• Title/Summary/Keyword: Hepatitis, Autoimmune

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Minocycline-Induced Autoimmune Hepatitis: A Rare But Important Cause of Drug-Induced Autoimmune Hepatitis

  • Harmon, Elizabeth G.;McConnie, Randolph;Kesavan, Anil
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.347-350
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    • 2018
  • Drug-induced autoimmune hepatitis (DIAIH) is an increasingly recognized form of drug-induced liver injury that leads to a condition similar to idiopathic autoimmune hepatitis. A number of drugs have been associated with DIAIH, minocycline is one of the most well characterized. Minocycline is a semisynthetic tetracycline antibiotic used in the treatment of acne vulgaris. Minocycline-induced autoimmune hepatitis presents with serologic and histologic features similar to idiopathic autoimmune hepatitis. However, the natural history and outcomes of these two conditions differ significantly. The majority of patients with minocycline-induced autoimmune hepatitis experience complete resolution of symptoms after withdrawal of the medication. Some patients may require a short course of steroids and rarely use of an immunomodulator to achieve resolution of disease. Recurrence of symptoms is rare and typically only occurs with reintroduction of minocycline. It is important for primary care providers to consider minocycline-induced autoimmune hepatitis when liver injury develops during minocycline therapy.

A Case of Chronic Lymphoplasmacellular Osteomyelitis with Autoimmune Hepatitis/Primary Sclerosing Cholangitis Overlap Syndrome in a Child (자가면역간염과 원발성 경화담관염을 가진 중복증후군 소아 환자에서 발생한 형질세포성 골수염 1예)

  • Lee, Ji-Hyuk;Lee, Hyun-Young;Kim, Jin-Kyu;Lee, Jee-Hyun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.91-97
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    • 2007
  • The Overlap syndrome is characterized by a combination of the major hepatobiliary autoimmune diseases such as autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. It is frequently accompanied by inflammatory bowel disease. Chronic lymphoplasmacellular osteomyelitis is characterized by recurrent episodes of bacterial osteomyelitis and is associated with autoimmune diseases (especially inflammatory bowel disease). We report the case of a girl who was diagnosed with ulcerative colitis and autoimmune hepatitis at 4 years of age and with the overlap syndrome with primary sclerosing cholangitis at 6 years. At 9 years, she was diagnosed with chronic lymphoplasmacellular osteomyelitis.

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Anti-nuclear antibody-negative immunoglobulin G4-associated autoimmune hepatitis mimicking lymphoproliferative disorders

  • Kang, Min Kyu;Park, Jung Gil;Choi, Joon Hyuk
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.136-140
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    • 2020
  • Immunoglobulin G4 (IgG4)-associated autoimmune hepatitis (AIH) is a very rare subtype of autoimmune hepatitis and characterized by marked elevated serum IgG and hepatic infiltration of IgG4-expressing plasma cells. Pathologic confirmation of hepatic IgG4-expressing plasma cells is usually required for the final diagnosis of IgG4-associated AIH. Herein, we report the case of a 47-year-old female diagnosed with autoantibody-negative IgG4-associated AIH mimicking lymphoproliferative disorders.

Autoimmune hepatitis and thyroiditis associated with antituberculous medications : A case report (항결핵약으로 유발되고 갑상선염이 동반된 자가면역간염 1례)

  • Yu, Seong Keun;Kim, Sara;Moon, Jin Soo;Kim, Han Seong
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.528-532
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    • 2008
  • Drug-induced toxic hepatitis is a relatively common hepatic disease in children, and it is usually self-limiting upon cessation of the offending drugs. Antituberculous drugs are well known for inducing hepatitis. Some cases of drug-induced hepatitis with autoimmune features have been reported; in these cases, the offending drugs were usually methyldopa, nitrofurantoin, minocycline, and interferon. The authors report the first case in Korea of drug-induced autoimmune hepatitis associated with thyroiditis and multiple autoantibodies that was induced by the antituberculous drugs isoniazid and rifampin.

Visceral Leishmaniasis Mimicking Autoimmune Hepatitis, Primary Biliary Cirrhosis, and Systemic Lupus Erythematosus Overlap

  • Tunccan, Ozlem Guzel;Tufan, Abdurrahman;Telli, Gulcin;Akyurek, Nalan;Pamukcuoglu, Merve;Yilmaz, Guldal;Hizel, Kenan
    • Parasites, Hosts and Diseases
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    • v.50 no.2
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    • pp.133-136
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    • 2012
  • Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In addition to typical clinical findings as fever, hepatosplenomegaly, and cachexia, VL is associated with autoimmune phenomena. To date, VL mimicking or exacerbating various autoimmune diseases have been described, including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune hepatitis (AIH). Herein, we presented a patient with VL who had overlapping clinical features with SLE, AIH, as well as antimitochondrial antibody (AMA-M2) positive primary biliary cirrhosis.

