title: [A case of systemic lupus erythematosus presenting with jaundice and lupus pneumonia].
abstract: A 27-year-old Japanese woman was referred to our hospital for acute hepatitis in April 2002. She had been suffering from low grade fever and fatigue for a week. She also presented with dyspnea. On admission, ALT and AST were 857 U/l and 473 U/l respectively. Urine protein was 2 g/day. Chest radiograph showed bilateral infiltrative shadow and pleural effusion. She developed jaundice and her level of total bilirubin was increased to 9.6 mg/dl on May 9. Antibodies to hepatitis viruses were not detected. Testing for antimitochondrial antibodies, antismooth muscle antibodies, and antiribosomal P antibodies showed all negative. However, antinuclear antibodies were positive at titer 1:160 and anti-double stranded DNA antibodies were 130 U/ml. A diagnosis of systemic lupus erythematosus was made and oral administration of 60 mg/day prednisolon was started on May 10. Serum levels of ALT, AST and bilirubin were reduced to within normal range and pulmonary lesions were also improved. We conclude that this is a rare case of systemic lupus erythematosus presenting with acute hepatitis and jaundice.
authors.affiliation: Department of Internal Medicine, Yokohama Seamen's Insurance Hospital. kawai-alg@umin.ac.jp
authors.forename: Takako
authors.initials: T
authors.lastname: Kawai
authors.forename: Sizuo
authors.initials: S
authors.lastname: Tominaga
authors.forename: Akiko
authors.initials: A
authors.lastname: Okouchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Kudo
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Katoh
authors.forename: Masataka
authors.initials: M
authors.lastname: Shoda
authors.forename: Masayuki A
authors.initials: MA
authors.lastname: Fujino
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D007565:Jaundice / Q000150:complications*; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy; D008177:Lupus Vulgaris / Q000150:complications; D011014:Pneumonia / Q000150:complications; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone