title: [Persistent acute hepatitis in a patient with chronic hepatitis C].
abstract: We describe the case of a patient with chronic hepatitis C (CHC) who showed a progressive increase in aminotransferase level, reaching values of aspartate aminotransferase 1723 UI/L, alanine aminotransferase 1519 UI/L and gamma-glutamyl-transpeptidase 296 with a bilirubin level of 6 mg/dL and direct bilirubin level of 4.6 mg/dL. One year previously, the patient had been diagnosed with CHC, genotype 1, and had an initial hepatitis C virus RNA load of 249,000 UI/mL. All the specific blood tests performed were negative except for antisoluble liver antigen (anti-SLA) antibodies, which were positive in two different determinations. A diagnosis of overlap syndrome CHC and autoimmune hepatitis was made. Steroid and azathioprine treatment was started with good response. The relationship between CHC and anti-SLA is not well characterized but has been described in these patients. We found no prior reports in the literature of CHC associated with positive anti-SLA in a patient with persistent acute hepatitis.
authors.affiliation: Sección Aparato Digestivo, Medicina Interna, Hospital de la Vega Baja, Avda. San Vicente Ferrer 17B, 03330 Crevillent, Orihuela, Alicante, Spain. juancarlospenalva@hotmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Penalva Polo
authors.forename: C
authors.initials: C
authors.lastname: Verdú Benavente
authors.forename: G
authors.initials: G
authors.lastname: Belda Abad
authors.forename: J A
authors.initials: JA
authors.lastname: Ruiz
authors.forename: E
authors.initials: E
authors.lastname: Gaspar Martínez
authors.forename: J A
authors.initials: JA
authors.lastname: Correa Estañ
authors.forename: E
authors.initials: E
authors.lastname: Muñoz Ramírez
authors.forename: C
authors.initials: C
authors.lastname: Martínez Prieto
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001707:Biopsy, Needle; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology / Q000628:therapy; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000276:immunology / Q000473:pathology / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D018937:Hepatitis C Antibodies; D007166:Immunosuppressive Agents; C046431:liver antigen LA-1