Fatma Saïd, Ines Naceur, Maysam Jridi, Tayssir Ben Achour, Monia Smiti
Department of Internal Medicine, University Hospital La Rabta, Tunis, Tunisia.
Department of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Hepatol Forum. 2025 Feb 21;6(3):116-117. doi: 10.14744/hf.2024.2024.0032. eCollection 2025.
The association of dermatomyositis (DM) and autoimmune hepatitis (AIH) is rare and presents a diagnostic and therapeutic challenge. We describe the case of a 36-year-old man with DM diagnosed in 2012 and treated with corticosteroid and methotrexate. The patient achieved total remission 18 months later. In 2022, an AIH was diagnosed (cytolysis, cholestasis, anti-LC1, and anti-SLA antibodies) while DM was in remission. Liver function normalized after two months of treatment with mycophenolate mofetil and corticosteroids. Liver damage in systemic autoimmune diseases can result from viral, iatrogenic, or autoimmune processes. The association between DM and AIH is exceptional and has only been documented in one previous observation. Autoantibodies are essential for diagnosing and managing patients with inflammatory myopathy and AIH. In conclusion, this exceptional association of AIH and DM raises many questions regarding the presence of etiopathogenic links, such as genetic predisposition, autoimmunity disorders, viral infection triggers, or simply a happenstance.
皮肌炎（DM）与自身免疫性肝炎（AIH）的关联较为罕见，在诊断和治疗方面都具有挑战性。我们描述了一名36岁男性的病例，该患者于2012年被诊断为皮肌炎，并接受了皮质类固醇和甲氨蝶呤治疗。18个月后患者实现完全缓解。2022年，在皮肌炎缓解期诊断出自身免疫性肝炎（伴有细胞溶解、胆汁淤积、抗-LC1和抗-SLA抗体）。使用霉酚酸酯和皮质类固醇治疗两个月后肝功能恢复正常。系统性自身免疫性疾病中的肝损伤可能由病毒、医源性或自身免疫过程引起。皮肌炎与自身免疫性肝炎的关联极为罕见，此前仅有一例相关报道。自身抗体对于诊断和管理炎性肌病及自身免疫性肝炎患者至关重要。总之，这种皮肌炎与自身免疫性肝炎的罕见关联引发了许多关于病因学联系的问题，如遗传易感性、自身免疫性疾病、病毒感染触发因素，或者仅仅是一种偶然情况。
