Recurrent autoimmune LKM hepatitis with multiple relapses.
We describe three females who since childhood and puberty have presented with several relapsing episodes of acute or chronic LKM positive hepatitis. Many episodes resolved spontaneously with recovery of normal liver function, although treatment with steroids, steroids/azathioprine was used at occasions. No clear pattern of precipitating factors has emerged though in some cases possible temporal relationship of episodes to menarche, oral contraceptives use or pregnancy has suggested a role for female sex hormones. We discuss briefly the possible mechanisms of LKM positive hepatitis, particularly in terms of drugs as possible trigger factors.
Milkiewicz
P
P
Liver and Hepatobiliary Unit, University of Birmingham, United Kingdom.
Mendoza
A
A
Cardenas
T
T
Keogh
A
A
Hubscher
S G
SG
Elias
E
E
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D009336:Necrosis; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D012008:Recurrence; D012075:Remission, Spontaneous
D001323:Autoantibodies; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; C060729:anti-liver kidney microsome antibody; D011239:Prednisolone; D001379:Azathioprine