Tajiri Kazuto, Shimizu Yukihiro, Tokimitsu Yoshiharu, Tsuneyama Koichi, Sugiyama Toshiro
The Third Department of Internal Medicine, University of Toyama, Japan.
Intern Med. 2012;51(16):2141-4. doi: 10.2169/internalmedicine.51.7870. Epub 2012 Aug 15.
Here, we report an elderly man with acute-on-chronic hepatitis accompanied by massive ascites. He showed elevated serum transaminase and anti-nuclear antibody (ANA) levels. Liver biopsy showed diffuse multinucleated giant hepatocytes with interface hepatitis, and he recovered with administration of azathioprine in addition to corticosteroids. Follow-up liver biopsy after recovery showed improvement of hepatic inflammation and reduction of giant hepatocyte formation. The patient is receiving low-dose corticosteroid maintenance therapy and he has remained healthy for 8 years to date. Active immunosuppressive treatment may be beneficial in patients with adult syncitial giant cell hepatitis (AGCH).
在此，我们报告一名患有慢性肝炎急性发作并伴有大量腹水的老年男性。他的血清转氨酶和抗核抗体（ANA）水平升高。肝活检显示弥漫性多核巨肝细胞伴界面性肝炎，在使用皮质类固醇的基础上加用硫唑嘌呤后他康复了。康复后的随访肝活检显示肝脏炎症改善，巨肝细胞形成减少。该患者正在接受低剂量皮质类固醇维持治疗，迄今为止已保持健康8年。积极的免疫抑制治疗可能对成人合胞体巨细胞肝炎（AGCH）患者有益。
