Клинический случай аутоиммунного гепатита 1 типа у ребенка 10 лет

Abstract

Aim. To demonstrate a clinical case of autoimmune hepatitis type 1 in a patient aged 10 years. Key points. Certain infections can cause frequently asymptomatic and self-limited hepatitis, while others may result to severe acute hepatitis and/or act as a trigger for autoimmune hepatitis in young children. We present the case of a previously healthy 10-year-old girl with a syndrome of cytolysis and cholestasis who had elevated serum transaminases, Epstein — Barr virus (EBV) serology compatible with recent EBV infection, and positive anti-smooth muscle antibody characteristic of onset autoimmune hepatitis type 1. Liver biopsy was also typical of autoimmune hepatitis as attested by the presence of portal inflammation and interface hepatitis. Persistent EBV-related hepatitis was excluded by negative serum EBV-PCR. Conclusion. The presented clinical case suggests that in children with cholestatic hepatitis, positive EBV serology cannot exclude the presence of other causes of liver disease. In this context, autoimmune hepatitis should be considered as an alternate diagnosis, particularly when there is specific liver-related autoantibody detection. In such conditions, a liver biopsy seems mandatory to achieve a correct and on-time diagnosis of a poor prognostic disease such as autoimmune hepatitis. Keywords: autoimmune hepatitis, Epstein — Barr virus, liver transaminase elevation, anti-smooth muscle antibody