Saini Vandana, Gupta Mamta, Mishra S K
J Indian Med Assoc. 2013 May;111(5):341-2.
Auto-immune hepatitis first presenting in the early postpartum period is rare. Immunosuppressive effects of pregnancy result in delayed manifestation of auto-immune hepatitis, and in established cases, the spontaneous improvements are there. Auto-immune hepatitis should be considered in the differential diagnosis of liver dysfunction first presenting in the early postpartum period. A case of postpartum hepatitis of auto-immune aetiology is being presented here. It is disease of unknown aetiology, characterised by inflammation of liver (as evidenced by raised serum transaminases, presence of interface hepatitis on histological examination), hypergammaglobulinaemia (> 1.5 times normal), presence of auto-antibodies [(antinuclear antibodies (ANA)], smooth muscle antibody (SMA) and antibody to liver-kidney microsome type 1 (LKM1) in the absence of viral markers ie, hepatitis B (HBsAg) and C (AntiHCV) and excellent response to corticosteroid therapy.
首次出现在产后早期的自身免疫性肝炎很罕见。妊娠的免疫抑制作用导致自身免疫性肝炎的表现延迟，在确诊病例中，也会有自发改善的情况。对于首次出现在产后早期的肝功能障碍进行鉴别诊断时应考虑自身免疫性肝炎。本文介绍了一例自身免疫病因的产后肝炎病例。这是一种病因不明的疾病，其特征为肝脏炎症（血清转氨酶升高、组织学检查显示界面性肝炎可证实）、高球蛋白血症（>正常水平1.5倍）、存在自身抗体[抗核抗体（ANA）]、平滑肌抗体（SMA）以及1型肝肾微粒体抗体（LKM1），且不存在病毒标志物，即乙型肝炎（HBsAg）和丙型肝炎（抗HCV），并且对皮质类固醇治疗反应良好。
