Al-Fadda M, Zafar M, Ayub A, al-Kahtani K
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
J Clin Gastroenterol. 1994 Dec;19(4):313-7. doi: 10.1097/00004836-199412000-00012.
A 56-year-old Saudi male was admitted with abnormal liver chemistry values and a > 5-month history of lethargy, malaise, anorexia, and jaundice. Extensive investigations did not establish an etiological diagnosis. Liver histology confirmed the clinically apparent aggressive hepatitis with fibrosis but gave no clue to its etiology. The patient was empirically treated with alpha-interferon for presumed non-A, non-B hepatitis, with clinical and biochemical worsening. Interferon was discontinued and the patient was started on immunosuppression. Dramatic clinical and biochemical improvement occurred, with normalization of the liver chemistry within 4 weeks. The patient has been followed-up for 12 months and has not suffered a relapse. This case highlights the etiological heterogeneity of chronic active hepatitis. The entity of autoimmune chronic active hepatitis is unclear, and perhaps it is better defined as steroid-responsive hepatitis. Steroid-responsive hepatitis should always be considered in cases of cryptogenic chronic active hepatitis.
一名56岁的沙特男性因肝功能检查值异常以及长达5个月以上的乏力、不适、厌食和黄疸病史入院。广泛的检查未能确立病因诊断。肝脏组织学证实了临床上明显的侵袭性肝炎伴纤维化，但未提示其病因。该患者因推测为非甲非乙型肝炎而接受α干扰素经验性治疗，结果临床和生化指标恶化。停用干扰素后，患者开始接受免疫抑制治疗。临床和生化指标显著改善，肝功能在4周内恢复正常。该患者已随访12个月，未出现复发。此病例突出了慢性活动性肝炎病因的异质性。自身免疫性慢性活动性肝炎的实体尚不清楚，或许更好地定义为类固醇反应性肝炎。对于原因不明的慢性活动性肝炎病例，应始终考虑类固醇反应性肝炎。
