Autoimmune hepatitis: a histological variant associated with prominent centrilobular necrosis.
A patient presented with pruritus and recent elevation of aminotransferases. The case fulfilled most of the criteria for the diagnosis of autoimmune hepatitis and achieved clinical and complete biochemical response to steroid therapy. However, the liver biopsy specimen revealed an unusual histological pattern consisting of severe centrilobular necrosis demarcated by a thin rim of hepatitic reaction. In contrast, the portal tracts appeared almost normal. This histological appearance has not been associated with autoimmune hepatitis. This presentation and the histology may represent an early pattern of autoimmune injury to the liver.
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Department of Internal Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois 60612, USA.
Koukoulis
G
G
Ganger
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DR
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000473:pathology*; D001379:Azathioprine / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D006505:Hepatitis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000276:immunology / Q000473:pathology*; D008775:Methylprednisolone / Q000627:therapeutic use; D009336:Necrosis
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine; D008775:Methylprednisolone