Shibata M, Morizane T, Tanaka A, Onozuka Y, Uchida T, Gershwin M E, Mitamura K
Second Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.
J Gastroenterol Hepatol. 2001 Jul;16(7):830-5. doi: 10.1046/j.1440-1746.2001.02413.x.
We report here a patient with chronic active hepatitis who had no markers for hepatitis viruses and no hyper-gamma-globulinemia, but had high titers of antimitochondrial antibody. Serum levels of alkaline phosphatase were normal, and antinuclear antibody, antismooth muscle antibody, and antiliver kidney microsome antibody tested negative. The titers of antimitochondrial antibody exceeded 1:640, and the positivity for anti-M2 was ascertained by using both ELISA and immunoblot with beef-heart mitochondria and a recombinant pyruvate dehydrogenase E2 subunit as antigens. This patient responded to ursodeoxycholic acid (UDCA) therapy in the beginning, but her hepatitis flared up during UDCA therapy. In contrast, she responded completely to corticosteroid therapy. The clinical course and histological findings of this patient strongly suggest that this patient has autoimmune hepatitis.
我们在此报告一名慢性活动性肝炎患者，其无肝炎病毒标志物，无高γ球蛋白血症，但抗线粒体抗体滴度很高。血清碱性磷酸酶水平正常，抗核抗体、抗平滑肌抗体及抗肝肾微粒体抗体检测均为阴性。抗线粒体抗体滴度超过1:640，采用酶联免疫吸附测定（ELISA）以及以牛心线粒体和重组丙酮酸脱氢酶E2亚基作为抗原的免疫印迹法确定抗-M2呈阳性。该患者起初对熊去氧胆酸（UDCA）治疗有反应，但在UDCA治疗期间肝炎复发。相比之下，她对皮质类固醇治疗完全有反应。该患者的临床病程和组织学检查结果强烈提示其患有自身免疫性肝炎。
