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Immunoglobulin G4-Hepatopathy with Acute Hepatitis-Like Onset and Marked Centrilobular Necrosis: Clinicopathologically Unique Pattern of Hepatic Injury Related to Immunoglobulin G4-Related Disease
- Source :
- Case Reports in Gastroenterology, Case Reports in Gastroenterology, Vol 15, Iss 2, Pp 720-728 (2021)
- Publication Year :
- 2021
- Publisher :
- S. Karger AG, 2021.
-
Abstract
- A 69-year-old man presented with jaundice and appetite loss. Blood analyses showed elevated aminotransferase levels, hyperbilirubinemia, positivity for antinuclear antibody, elevated immunoglobulin (Ig) G4 levels, and negativity for hepatitis virus markers. Additionally, computed tomography revealed a focal enlargement of the pancreatic body and enhancement of the peripheral bile ducts. Liver biopsy showed interface hepatitis, supporting a clinical diagnosis of autoimmune hepatitis (AIH). Immunohistochemistry revealed that IgG4-bearing plasma cells accounted for more than 60% of the IgG-bearing plasma cells in the portal area. Then, we started oral prednisolone therapy. After tapering, serum transaminase levels became elevated again, and we had to adjust the dose. Azathioprine maintenance therapy was necessary to prevent relapse. We herein report a case of IgG4-hepatopathy with a clinical course similar to that of AIH with acute onset.
- Subjects :
- medicine.medical_specialty
Anti-nuclear antibody
Single Case
Azathioprine
Autoimmune hepatitis
RC799-869
Gastroenterology
Maintenance therapy
Internal medicine
medicine
Acute hepatitis
medicine.diagnostic_test
biology
business.industry
Centrilobular necrosis
Jaundice
Diseases of the digestive system. Gastroenterology
medicine.disease
Liver biopsy
biology.protein
medicine.symptom
Antibody
business
Immunoglobulin G4-hepatopathy
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 16620631
- Volume :
- 15
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Case Reports in Gastroenterology
- Accession number :
- edsair.doi.dedup.....61ff6b882b710b2213ef954cbf7fbeea