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Diffuse gallbladder wall thickening in autoimmune hepatitis: an unusual presentation.
Chitchai Rattananukrom1,2, Napat Angkathunyakul3,4, Abhasnee Sobhonslidsuk2
1Department of Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand Chitra@kku.ac.th.
BMJ Case Reports
|June 1, 2021
Summary
Autoimmune hepatitis can cause gallbladder thickening, presenting as jaundice and pain. Prompt steroid and azathioprine treatment led to symptom resolution and normalized liver function tests.
Area of Science:
- Hepatology
- Immunology
Background:
- Autoimmune hepatitis (AIH) is a chronic liver disease characterized by autoimmune-mediated liver inflammation.
- AIH diagnosis typically relies on serological markers, histology, and exclusion of other liver diseases.
Observation:
- A 63-year-old woman presented with jaundice, epigastric pain, and elevated liver enzymes indicating hepatocellular injury.
- Serological tests revealed positive antinuclear and anti-smooth muscle antibodies with elevated IgG.
- Imaging showed liver parenchyma edema and significant gallbladder wall thickening.
Findings:
- Liver biopsy confirmed autoimmune hepatitis with interface hepatitis, plasma cell infiltration, and emperipolesis.
- The patient experienced complete symptom resolution and normalization of liver function tests after treatment with corticosteroids and azathioprine.
- Diffuse gallbladder thickening was observed in this case of acute autoimmune hepatitis.
Implications:
- This case highlights gallbladder wall thickening as a potential, though uncommon, manifestation of acute autoimmune hepatitis.
- Early diagnosis and immunosuppressive therapy are crucial for managing autoimmune hepatitis and preventing complications.
- Further research may elucidate the mechanisms linking autoimmune hepatitis and gallbladder pathology.
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