Prolonged acute hepatitis A mimicking autoimmune hepatitis.
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.
Mikata
Rintaro
R
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
Yokosuka
Osamu
O
Imazeki
Fumio
F
Fukai
Kenichi
K
Kanda
Tatsuo
T
Saisho
Hiromitsu
H
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
D000974:Antibodies, Antinuclear; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid