Lee J Y, Chi C S
Department of Pediatrics, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1996 Nov-Dec;37(6):461-5.
In this article, a girl with an especially severe form of autoimmune acute hepatitis was successfully treated with immunosuppressive medication. This 11 year-old girl was hospitalized with the chief complaint of persistent jaundice for three months. The pathohistology of liver biopsy was chiefly composed of massive necrosis and heavy lymphoid infiltration. With the clinical findings of pericardial effusion, arthritis, positive ANA, and positive anti-dsDNA, she initially was mistaken for a case of unusual SLE complicated with hepatic involvement. Differentiating the autoimmune hepatitis from the hepatic involvement of SLE for this case is illustrated by a review of the pertinent literature and our experiences with SLE. The characteristic features of autoimmune hepatitis, the relatively low titer of anti-dsDNA, and the inherent low level of C4 finally led to the conclusion that the cause for her liver disease was in favor of autoimmune hepatitis.
在本文中，一名患有特别严重形式自身免疫性急性肝炎的女孩通过免疫抑制药物治疗成功康复。这名11岁女孩因持续黄疸三个月为主诉入院。肝活检的病理组织学主要表现为大片坏死和大量淋巴细胞浸润。结合心包积液、关节炎、抗核抗体阳性和抗双链DNA抗体阳性的临床表现，她最初被误诊为罕见的系统性红斑狼疮合并肝脏受累病例。通过回顾相关文献以及我们对系统性红斑狼疮的经验，阐述了该病例中自身免疫性肝炎与系统性红斑狼疮肝脏受累的鉴别诊断。自身免疫性肝炎的特征、抗双链DNA相对低滴度以及补体C4固有低水平最终得出结论，她肝病的病因支持自身免疫性肝炎。
