Memon Mohammad B, Duplan Patrick, Iska Sindu, Slabaugh Erik, Patel JigneshKumar, Thakore Shaival
Graduate Medical Education, HCA Florida Bayonet Point Hospital, Hudson, USA.
Internal Medicine, HCA Florida Bayonet Point Hospital, Hudson, USA.
Cureus. 2022 Jul 15;14(7):e26884. doi: 10.7759/cureus.26884. eCollection 2022 Jul.
Autoimmune hepatitis (AIH) is a progressive inflammatory condition hypothesized to be a T-lymphocyte (T-cell)-mediated immune response that commonly affects females more than males. Given its proposed mechanism associated with immune response, it is more likely to present with other autoimmune conditions, particularly autoimmune disorders associated with the thyroid. AIH can be difficult to diagnose as it is a diagnosis of exclusion. AIH lacks validated algorithms for proper diagnosis and can seldom present with negative antibodies. If not fully worked up, AIH may progress to cirrhosis and even increase the risk of malignancy. Therefore, a liver biopsy is a crucial step in the workup for AIH. We report a rare case of acute severe AIH associated with negative antibodies and undiagnosed Graves' disease.
自身免疫性肝炎（AIH）是一种进行性炎症性疾病，据推测是由T淋巴细胞（T细胞）介导的免疫反应，通常女性比男性更易受影响。鉴于其与免疫反应相关的假定机制，它更有可能与其他自身免疫性疾病同时出现，尤其是与甲状腺相关的自身免疫性疾病。AIH可能难以诊断，因为它是一种排除性诊断。AIH缺乏用于正确诊断的有效算法，并且很少出现抗体阴性的情况。如果没有进行全面检查，AIH可能会进展为肝硬化，甚至增加患恶性肿瘤的风险。因此，肝活检是AIH检查过程中的关键步骤。我们报告了一例罕见的急性重症AIH病例，该病例伴有抗体阴性且未诊断出的格雷夫斯病。
