[Autoimmune hepatitis with prolonged IGM antibodies to HAV. Are serological markers reliable in ruling out a diagnosis of autoimmune hepatitis?].
We present the case of a 44-year-old woman who was referred to us for jaundice, choluria and acholia. Review of the patient's clinical history revealed that tests for hepatitis A virus (HAV) IgM antibody had been positive 4 and 2 years previously and continued to be so. The patient showed a score of 16 in the International Autoimmune Hepatitis Group's system when the HAV marker was not taken into account and a score of 13 when this marker was taken into account. The persistence of this viral marker for so many years in such patients is probably associated with polyclonal hypergammaglobulinemia. Consequently, we believe that the inclusion of this antibody as a negative datum in the diagnosis of autoimmune virus should be viewed with caution.
del Pozo
D
D
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, Spain. davpozo@mundofree.com
Cano
A
A
Peña
E
E
Miquel
J
J
Valer
M
M
Alemán
S
S
Merino
J
J
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D035922:Hepatitis A Antibodies; D030041:Hepatitis A virus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood*; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*
D015415:Biomarkers; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies; D007075:Immunoglobulin M