Crapper R M, Bhathal P S, Mackay I R, Frazer I H
Digestion. 1986;34(3):216-25. doi: 10.1159/000199332.
A previously well young woman presented with an acute hepatitis resembling viral hepatitis and a liver biopsy after 5 weeks showed features of acute hepatitis. Infection with identifiable viruses or other organisms known to cause hepatitis was excluded. Evidence for autoimmune chronic active hepatitis ab initio included prolonged fever, lymphadenopathy, urticaria, arthralgia, Coombs' positive hemolytic anemia, lymphopenia, a markedly raised level of immunoglobulin G and a positive antinuclear antibody test. Liver biopsies after 4 and 28 months showed typical histologic features of autoimmune chronic active hepatitis and the subsequent clinical course was typical, being marked by relapses and remissions responsive to prednisolone. Thus, described here is a woman in whom an acute onset of autoimmune chronic active hepatitis was clinically and histologically identified.
一名既往健康的年轻女性出现类似病毒性肝炎的急性肝炎，5周后进行的肝脏活检显示为急性肝炎特征。已排除由已知可引起肝炎的可识别病毒或其他生物体感染。从一开始就存在自身免疫性慢性活动性肝炎的证据包括持续发热、淋巴结病、荨麻疹、关节痛、库姆斯试验阳性的溶血性贫血、淋巴细胞减少、免疫球蛋白G水平显著升高以及抗核抗体试验阳性。4个月和28个月后的肝脏活检显示出自身免疫性慢性活动性肝炎的典型组织学特征，随后的临床病程也很典型，以对泼尼松龙有反应的复发和缓解为特征。因此，本文描述的是一名临床上和组织学上均确诊为自身免疫性慢性活动性肝炎急性起病的女性。
