Autoimmune hepatitis – 3 clinical case reports
Keywords:
autoimmune hepatitis, hyper-gammaglobulinemia, elevated aminotransferases, immunosupressionAbstract
Autoimmune hepatitis (AIH) is a form of chronic hepatic inflammation, with a female sex predominance (4:1), hypergammaglobulinemia, circulating autoantibodies, response to
immunosupressive therapy, possible association with other autoimmune diseases and greater prevalence of human leukocyte antigen (HLA) alleles DR3 or DR4.
We report three cases of AIH, two men (case 1: RAAOE, 23 years old and case 2: PFSC, 30 years old) and one woman (case 3: MANL, 61 years old), diagnosed in our Department in 1999. Two of the patients had few symptoms and the third had a previous spontaneous “remission”. The alanine aminotransferase (ALT) levels were 12 to 50 times the upper limit of normal. The three patients had an increased immunoglobulin G (IgG) level and positive autoantibodies.
Case 1 had the disease for a few years, but minor laboratory and histologic severity. Cases 2 and 3 correspond to severe forms of AIH, one with controversial histology and the other with a more typical form.
After diagnosis, they initiated treatment with corticosteroids and later azathioprine, with good response and maintained remission.
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