Case Report
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2005; 11(24): 3791-3793
Published online Jun 28, 2005. doi: 10.3748/wjg.v11.i24.3791
Prolonged acute hepatitis A mimicking autoimmune hepatitis
Rintaro Mikata, Osamu Yokosuka, Fumio Imazeki, Kenichi Fukai, Tatsuo Kanda, Hiromitsu Saisho
Rintaro Mikata, Osamu Yokosuka, Fumio Imazeki, Kenichi Fukai, Tatsuo Kanda, Hiromitsu Saisho, Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba 260-8670, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Osamu Yokosuka, MD, Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo Ward, Chiba 260-8670, Japan. yokosuka@med.m-chiba-u.ac.jp
Telephone: +81-43-2262083 Fax: +81-43-2262088
Received: September 6, 2004
Revised: September 7, 2004
Accepted: September 20, 2004
Published online: June 28, 2005
Abstract

AIM: We report a case with a prolonged course of hepatitis A, with alanine aminotransferase (ALT) higher than 500 IU/L for more than 2 mo.

METHODS: A middle-aged woman had an elevated IgG level of more than 2000 mg/dL, positive anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.

RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained.

CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCA proved to be effective.

Keywords: Prolonged; IgG; Hepatitis A; Autoimmune hepatitis