1983 Volume 24 Issue 6 Pages 659-663
An unusual case of acute hepatitis A, associated with muscular involvement, was reported.
A 34-year old male was admitted with a high fever, myalgia of extremities and jaundice.
Laboratory studies disclosed markedly elevated serum transaminase, lactic dehydrogenase and creatinine phosphokinase activites. Serum IgM anti HAV was positive. Serum creatinine phosphokinase level turned to normal values along with the normalization of serum transamirase and lactic dehydrogenase levels. Liver biopsy performed at 14th clinical day showed minimal changes, althouth serum transaminase activity was markedly elevated.
Circulatory immune complex (cIC) was measured by Raji cell assay method. IgA and IgM class cIC were detected at acute stage except for IgG class cIC. In this case unlike usual cases with acute hepatitis A, both of IgA and IgM class cIC were detected even at the convalescent stage. These findings suggested the possible role of IgA or IgM class cIC in the pathogenesis of this muscular involvement.
