Abstract
To the Editor: Liver/kidney microsomal antibody (LKM)-positive (type 2) autoimmune hepatitis (AIH) is a rare liver disease with typical autoantibodies reacting with cytochrome P450 (CYP) 2D6 (LKM-1) and it is involved in approximately 10% of cases with family 1 UDP-glucuronyltransferase (UGT1A and LKM-3) (1). AIH type 2 is more common in children, can present as acute hepatitis, generally responds well to immunosuppressive treatment, and usually requires life-long maintenance therapy (1). Malignant thymoma is capable of inducing immune-mediated paraneoplastic syndromes, it most commonly represented in myasthenia gravis. Mechanistically, paraneoplasia is believed to result from the humoral and/or cellular loss of tolerance to self-antigens expressed by the neoplasm and subsequent cross-reactivity with other self-antigens (2).
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