Clinical Case of Autoimmune Hepatitis in 59-year-old Woman with Effective Treatment with Budesonide

L.Ya. Melnychenko, V.M. Gladun, D.V. Popok

Abstract


Autoimmune hepatitis is a necroinflammatory liver disease of unknown etiology. According to the histology the disease is characterized by lobular hepatitis, in blood chemistry — increasing the level of aspartate aminotransferase and alanine aminotransferase, and according to serology, increased levels of autoantibodies and immunoglobulin G. We present to discuss the case of autoimmune hepatitis in a previously healthy 59-year-old woman with acute elevated levels of total bilirubin, aspartate aminotransferase, alanine aminotransferase. In view of these data differential diagnosis has been carried out between autoimmune hepatitis, viral hepatitis and jaundice. On examination there were no markers of viral hepatitis A, B, and C, the results of computed tomography and endoscopic retrograde choledochopancreatography hadn’t confirm the mechanical nature of jaundice. A liver biopsy showed the presence of periportal hepatitis and bridging necrosis (lymphomacrophagal infiltration in the portal and periportal areas), the typical feature of autoimmune hepatitis. Methylprednisolone therapy with transition to budesonide leads to a reduction and normalization of total bilirubin, aspartate aminotransferase, alanine aminotransferase. Thus, our description concerns autoimmune hepatitis in a patient of middle age, confirming contemporary statement about prevalence of the disease mainly among women in all age groups. Normalization of serum transaminases activity with the use of budesonide was achieved, which correlates with the data of several studies on the effective therapy of autoimmune hepatitis with budesonide.


Keywords


autoimmune hepatitis; corticosteroids; hepatomegaly

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DOI: https://doi.org/10.22141/2308-2097.2.48.2013.86152

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