Lupus-like autoimmune acute hepatitis: report of one case

In this article, a girl with an especially severe form of autoimmune acute hepatitis was successfully treated with immunosuppressive medication. This 11 year-old girl was hospitalized with the chief complaint of persistent jaundice for three months. The pathohistology of liver biopsy was chiefly composed of massive necrosis and heavy lymphoid infiltration. With the clinical findings of pericardial effusion, arthritis, positive ANA, and positive anti-dsDNA, she initially was mistaken for a case of unusual SLE complicated with hepatic involvement. Differentiating the autoimmune hepatitis from the hepatic involvement of SLE for this case is illustrated by a review of the pertinent literature and our experiences with SLE. The characteristic features of autoimmune hepatitis, the relatively low titer of anti-dsDNA, and the inherent low level of C4 finally led to the conclusion that the cause for her liver disease was in favor of autoimmune hepatitis.