Liver test abnormalities have been described in up to 60% of patients with systemic lupus erythematodes(SLE) at some point during the course of their disease.Prior treatment with potentially hepatotoxic drugs or viral...Liver test abnormalities have been described in up to 60% of patients with systemic lupus erythematodes(SLE) at some point during the course of their disease.Prior treatment with potentially hepatotoxic drugs or viral hepatitis is commonly considered to be the main cause of liver disease in SLE patients.However,in rare cases elevated liver enzymes may be due to concurrent autoimmune hepatitis(AIH).To distinguish whether the patient has primary liver disease with associated autoimmune clinical and laboratory features resembling SLE- such as AIH- or the elevation of liver enzymes is a manifestation of SLE remains a difficult challenge for the treating physician.Here,we present six female patients with complex autoimmune disorders and hepatitis.Patient charts were reviewed in order to investigate the complex relationship between SLE and AIH.All patients had coexisting autoimmune disease in their medical history.At the time of diagnosis of AIH,patients presented with arthralgia,abdominal complaints,cutaneous involvement and fatigue as common symptoms.All patients fulfilled the current diagnostic criteria of both,AIH and SLE.Remission of acute hepatitis was achieved in all cases after the initiation of immunosuppressive therapy.In addition to this case study a literature review was conducted.展开更多
BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Su...BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Super-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic HBV.CASE SUMMARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute hepatitis.Although the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was unclear.Acute HAV super-infection was diagnosed by positive serological and polymerase chain reaction analysis.Following acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were observed.CONCLUSION This case illustrates the importance of carefully checking the vaccination status.In our patient,unspecific immunological responses to HAV led to functional cure of HBV.展开更多
文摘Liver test abnormalities have been described in up to 60% of patients with systemic lupus erythematodes(SLE) at some point during the course of their disease.Prior treatment with potentially hepatotoxic drugs or viral hepatitis is commonly considered to be the main cause of liver disease in SLE patients.However,in rare cases elevated liver enzymes may be due to concurrent autoimmune hepatitis(AIH).To distinguish whether the patient has primary liver disease with associated autoimmune clinical and laboratory features resembling SLE- such as AIH- or the elevation of liver enzymes is a manifestation of SLE remains a difficult challenge for the treating physician.Here,we present six female patients with complex autoimmune disorders and hepatitis.Patient charts were reviewed in order to investigate the complex relationship between SLE and AIH.All patients had coexisting autoimmune disease in their medical history.At the time of diagnosis of AIH,patients presented with arthralgia,abdominal complaints,cutaneous involvement and fatigue as common symptoms.All patients fulfilled the current diagnostic criteria of both,AIH and SLE.Remission of acute hepatitis was achieved in all cases after the initiation of immunosuppressive therapy.In addition to this case study a literature review was conducted.
文摘BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Super-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic HBV.CASE SUMMARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute hepatitis.Although the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was unclear.Acute HAV super-infection was diagnosed by positive serological and polymerase chain reaction analysis.Following acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were observed.CONCLUSION This case illustrates the importance of carefully checking the vaccination status.In our patient,unspecific immunological responses to HAV led to functional cure of HBV.
