressed to CAH. Immuno-suppressive therapy with a combination of prednisone and azathioprine led to a long lasting normalization of transaminases, gammaglobulin levels, and finally liver histology. Despite a normal liver histology after more than six years of continuous treatment the discontinuation of therapy was followed by a relapse. The presented case with LKM-positive CAH demonstrates that discontinuation of immuno-suppressive therapy may be followed by a relapse even if normal liver histology has been achieved under treatment.
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D001323:Autoantibodies / Q000276:immunology; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D006521:Hepatitis, Chronic / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D007165:Immunosuppression Therapy; D007668:Kidney / Q000276:immunology; D008099:Liver / Q000276:immunology / Q000473:pathology; D008861:Microsomes / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D013961:Thyroid Gland / Q000276:immunology; D013997:Time Factors; D000637:Transaminases / Q000378:metabolism
chemical_list: D001323:Autoantibodies; D000637:Transaminases; D000469:Alkaline Phosphatase; D001379:Azathioprine; D011241:Prednisone
vernacular_title: Chronisch aktive Hepatitis: Rezidiv nach langjähriger immunsuppressiver Therapie trotz normaler Leberhistologie.