Abstract
This is a 46 year-old female who has had no remarkable symptoms besides high level of alkali-phosphatase, elevated blood sedimentation rate and positive rheumatoid factor. The patient showed itching, jaundice and fever after administration of Sulfisomesole. After treatment of this patient with steroid for eight months, jaundice disappeared and rheumatoid factor became negative but high levels of alkali-phosphatase and γ-GTP remained. On admission in our clinic, low titer of anti-mitochondria antibody (AMA) with normal level of immunoglobulin was observed. The histological examination of biopsy specimen of her liver showed a finding of acute intrahepatic cholestasis.
After stopping the steroid-therapy, rheumatoid factor became positive with high level of IgM and titer of AMA increased. Two years later, histoligical examination of her liver removed surgically showed a finding of primary biliary cirrhosis (PBC).
In surveying the clinical course of this patient, this case was considered to be a case of presymptomatic primary biliary cirrhosis whose sera showed increased characteristic serological findings after stopping steroid therapy for drug-induced hepatic injury.
