Hanai Tatsunori, Naiki Takafumi, Takamatsu Manabu, Imai Kenji, Kitagawa Junichi, Suetsugu Atsushi, Takai Koji, Shiraki Makoto, Shimizu Masahito, Hirose Yoshinobu, Tsurumi Hisashi, Moriwaki Hisataka
Department of Gastroenterology, Gifu University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2013 Oct;110(10):1814-22.
A 61-year-old female was admitted to our hospital with severe jaundice and anemia. She was diagnosed with severe acute hepatitis secondary to autoimmune hepatitis (AIH) on the basis of positive anti-nuclear antibody titers, high serum IgG levels, and liver biopsy. Autoimmune hemolytic anemia (AIHA) was diagnosed because of the presence of reticulocytosis, decreased haptoglobin, positive direct Coombs test, and erythroid hyperplasia in the bone marrow. Although AIH occurs in association with various immunological disorders, an association with AIHA is rarely reported. We report a rare case of severe AIH associated with AIHA.
一名61岁女性因严重黄疸和贫血入院。基于抗核抗体滴度阳性、血清IgG水平升高及肝活检,她被诊断为继发于自身免疫性肝炎(AIH)的严重急性肝炎。由于存在网织红细胞增多、触珠蛋白降低、直接抗人球蛋白试验阳性及骨髓红系增生,诊断为自身免疫性溶血性贫血(AIHA)。尽管AIH与多种免疫性疾病相关,但与AIHA相关的报道很少。我们报告一例与AIHA相关的严重AIH罕见病例。