Clinical Characteristics, Histology and Prognosis of Autoimmune Hepatitis in Korean Children (소아 자가면역성 간염: 임상적 특성, 조직 소견 및 예후)

  • Chung, Dae-Lim;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Park, Sung Hye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.186-196
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    • 2004
  • Purpose: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. Methods: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. Results: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. Conclusion: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.

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Successful Treatment of a Korean Infant with Giant Cell Hepatitis with Autoimmune Hemolytic Anemia Using Rituximab

  • Kim, Young Ho;Kim, Ju Whi;Lee, Eun Joo;Kang, Gyeong Hoon;Kang, Hyoung Jin;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.180-187
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    • 2020
  • Giant cell hepatitis with autoimmune hemolytic anemia (AHA) is a rare disease of infancy characterized by the presence of both Coombs-positive hemolytic anemia and progressive liver disease with giant cell transformation of hepatocytes. Here, we report a case involving a seven-month-old male infant who presented with AHA followed by cholestatic hepatitis. The clinical features included jaundice, pallor, and red urine. Physical examination showed generalized icterus and splenomegaly. The laboratory findings suggested warm-type AHA with cholestatic hepatitis. Liver biopsy revealed giant cell transformation of hepatocytes and moderate lobular inflammation. The patient was successfully treated with four doses of rituximab. Early relapse of hemolytic anemia and hepatitis was observed, which prompted the use of an additional salvage dose of rituximab. He is currently in clinical remission.

A case of chronic autoimmnune hepatitis, Jaundice by integration treatment of korean traditional medicine and western medicine (한양방결합요법에 의한 자가면역성 만성 활동성 간염, 고빌리루빈혈증 1례 보고)

  • Yang, Ju-No;Choi, Seung-Hoon;Ahn, Kyoo-Seok;Shim, Bum-Sang
    • Journal of Korean Traditional Oncology
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    • v.10 no.1
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    • pp.99-106
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    • 2005
  • Objective: This study was done to treat autoimmune chronic active heaptitis Jaundice patient. Method: I analyzed the medical records of a case of autoimmune chronic active hepatitis Jaundice who had been treated with korean traditional medicines from 1 December 2003 through 6 July 2004. Result: Following the korean traditional medicine method, during taking medicine the hematological markers (aspartate transferase(AST), alanine aminotranferase(ALT), Total bilirubin(T.bili)) were effectively controled.

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A Case of rule-out Autoimmune Hepatitis Using Injinoryung-san gagam (인진오령산가감이 유효했던 자가면역성 간염의증 환자 1례)

  • Lee, Yu Jin;Kim, Soo-hyun;Yang, Jung Yun;Cho, Ki-Ho;Moon, Sang-Kwan;Jung, Woo-Sang;Kwon, Seungwon;Jin, Chul
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.20 no.1
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    • pp.25-32
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    • 2019
  • ■ Objectives In this case report, we address a case of a 83-year-old female patient diagnosed with suspicious autoimmune hepatitis. ■ Methods A patient was treated with herbal medication, Injinoryung-san gagam. We evaluated the improvements of symptoms by AST, ALT, GGT, ALP and total score of Fatigue Severity Scale(FSS). ■ Results After 4 weeks of taking Injinoryung-san gagam, there were decrease in abnormal liver enzyme levels with improvement of the patient's fatigue. ■ Conclusion This study suggested that Injinoryung-san gagam might be effective in autoimmune hepatitis patient's liver enzyme levels and fatigue recovery.

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Autoimmune hepatitis-primary sclerosing cholangitis overlap syndrome in a 10-year-old girl with ulcerative colitis (궤양성 대장염에 동반된 자가면역성 간염-원발성 경화성 담관염의 중복 증후군 1예)

  • Hong, Jeana;Song, Mi Kyoung;Ko, Jae Sung;Kang, Gyeong Hoon;Kim, Woo Sun;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.504-507
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    • 2009
  • Autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and primary biliary cirrhosis (PBC) are chronic autoimmune liver diseases. Overlap syndrome is defined as a condition in which the clinical, biochemical, and histological features of these autoimmune diseases are overlapped. Thus, it is difficult to appreciate overlap syndrome as an actual diagnostic entity. Only a few cases of the overlap syndrome of AIH and PSC have been reported, especially in children. Moreover, PSC is known to be the most frequent liver disorder associated with inflammatory bowel diseases such as ulcerative colitis. We report one case of AIH-PSC overlap syndrome in a child who was diagnosed as having ulcerative colitis.