Autoimmune hepatitis with subacute liver failure as the initial manifestation:A case report
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摘要: <正>1病例资料患者男性,76岁,退休,病程9个月,反复乏力、纳差、尿黄,先后入住本院3次。患者首次住院于2017年2月8日主诉"乏力、纳差、尿黄10余天",无畏寒、发热,无鼻衄及牙龈出血,无恶心、呕吐、腹痛、腹泻。既往史、个人史无特殊。查体:皮肤、巩膜黄染,未见其他阳性体征。肝功能:TBil 218. 9μmol/L,DBil 187. 6μmol/L,ALT 496 U/L,AST 723 U/L,GGT 268 U/L;
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Key words:
- hepatitis,autoimmune /
- liver failure /
- herpesvirus 4,human
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[1] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Infectious Diseases,Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. J Clin Hepatol,2016,32(1):9-22.(in Chinese)中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.自身免疫性肝炎诊断和治疗共识(2015)[J].临床肝胆病杂志,2016,32(1):9-22. [2] ZHU B,YOU SL,WAN ZH,et al. Clinical characteristics and corticosteroid therapy in patients with autoimmune-hepatitisinduced liver failure[J]. World J Gastroenterol,2014,20(23):7473-7479. [3] ANAND L,CHOUDHURY A,BIHARI C,et al. Flare of autoimmune hepatitis causing acute on chronic liver failure(ACLF):Diagnosis and response to corticosteroid therapy[J]. Hepatology,2018.[Epub ahead of print] [4] PORTA G,CARVALHO E,SANTOS JL,et al. Autoimmune hepatitis in 828 Brazilian children and adolescents:Clinical and laboratory findings,histological profile,treatments,and outcomes[J]. J Pediatr(Rio J),2018.[Epub ahead of print] [5] YOU S,RONG Y,ZHU B,et al. Changing etiology of liver failure in 3,916 patients from northern China:A 10-year survey[J]. Hepatol Int,2013,7(2):714-720. [6] LOHSE AW,MIELI VERGANI G. Autoimmune hepatitis[J]. J Hepatol,2011,55(1):171-182. [7] GAO XQ,ZHAO YX,REN Q,et al. Research advances in drug-induced autoimmune hepatitis[J]. J Clin Hepatol,2017,33(11):2222-2225.(in Chinese)高晓琴,赵永勋,任茜,等.药物诱导的自身免疫性肝炎的研究进展[J].临床肝胆病杂志,2017,33(11):2222-2225. [8] van GEMEREN MA,van WIJNGAARDEN P,DOUKAS M,et al. Vaccine-related autoimmune hepatitis:The same disease as idiopathic autoimmune hepatitis? Two clinical reports and review[J]. Scand J Gastroenterol,2017,52(1):18-22. [9] AMDTZ K,HIRSCHFIELD GM. The pathogenesis of autoimmune liver disease[J]. Dig Dis,2016,34(4):327-333. [10] RIGOPOULOU EI,SMYK DS,MATTHEWS CE,et al. Epstein-barr virus as a trigger of autoimmune liver diseases[J]. Adv Virol,2012,2012:987471. [11] EDER M,STRASSL R,BEINHARDT S,et al. High seroprevalence of anti-hepatitis E antibodies in Austrian patients with autoimmune hepatitis[J]. Liver Int,2019,39(4):640-645. [12] Infectious Medicine Branch of Chinese Medical Association.Clinical guidelines of hepatitis E[J]. Chin J Clin Infect Dis,2009,2(5):260-263.(in Chinese)中国医师协会感染科医师分会.戊型病毒性肝炎诊疗规范[J].中华临床感染病杂志,2009,2(5):260-263. [13] DUNMIRE SK,HOGQUIST KA,BALFOUR HH. Infectious mono-nucleosis[J]. Curr Top Microbiol Immunol,2015,390(Pt 1):211-240. [14] TIAN QH,ZHU SX. Research advances in Epstein-Barr virus infection and related common diseases in children[J]. Int J Virol,2017,24(1):69-72.(in Chinese)田巧焕,朱淑霞.儿童EB病毒感染及其相关常见疾病研究进展[J].国际病毒学杂志,2017,24(1):69-72. [15] ZHANG H,LI SJ,YUAN YH,et al. The correlation of the liver damage induced by Epstein-Barr virus infection with peripheral blood lymphocyte subsets[J]. J Clin Pediatr,2013,31(3):233-235.(in Chinese)张慧,李双杰,袁远宏,等. EB病毒感染肝脏损伤与外周血淋巴细胞亚群相关性[J].临床儿科杂志,2013,31(3):233-235. [16] BOGDANOS DP,OKAMOTO M,MA Y,et al. Virus/self double reactivity characterises the humoral immune response in autoimmune hepatitis[J]. J Hepatol,2000,32:article 45. [17] VERGANI D,MIELI-VERGANI G. Immunology of Autoimmune hepatitis[J]. Curr Opin Gastroenterol,2001,17(6):562-567. [18] CHEN RL,WANG QX,MA X. Research advances in precision medicine for autoimmune hepatitis[J]. Int J Dig Dis,2019,39(2):77-80.(in Chinese)陈瑞玲,王绮夏,马雄.自身免疫性肝炎精准医学的研究进展[J].国际消化病杂志,2019,39(2):77-80.
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