Autoimmune chronic active hepatitis responsive to immunosuppressive therapy evolving into a typical primary biliary cirrhosis syndrome: a case report.
The evolution from a characteristic picture of autoimmune chronic hepatitis type I to primary biliary cirrhosis is reported in a middle-aged woman. The initial diagnosis of autoimmune chronic liver disease was based on clinical, bio-serological and histological grounds. It was further confirmed by complete remission following immunosuppressive treatment and prompt relapses at the time of therapy withdrawal. After 7 years, the characteristics of liver disease were altered with increased biochemical cholestasis and serum IgM concentrations, positivation of previously negative anti-M2 antimitochondrial antibodies and the appearance of a typical histological picture of stage I primary biliary cirrhosis. We believe that this is the first reported case in which autoimmune chronic hepatitis highly responsive to immunosuppressive therapy has been followed by the development of a characteristic picture of primary biliary cirrhosis.
Horsmans
Y
Y
Department of Hepato-Gastroenterology, St Luc University Hospital (Catholic University of Louvain), Brussels, Belgium.
Piret
A
A
Brenard
R
R
Rahier
J
J
Geubel
A P
AP
D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D001379:Azathioprine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008105:Liver Cirrhosis, Biliary / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D013997:Time Factors
D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine