A case of lupoid hepatitis associated with hepatocellular carcinoma

Abstract

A 60-year-old woman with hepatocellular carcinoma about 7 years after the diagnosis of lupoid hepatitis, was reported.
Her liver dysfunction was pointed out in 1976, and icterus and ascites developed in 1978. Laboratory examinations showed hypergammaglobulinemia (5.0g/dl), 6350mg/dl of IgG, and positive LE cell, antinuclear antibody and anti-DNA antibody. Diagnosis of lupoid hepatitis was made. Symptomatic relief was obtained after about two years of steroid therapy. Laparoscopy in October, 1979 revealed nodular liver and chronic active hepatitis was confirmed histologically.
In October, 1985, high AFP and various image diagnosis confirmed the complication with hepatocellular carcinoma, which led to her death due to intraperitoneal massive hemorrhage in March, 1986. Needle necropsy revealed findings of liver cirrhosis (Nagayo's type A) and trabecular-type hepatocellular carcinoma of Edmondson Type II. So far as we know, this case was the 7th one in the world.