title: Deep cholestatic jaundice as the predominant manifestation in autoimmune hepatitis.
abstract: Autoimmune hepatitis is a chronic liver disease of unknown etiology. The diagnosis is based on the exclusion of other liver diseases such as drug-induced liver disease, alcohol liver disease, viral liver diseases and so on, characterizing by elevation of transaminases, hypergammaglobulinemia, auto antibodies and the histological features of interface hepatitis and plasma cells infiltration. However, deep cholestatic jaundice as the initial presentation, with elevated serum transaminases one month later, is rare in autoimmune hepatitis. We described a case of type 1 autoimmune hepatitis with deep cholestatic jaundice and hyperbilirubinemia as the initial predominant manifestation. It demonstrated that the cholestasis can also occur as the initial predominant syndrome in autoimmune hepatitis and respond well to the treatment with the glycyrrhizin and ursodeoxycholic acid.
authors.affiliation: Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Road II, Guangzhou, China.
authors.forename: Shu-Bing
authors.initials: SB
authors.lastname: Wang
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Wang
authors.forename: Ru-Hua
authors.initials: RH
authors.lastname: Zheng
authors.forename: Bi-Hui
authors.initials: BH
authors.lastname: Zhong
authors.forename: Min-Hu
authors.initials: MH
authors.lastname: Chen
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D019695:Glycyrrhizic Acid / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D041781:Jaundice, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008111:Liver Function Tests; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D002756:Cholagogues and Choleretics; D019695:Glycyrrhizic Acid; D014580:Ursodeoxycholic Acid