[A case of autoimmune hepatitis needed to be differentiated from EBV hepatitis, in that the histology of liver biopsy specimen was useful for diagnosis].
A 10-year-old girl with autoimmune hepatitis (AIH) was reported. She was admitted to our hospital because of cholestasis and elevation of liver enzymes for 2 months. Laboratory examination revealed that EBV-DNA copy number in the PBMNC (peripheral mononuclear cells) was 1.2 x 10(3) copies/microg of DNA, hypergammaglobulinemia, and positive antinuclear antibody, positive anti-smooth muscle antibody. The histology of her liver biopsy specimen revealed interface hepatitis, dense mononuclear cell infiltrates, mild fibrosis, and negative for EBV in situ hybridization assay indicating AIH and not EBV-associated hepatitis. She was treated firstly with methylprednisolone pulses, then will prednisolone p.o.+azathioprine p.o.. Intravenous cyclophosphamide pulse therapy was introduced because of her abnormal immune pathology. All abnormal laboratory parameters improved to normal levels within 2 months, and EBV-DNA copy number in the PBMNC became negative after 4 months. The histology of liver biopsy specimen was useful for the diagnosis of AIH in such a difficult case needed to be differentiated from EBV hepatitis.
Department of Pediatrics, Yokohama City University of Medicine, Yokohama, Japan.
Shoko
S
Nakajima
Hiroaki
H
Umebayashi
Rumiko
R
Kurosawa
Tomoyuki
T
Imagawa
Shigeki
S
Katakura
Masaaki
M
Mori
Yuko
Y
Aihara
Shumpei
S
Yokota
Tuyoshi
T
Sogo
Ayano
A
Inui
Tomoo
T
Fujisawa
Norio
N
Hanzawa
D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000473:pathology*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000473:pathology*; D006525:Hepatitis, Viral, Human / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*