Simultaneous Presentation of Wilson's Disease and Autoimmune Hepatitis; A Case Report and Review of Literature.
BACKGROUND
Coexistence of Wilson's disease and autoimmune hepatitis has been rarely reported in English literature. In this group of patients, there exist features of both diseases and laboratory and histopathological studies may be misleading. Medical treatment for any of these entities, per se, may result in poor response. Therefore, by considering the acute hepatitis resembling Wilson's disease and autoimmune hepatitis, simultaneous therapy with immunosuppressive and penicillamine may have a superior benefit.


METHODS
We present the case of a 10-year-old boy with nausea, vomiting, yellowish discoloration of skin and sclera, abdominal pain and tea-color urine. Physical examination showed mild hepatomegaly and right upper quadrant tenderness. Laboratory and histochemical studies and atomic absorption test were done and the results were highly suggestive of both Wilson's disease and autoimmune hepatitis, in him.


CONCLUSIONS
This case study highlights, although rare, the coexistence of Wilson's disease and autoimmune hepatitis and the need to maintain a high level of awareness of this problem. Therefore, it is reasonable to consider this type of hepatitis in rare patients, with dominant features of both diseases at the same time.
Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Naghi
N
Dara
Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Farid
F
Imanzadeh
Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Ali Akbar
AA
Sayyari
Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Peiman
P
Nasri
Department of Pediatric Gastroenterology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Amir Hossein
AH
Hosseini
Autoimmune; Hepatitis, Hepatolenticular Degeneration