Severe autoimmune hepatitis triggered by varicella zoster infection.
Autoimmune hepatitis (AIH) is a chronic disease of unknown etiology that is characterized by the presence of circulatory autoantibodies and inflammatory histological changes in the liver. Although the pathogenesis of AIH is not known, it is thought that, in a genetically predisposed individual, environmental factors such as viruses can trigger the autoimmune process. Herpes simplex virus, Epstein-Barr virus, measles virus, and hepatitis viruses are thought to play a role in the etiology of AIH. Proteins belonging to these viruses may be similar to the amino acid chains of different autoantigens in the liver, this causes immune cross reactions and liver tissue damage. We report a case of severe AIH following varicella zoster infection in a 23-year-old man, and speculate that, based on the molecular mimicry hypothesis, the liver damage was caused by an immune cross reaction to the viral proteins. Varicella-zoster-induced AIH has not been reported previously.
Al-Hamoudi
Waleed K
WK
Gastroenterology and Hepatology Unit (59), Department of Medicine, King Saud University, Riyadh, Saudi Arabia. walhamoudi@gmail.com
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002644:Chickenpox / Q000150:complications*; D019693:Hepatitis, Autoimmune / Q000209:etiology / Q000473:pathology*; D014645:Herpesvirus 3, Human; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D055815:Young Adult
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase