迅速な肝生検による診断とステロイド療法で重症肝不全を回避できた急性発症型自己免疫性肝炎の1 例

有間 修平; 藤川 博敏; 遠渡 貴子; 大内 琴世; 増田 あい; 藤井 徹朗; 堤 菜津子; 宇野 昭毅; 辻村 隆介; 根本 則道; 三浦 隆生; 松岡 俊一; 森山 光彦

doi:10.4264/numa.77.1_45

Case Reports:

A Case of Severe Autoimmune Hepatitis that was Treated Successfully with Steroid Therapy

Shuhei Arima, Hirotoshi Fujikawa, Takako Endo, Kotoyo Ouchi, Ai Masuda, Tetsuro Fujii, Natsuko Tsutsumi, Akitake Uno, Ryusuke Tsujimura, Norimichi Nemoto, Takao Miura, Shunichi Matsuok, Mitsuhiko Moriyama

Author information

Shuhei Arima
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Hirotoshi Fujikawa
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Takako Endo
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Kotoyo Ouchi
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Ai Masuda
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Tetsuro Fujii
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Natsuko Tsutsumi
Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
Akitake Uno
Endoscopy Center, Japan Community Health care Organization Yokohama Central Hospital
Ryusuke Tsujimura
Division of Morphological and Functional Pathology, Department of pathology and Microbiology, Nihon University School of Medicine
Norimichi Nemoto
Division of Morphological and Functional Pathology, Department of pathology and Microbiology, Nihon University School of Medicine
Takao Miura
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
Shunichi Matsuok
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
Mitsuhiko Moriyama
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine

Keywords: autoimmune hepatitis, severe autoimmune hepatitis with acute presentation

JOURNAL FREE ACCESS

2018 Volume 77 Issue 1 Pages 45-50

DOI https://doi.org/10.4264/numa.77.1_45

Details

Abstract

A 56-year-old woman was admitted to our hospital due to liver dysfunction with epigastralgia and jaundice. Her laboratory data showed AST: 731 IU/L, ALT: 839 IU/L, T-B: 7.0 mg/dl, PT: 57%, ANA: ·640, and IgG: 1444 mg/dl. Liver biopsy findings and laboratory data were consistent with severe autoimmune hepatitis with acute presentation. Therefore, we started steroid therapy from the 8th hospital day, and she exhibited a benign course. Severe autoimmune hepatitis with acute presentation may develop into a more severe course and liver failure in the absence of treatment. If clinically autoimmune hepatitis is suspected, liver biopsy and initiation of steroid therapy as soon as possible are important in determining the convalescence of the patient.

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