title: Association of an overlap syndrome of autoimmune hepatitis and primary biliary cirrhosis with cytomegalovirus infection.
abstract: A 63-year-old woman, who presented with severe jaundice and elevated serum conjugated bilirubin level, denied alcohol and drug use and showed no evidence of viral hepatitis. Based on clinical and laboratory features, she was diagnosed with autoimmune hepatitis with primary biliary cirrhosis. Hematological and immunochemical assays, radiographic imaging, clinical examination, and liver biopsy were conducted. Laboratory results were the following: negative for fluorescence antinuclear antibody, negative for antismooth muscle antibodies but positive for antinuclear antibody (enzyme-linked immunosorbent assay) and antimitochondrial M2 antibody, high titers of serum globulin, and positive for cytomegalovirus IgM. Liver biopsy showed submassive lobular necrosis, inflammation with broad areas of parenchymal collapse, and chronic nonsuppurative destructive cholangitis. The patient responded well to corticosteroid therapy. This case might illustrate an association between cytomegalovirus infection and the occurrence of autoimmune hepatitis.
authors: Department of Internal Medicine.
authors: Megumi
authors: M
authors: Toyoda-Akui
authors: Hiroaki
authors: H
authors: Yokomori
authors: Fumihiko
authors: F
authors: Kaneko
authors: Yuki
authors: Y
authors: Shimizu
authors: Hajime
authors: H
authors: Takeuchi
authors: Kumiko
authors: K
authors: Tahara
authors: Hide
authors: H
authors: Yoshida
authors: Hirobumi
authors: H
authors: Kondo
authors: Tadashi
authors: T
authors: Motoori
authors: Makoto
authors: M
authors: Ohbu
authors: Masaya
authors: M
authors: Oda
authors: Toshifumi
authors: T
authors: Hibi