Abstract
Autoimmune hepatitis is often unrecognized and under-diagnosed, especially in our part. Acute on chronic liver failure (ACLF) on the other hand is a newly recognized disease entity describing patients who develop acute liver failure on the background of pre-existing chronic liver disease. Methods: We present an elderly lady who presented to us with history of episodic fever and jaundice over a period of two years. Results: Although initially diagnosed as a case of idiopathic thrombocytopenic pupura (ITP), on further investigation she was finally diagnosed as ACLF (hepatitis B virus induced acute liver failure on autoimmune hepatitis induced cirrhosis of liver).DOI: http://dx.doi.org/10.3329/jom.v14i2.19674 J Medicine 2013, 14(2): 192-194
Highlights
Liver failure can develop either as acute liver failure in the absence of any pre-existing liver disease, an acute deterioration of known or unknown chronic liver disease, the Acute on chronic liver failure (ACLF), or as a chronic decompensation in an end-stage liver disease
Autoimmune hepatitis is a form of chronic liver disease of unknown aetiology with aberrant auto-reactivity and genetic predisposition
We present an elderly lady with ACLF, who was initially diagnosed as a case of idiopathic thrombocytopenic purpura (ITP), but subsequently found to have HBV induced acute liver failure on autoimmune hepatitis induced cirrhosis of liver
Summary
Liver failure can develop either as acute liver failure in the absence of any pre-existing liver disease, an acute deterioration of known or unknown chronic liver disease, the ACLF, or as a chronic decompensation in an end-stage liver disease. Autoimmune hepatitis is a form of chronic liver disease of unknown aetiology with aberrant auto-reactivity and genetic predisposition. We present an elderly lady with ACLF, who was initially diagnosed as a case of idiopathic thrombocytopenic purpura (ITP), but subsequently found to have HBV induced acute liver failure on autoimmune hepatitis induced cirrhosis of liver. She presented with episodic fever for 2 years, yellow eyes and urine and abdominal distension for 3 months.
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