Abstract
We report a 19 years old male presenting with knee pain, elevated liver enzymes and proteinuria. Further investigation found positive antinuclear and anti-smooth muscle antibodies and a liver biopsy revealed the presence of an autoimmune hepatitis. Treatment with corticosteroids and azathioprine was started, resulting in normalization of liver enzymes but proteinuria persisted and a kidney biopsy disclosed a focal segmental glomerulosclerosis. The use of lisinopril resulted in a significative reduction of proteinuria and, after 30 months of follow up, he continues with azathioprine, lisinopril and a low prednisone dose without evidence of liver or kidney disease activity.
Highlights
We report a 19 years old male presenting with knee pain, elevated liver enzymes and proteinuria
Further investigation found positive antinuclear and anti-smooth muscle antibodies and a liver biopsy revealed the presence of an autoimmune hepatitis
The use of lisinopril resulted in a significative reduction of proteinuria and, after 30 months of follow up, he continues with azathioprine, lisinopril and a low prednisone dose without evidence of liver or kidney disease activity. (Rev Med Chile 2018; 146: 808-812) Key words: Glomerulosclerosis, Focal Segmental; Hepatitis, Autoimmune; Proteinuria
Summary
We report a 19 years old male presenting with knee pain, elevated liver enzymes and proteinuria. Dadas las manifestaciones multisistémicas (articular, renal y hepático) se sospechó una condición autoinmune, particularmente un debut de Lupus Eritematoso Sistémico (LES), obteniéndose anticuerpos antinucleares (ANA) positivos en 1/160, patrón moteado, pero con Anti-DNA negativo y complemento C3 y C4 normales.
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