Autoimmune chronic active hepatitis responsive to immunosuppressive therapy evolving into a typical primary biliary cirrhosis syndrome: a case report

J Hepatol. 1994 Aug;21(2):194-8. doi: 10.1016/s0168-8278(05)80394-0.

Abstract

The evolution from a characteristic picture of autoimmune chronic hepatitis type I to primary biliary cirrhosis is reported in a middle-aged woman. The initial diagnosis of autoimmune chronic liver disease was based on clinical, bio-serological and histological grounds. It was further confirmed by complete remission following immunosuppressive treatment and prompt relapses at the time of therapy withdrawal. After 7 years, the characteristics of liver disease were altered with increased biochemical cholestasis and serum IgM concentrations, positivation of previously negative anti-M2 antimitochondrial antibodies and the appearance of a typical histological picture of stage I primary biliary cirrhosis. We believe that this is the first reported case in which autoimmune chronic hepatitis highly responsive to immunosuppressive therapy has been followed by the development of a characteristic picture of primary biliary cirrhosis.

Publication types

  • Case Reports

MeSH terms

  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / drug therapy*
  • Autoimmune Diseases / pathology
  • Azathioprine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Hepatitis, Chronic / complications*
  • Hepatitis, Chronic / drug therapy*
  • Hepatitis, Chronic / pathology
  • Humans
  • Immunoglobulin M / analysis
  • Immunoglobulin M / blood
  • Immunosuppressive Agents / therapeutic use*
  • Liver Cirrhosis, Biliary / etiology*
  • Liver Cirrhosis, Biliary / pathology
  • Middle Aged
  • Prednisolone / therapeutic use
  • Time Factors

Substances

  • Immunoglobulin M
  • Immunosuppressive Agents
  • Prednisolone
  • Azathioprine