title: Development of hepatocellular carcinoma in a woman with HBV- and HCV-negative autoimmune hepatitis with unsatisfactory response to Corticosteroid.
abstract: A 57-year-old woman was admitted due to a hemorrhage from esophageal varices. Laboratory tests showed liver dysfunction, elevated immunoglobulin G levels and positivity for anti-nuclear antibodies. Serum hepatitis B virus and hepatitis C virus markers were negative. The liver biopsy specimen was compatible with autoimmune hepatitis, and low-dose prednisolone was started. During the follow-up, her serum alanine aminotransferase levels continued to fluctuate between 40 and 60 IU/l. Nine years later, hepatocellular carcinoma 20 mm in diameter was detected. This case suggests that hepatocellular carcinoma develops even if serum alanine aminotransferase levels are maintained at less than twice the upper normal limit.
authors.affiliation: Department of Gastroenterology & Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Fujioka
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000410:Alanine Transaminase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000302:isolation & purification; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology / Q000821:virology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D000410:Alanine Transaminase