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CD8-positive T cell-induced liver damage was found in a patient with polymyositis
Atsushi Takahashi1, Isao Takeda, Takashi Kanno
1Divisions of Rheumatology, Ohta Nishinouchi Hospital, Koriyama.
Abstract:
We describe a case of polymyositis (PM) with liver injury that occurred in a patient with rheumatoid arthritis (RA). A 74-year-old woman who had a 12-year history of RA was admitted to our hospital because of muscle weakness and liver dysfunction. CD8-positive T cell infiltration was found in the interstitium of both the liver and muscle. In addition to the administration of a large amount of prednisolone (PSL), high-dose intravenous immunoglobulin (IVIG) successfully improved myositis and hepatitis. Our case indicates the pathogenic potential of CD8-positive T cells in PM-associated liver injury.
Insights
This case study highlights CD8-positive T cells in polymyositis (PM)-associated liver injury in a rheumatoid arthritis (RA) patient. Treatment with prednisolone and intravenous immunoglobulin effectively resolved both myositis and hepatitis.
Area of Science:
- Immunology
- Hepatology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting joints.
- Polymyositis (PM) is an idiopathic inflammatory myopathy characterized by muscle inflammation.
- Liver injury can be a rare complication in patients with autoimmune diseases.
Observation:
- A 74-year-old female patient with a 12-year history of RA presented with muscle weakness and liver dysfunction.
- Liver and muscle biopsies revealed interstitial infiltration by CD8-positive T cells.
- The patient exhibited symptoms consistent with polymyositis and hepatitis.
Findings:
- CD8-positive T cell infiltration was identified as a key pathological feature in both muscle and liver tissues.
- Treatment with high-dose prednisolone (PSL) and intravenous immunoglobulin (IVIG) led to significant improvement in both myositis and hepatitis.
- The combined therapeutic approach demonstrated efficacy in managing this complex presentation.
Implications:
- This case suggests a significant pathogenic role for CD8-positive T cells in polymyositis-associated liver injury.
- It underscores the importance of considering immune-mediated mechanisms in liver dysfunction among RA patients.
- The successful treatment highlights the potential benefit of immunosuppressive therapies like IVIG in managing such cases.
