Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 28, 2009; 15(8): 1004-1006
Published online Feb 28, 2009. doi: 10.3748/wjg.15.1004
Severe autoimmune hepatitis triggered by varicella zoster infection
Waleed K Al-Hamoudi
Waleed K Al-Hamoudi, Gastroenterology and Hepatology Unit (59), Department of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia
Author contributions: This article was arranged and written by Al-Hamoudi WK.
Correspondence to: Waleed K Al-Hamoudi, MD, Gastro-enterology and Hepatology Unit (59), Department of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. walhamoudi@gmail.com
Telephone: +966-1-4671215 
Fax: +966-1-4671217
Received: December 8, 2008
Revised: January 19, 2009
Accepted: January 26, 2009
Published online: February 28, 2009
Abstract

Autoimmune hepatitis (AIH) is a chronic disease of unknown etiology that is characterized by the presence of circulatory autoantibodies and inflammatory histological changes in the liver. Although the pathogenesis of AIH is not known, it is thought that, in a genetically predisposed individual, environmental factors such as viruses can trigger the autoimmune process. Herpes simplex virus, Epstein-Barr virus, measles virus, and hepatitis viruses are thought to play a role in the etiology of AIH. Proteins belonging to these viruses may be similar to the amino acid chains of different autoantigens in the liver, this causes immune cross reactions and liver tissue damage. We report a case of severe AIH following varicella zoster infection in a 23-year-old man, and speculate that, based on the molecular mimicry hypothesis, the liver damage was caused by an immune cross reaction to the viral proteins. Varicella-zoster-induced AIH has not been reported previously.

Keywords: Autoimmune liver disease; Varicella zoster virus; Infection