title: [A case of systemic lupus erythematosus complicated with autoimmune hepatitis and thrombotic thrombocytic purpura].
abstract: A 51-year-old woman was admitted to our hospital because of systemic jaundice, general fatigue in August 24, 2007. She was diagnosed with systemic lupus erythematosus (SLE) as a result of a discoid rash, photosensitivity, lymphocytopenia, elevated serum anti ds-DNA antibody and a positive test for antinuclear antibody. Her laboratory data revealed severe liver dysfunction, suggesting autoimmune hepatitis (AIH). She was also diagnosed with thrombotic thrombocytic purpura (TTP) because of thrombocytopenia, hemolytic anemia, renal dysfunction and decreased ADAM-TS13 activity. The patient was treated by methylprednisolone pulse therapy, fresh frozen plasma infusion and ursodeoxycholic acid. Her symptoms and laboratory data rapidly improved and a liver biopsy was carried out. Interface hepatitis and lymphocyte infiltration were observed in the specimen. A diagnosis of definite AIH was made from her International AIH group score of 20 points. AIH and TTP are rare complications of SLE. The prevalence of the complication of SLE and AIH has been reported as 1.7 approximately 2.7%, and that of SLE and TTP as 1 approximately 4%. We reported here a rare case of SLE complicated with AIH and TTP.
authors.affiliation: Departments of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center.
authors.forename: Koshiro
authors.initials: K
authors.lastname: Sonomoto
authors.forename: Tomoya
authors.initials: T
authors.lastname: Miyamura
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Soichiro
authors.initials: S
authors.lastname: Takahama
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Rumi
authors.initials: R
authors.lastname: Minami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suematsu
mesh_terms: D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications*