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[A case of type B chronic hepatitis showing rapid progression to liver cirrhosis with prolonged positive IgM
K Tsuji1, C Hasebe, Y Murazumi
1Third Department of Medicine, Asahikawa Medical College, Japan.
Insights
This case study details a rare instance of chronic hepatitis B with persistently high IgM anti-HBc levels, leading to rapid liver cirrhosis. The findings highlight a potential link between prolonged IgM anti-HBc and disease progression in hepatitis B patients.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B (CHB) is a significant global health concern.
- Persistent infection with the hepatitis B virus (HBV) can lead to severe liver disease, including cirrhosis and hepatocellular carcinoma.
- Immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) is typically a marker of acute HBV infection, but its prolonged presence is unusual.
Abstract:
We reported a case of type B chronic hepatitis with high titer of IgM anti-HBc continuously, which progressed to liver cirrhosis rapidly. The patient was a 37-years-old man, and was diagnosed as chronic type B hepatitis with severe activity by laparoscopy and liver biopsy. The titer of IgM anti-HBc persisted high level for more than 2 years. Then the second liver biopsy showed the progression to liver cirrhosis within only about 2 years. It is a very rare case to prolong positive IgM anti-HBc for such a long time. Anti-HBc production of PBMC was enhanced remarkably in this case. We considered that HBc antigens released into serum from hepatocytes with severe exacerbations had enhanced the anti-HBc producing activity of B lymphocytes. And the rapid progression in this case would be due to the episodes of severe exacerbations.