Autoimmune hepatitis--a diagnostic challenge

Autoimmune hepatitis is a type of chronic hepatitis characterized by hypergammaglobulinemia, hypertransaminasemia, presence of autoantibodies, and active necroinflammatory process in the liver revealed by histology. Its onset is usually acute and has a bad prognosis. Tissue antibodies are found in large proportions of patients. Women outnumber men in a 2-3:1 ratio, and it is mostly young women who are affected. Ten percent of all affected have severe disease characterized by elevations of serum aminotransferase levels greater than five-fold, along with a two-fold elevation of gamma globulin or a 10-fold elevation of serum aminotransferase levels alone. We present an unusual case of this disorder in a 60-year-old male patient manifesting its severe form.