Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Thessaly, Greece
Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Thessaly, Greece.
BMJ Case Rep. 2020 Dec 21;13(12):e238400. doi: 10.1136/bcr-2020-238400.
Non-alcoholic fatty liver disease (NAFLD) is nowadays the most common liver disease worldwide. Autoimmune hepatitis (AIH) is a relatively rare disease of the liver characterised by female predominance, circulating autoantibodies, polyclonal hypergammaglobulinaemia, interface hepatitis on histology and favourable response to immunosuppression. The possibility of an additional AIH diagnosis in patients with NAFLD (NAFLD/AIH concurrence) or the presence of AIH alone instead of a supposed NAFLD diagnosis represents a challenge for clinicians. We report herein two adult patients (a 33-year-old woman and a 59-year-old man) with a previous NAFLD diagnosis who proved finally to suffer from AIH alone. These two representative cases indicate how difficult and complicated could be sometimes the diagnosis of patients with AIH highlighting the range of disease manifestations and severity while they also underline that although NAFLD is by far the most frequent chronic liver disease this could not be always the case.
非酒精性脂肪性肝病（NAFLD）是目前全球最常见的肝脏疾病。自身免疫性肝炎（AIH）是一种相对罕见的肝脏疾病，其特征为女性多发、循环自身抗体、多克隆高丙种球蛋白血症、组织学上的界面肝炎和对免疫抑制的良好反应。在患有 NAFLD 的患者中（NAFLD/AIH 并存）或存在单独的 AIH 而不是假定的 NAFLD 诊断的情况下，存在另外诊断 AIH 的可能性，这对临床医生来说是一个挑战。我们在此报告两例成年患者（一名 33 岁女性和一名 59 岁男性），他们之前被诊断为 NAFLD，但最终被证实患有单独的 AIH。这两个具有代表性的病例表明，有时诊断 AIH 患者可能会非常困难和复杂，突出了疾病表现和严重程度的范围，同时也强调了尽管 NAFLD 是迄今为止最常见的慢性肝病，但情况并非总是如此。
