Fulminant hepatic failure in a case of autoimmune hepatitis in hepatitis C during peg-interferon-alpha 2b plus ribavirin treatment

Table 1 Laboratory findings before interferon treatment

WBC	5300 /μL	Total bilirubin	0.6 mg/dL	HCV-Ab	Positive
Hb	11.0 g/dL	Direct bilirubin	0.1 mg/dL	HCV-RNA	4600 kIU/L
Plt	452 × 103 /μL	Total protein	7.7 g/dL	HCV genotype	Ib
PT	101.8%	Albumin	4.2 g/dL	HBs-Ag	Negative
		BUN	16 mg/dL	HBs-Ab	Negative
		Creatinine	0.8 mg/dL	ANA	× 80
AST	39 IU/L	Uric acid	3.4 mg/dL	ASMA	Negative
ALT	47 IU/L	Na	140 mEq/L	AMA	Negative
LDH	176 IU/L	K	4.5 mEq/L	IgG	1635 mg/dL
ALP	278 IU/L	Cl	104 mEq/L	IgA	108 mg/dL
γ-GTP	11 IU/L	Total cholesterol	133 mg/dL	IgM	283 mg/dL
ChE	386 IU/L	Glucose	77 mg/dL	HLA-DR	DR17/DR13
				allele	DRB1*0301/*1302

WBC: white blood cell; Hb: hemoglobin; Plt: platelet; PT: prothrombin time; AST: asparate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehidrogenase; ALP: alkaline phosphatase; γ-GTP: gamma glutamil transpeptidase; ChE: choline esterase; BUN: blood urea nitrogen; HCV: hepatitis C virus; HBs-Ag: hepatitis B virus surface antigen; HBs-Ab: hepatitis B virus surface antibody; ANA: antinuclear antibody; ASMA: anti-smooth muscle antibody; AMA: anti-mitochondrial antibody; Ig: immunoglobulin; HLA: human leukocyte antigen.

Table 2 Laboratory findings at onset of acute liver failure

WBC	5800/μL	BUN	5.0 mg/dL	ANA	× 160
Hb	12.2 g/dL	Creatinine	0.7 mg/dL	ASMA	Negative
Plt	290 × 103 /μL	Uric acid	2.8 mg/dL	LKM-1	Positive
PT	41.4%	Na	138 mEq/L	AMA	Negative
APTT	44.4 sec	K	3.9 mEq/L	IgG	2436mg/dL
		Cl	105 mEq/L	IgA	175 mg/dL
		Total cholesterol	175 mg/dL	IgM	280 mg/dL
AST	311 IU/L	Triglyceride	67 mg/dL
ALT	280 IU/L	Glucose	127 mg/dL
LDH	245 IU/L	CRP	0.2 mg/dL	HCV-RNA	13 kIU/l
ALP	571 IU/L			HBs-Ag	Negative
γ-GTP	108 IU/L	Tyrosin	262 μmol/L	HBs-Ab	Negative
ChE	124 IU/L	BCAA	313 μmol/L	HBc-Ab IgM	Negative
Total bilirubin	5.5 mg/dL			HAV	Negative
Direct bilirubin	3.3 mg/dL	TSH	0.499 μIU/mL	EBV	Negative
Total protein	7.4 g/dL	T3	1.66 pg/mL	HSV	Negative
Albumin	3.1 g/dL	T4	0.55 ng/dL	CMV	Negative

APTT: activated partial thromboplastin time; CRP: C-reactive protein; BCAA: branched-chain amino acid; TSH: thyroid-stimulating hormone; LKM-1: antibody to microsomes type 1; HBc-Ab: hepatitis B virus core antibody; HAV: hepatitis A virus; EBV: Epstein-Barr virus; HSV: herpes simplex virus; CMV: cytomegalovirus.