A Case of Sjögren Syndrome with Autoimmune Hepatitis

Abstract

A 57-year-old woman developed general fatigue in December 1998 and was diagnosed with autoimmune hepatitis based on increased serum levels of transaminases, positive antinuclear antibody and anti-smooth muscle antibody. Treatment with prednisolone resulted in the improvement of symptoms and restoration of serum transaminase levels to the normal ranges. Prednisolone was gradually reduced and discontinued in December 2002. Thereafter, thirst, arthralgia, facial erythema and dry eyes appeared. Sjögren syndrome was diagnosed based on abnormal findings on Saxon test, Schirmer's test and positive anti-SS-A antibody. Symptoms improved after readministration of prednisolone. It is suggested that early diagnosis and initial treatment are critical for a Sjögren syndrome patient with liver dysfunction since prednisolone is effective for autoimmune hepatitis.