S2836 Incidental Finding of Elevated Transaminases in an Octogenarian Man: An Unexpected Case of Autoimmune Hepatitis

The common causes of abnormal liver chemistries in human immunodeficiency virus (HIV) infected patients are multifactorial. Diagnosis of autoimmune hepatitis (AIH) in HIV infected patients is intriguing but data is scarce. Unmasking of AIH during immune reconstitution in HIV patients after starting antiretroviral therapy is reported but not with advanced acquired immunodeficiency syndrome (AIDS). Here we present a fascinating case of 32-year-old African-American man with advanced AIDS who presented with elevated transaminases. He was diagnosed with AIH before starting antiretroviral therapy and successfully treated with prednisolone and azathioprine with antiretroviral therapy despite very low CD4 count.

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Chronic Elevation of Liver Enzymes in Acute Intermittent Porphyria Initially Misdiagnosed as Autoimmune Hepatitis

International Journal of Hepatology ◽

10.4061/2011/392049 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

A. González Estrada ◽

S. García-Morillo ◽

L. Gómez Morales ◽

P. Stiefel García-Junco

Keyword(s):

Autoimmune Hepatitis ◽

Liver Enzymes ◽

Correct Diagnosis ◽

Fatal Outcome ◽

Rare Condition ◽

Acute Intermittent Porphyria ◽

Biopsy Result ◽

Prompt Treatment ◽

History Of ◽

Elevated Transaminases

Autoimmune hepatitis is a disease characterized by an elevation of liver enzymes, as well as specific autoantibodies. It is more common in women than men. We describe a 32-year-old woman with elevated transaminases, autoantibodies, and a liver biopsy result suggestive of autoimmune hepatitis. The indicated treatment was administered without showing a satisfactory response. The patient had a family history of acute intermittent porphyria (AIP) so we decided to begin treatment with hematin, achieving a complete remission of the symptoms. Acute intermittent porphyria is a rare condition characterized by neurovisceral symptoms, abdominal pain being the most common of them. The disease has a higher prevalence among young women and certain European countries such as Sweden, Great Britain, and Spain. A correct diagnosis and prompt treatment are essential because patients affected by AIP must have a strict followup due to the fatal outcome of the outbreaks.

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Case Report of Sweet’s Syndrome Associated With Autoimmune Hepatitis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475416665602 ◽

2016 ◽

Vol 21 (1) ◽

pp. 72-74 ◽

Cited By ~ 2

Author(s):

Allison K. Cinats ◽

Richard M. Haber

Keyword(s):

Autoimmune Hepatitis ◽

Neutrophilic Dermatosis ◽

Sweet’S Syndrome ◽

Drug Induced ◽

Sweet's Syndrome ◽

Clinical Presentations ◽

Neutrophilic Dermatoses ◽

History Of ◽

Erythematous Plaques ◽

Elevated Transaminases

Autoimmune hepatitis is a subtle diagnosis that has many diverse clinical presentations. It has been reported in the literature to occur concomitantly with pyoderma gangrenosum, a neutrophilic dermatosis. Sweet’s syndrome is another neutrophilic dermatosis and has been reported to be associated with autoimmune hepatitis in only 2 previous cases: 1 idiopathic and 1 drug induced. Here we report a third case in a 24-year-old woman diagnosed with Sweet’s syndrome in association with autoimmune hepatitis, documenting a possible trend between neutrophilic dermatoses and autoimmune hepatitis. The patient presented with a history of fever and tender, erythematous plaques on her legs. Skin biopsy of a plaque confirmed histiocytoid Sweet’s syndrome. Initial laboratory investigations revealed elevated transaminases, and liver biopsy confirmed autoimmune hepatitis. This case suggests autoimmune hepatitis should be considered as an association when investigating a patient with Sweet’s syndrome.

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