Abstract
Here, a case of autoimmune hepatitis in 34 yrs old lady has been described. She presented with prolonged jaundice, amenorrhea, arthritis and lactation. In laboratory examination, her aminotransferases, alkaline phosphatase and all immunoglobulins were raised. Her serum was positive for antinuclear antibody, anti SLA antibody and antibody to F-actin. Other autoantibodies like anti ds DNA, anti SSA, anti SSB, anti Scl 70, anti Jo-1, anti-centromere and anti-cardiolipinAb were negative. There were no clinical features of any other autoimmune disease. On MRI examination, microadenoma of pituitary gland was detected and her serum prolactin & T4 level were also high. She was finally diagnosed as a case of AIH with pituitary microadenomaand anti SLA Ab, which is an uncommon entity.She was kept on steroid and Bromocriptine, but follow up could not be done. This case suggests that AutoImmune Hepatitis (AIH) with ANA, F-actin and anti SLAAb may present with Prolactinoma.
Highlights
On MRI examination, microadenoma of pituitary gland was detected and her serum prolactin & T4 level were high. She was diagnosed as a case of AIH with pituitary microadenomaand anti soluble liver antigens (SLA) Ab, which is an uncommon entity.She was kept on steroid and Bromocriptine, but follow up could not be done. This case suggests that AutoImmune Hepatitis (AIH) with antinuclear antibody (ANA), F-actin and anti SLAAb may present with Prolactinoma
Prolactin is a hormone synthesized in lactotrope and pituitary tumor present in anterior pituitary
Cells of the immune system synthesizes this hormone and have receptors for cytokines secreted by immune cells like IL-1, IL-6, IFN gamma, TNF, platelet activation factor and substance P participate in the release of prolactin which act on lymphocyte
Summary
AutoImmune Hepatitis (AIH) is an autoimmune disease which constitutes 5% of all chronic liver diseases. On MRI examination, microadenoma of pituitary gland was detected and her serum prolactin & T4 level were high. She was diagnosed as a case of AIH with pituitary microadenomaand anti SLA Ab, which is an uncommon entity.She was kept on steroid and Bromocriptine, but follow up could not be done. This case suggests that AutoImmune Hepatitis (AIH) with ANA, F-actin and anti SLAAb may present with Prolactinoma.
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