title: Prolonged acute hepatitis A mimicking autoimmune hepatitis.
abstract: OBJECTIVE
  We report a case with a prolonged course of hepatitis A, with alanine aminotransferase (ALT) higher than 500 IU/L for more than 2 mo.
  
  
  METHODS
  A middle-aged woman had an elevated IgG level of more than 2,000 mg/dL, positive anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.
  
  
  RESULTS
  It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained.
  
  
  CONCLUSIONS
  We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCA proved to be effective.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mikata
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
authors.forename: Fumio
authors.initials: F
authors.lastname: Imazeki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fukai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000208:Acute Disease; D000974:Antibodies, Antinuclear / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D000974:Antibodies, Antinuclear; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid