An elderly man with syncytial giant cell hepatitis successfully treated by immunosuppressants.
Here, we report an elderly man with acute-on-chronic hepatitis accompanied by massive ascites. He showed elevated serum transaminase and anti-nuclear antibody (ANA) levels. Liver biopsy showed diffuse multinucleated giant hepatocytes with interface hepatitis, and he recovered with administration of azathioprine in addition to corticosteroids. Follow-up liver biopsy after recovery showed improvement of hepatic inflammation and reduction of giant hepatocyte formation. The patient is receiving low-dose corticosteroid maintenance therapy and he has remained healthy for 8 years to date. Active immunosuppressive treatment may be beneficial in patients with adult syncitial giant cell hepatitis (AGCH).
The Third Department of Internal Medicine, University of Toyama, Japan. tajikazu@med.u-toyama.ac.jp
Kazuto
K
Tajiri
Yukihiro
Y
Shimizu
Yoshiharu
Y
Tokimitsu
Koichi
K
Tsuneyama
Toshiro
T
Sugiyama
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001201:Ascites / Q000188:drug therapy; D001379:Azathioprine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006525:Hepatitis, Viral, Human / Q000188:drug therapy* / Q000201:enzymology / Q000276:immunology / Q000473:pathology; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage*
D007166:Immunosuppressive Agents; D011239:Prednisolone; D000410:Alanine Transaminase; D001379:Azathioprine