Giant Cell Hepatitis - A Rare Association with Connective Tissue Disease.
antiphospholipid antibodies
connective tissue disease
giant cell hepatitis
Journal
Mediterranean journal of rheumatology
ISSN: 2529-198X
Titre abrégé: Mediterr J Rheumatol
Pays: Greece
ID NLM: 101730166
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
25
04
2019
revised:
09
11
2019
accepted:
11
11
2019
entrez:
30
5
2020
pubmed:
30
5
2020
medline:
30
5
2020
Statut:
epublish
Résumé
A 68-year-old gentleman presented to hepatology department with asymptomatic year-long history of stably deranged liver function tests. His peak alkaline phosphatase (ALP), was 828 with alanine transaminase (ALT) of 141. Full liver workup was negative; hence, a liver biopsy was organised, which confirmed giant cell hepatitis (GCH). A computed tomography (CT) scan revealed non-specific interstitial pneumonitis (NSIP) pattern interstitial lung disease supported by lung function tests. Antibody testing showed strongly positive antinuclear antibody (ANA) with anti-polymyositis/scleroderma (anti-PM-SCL) antibody. Clinical picture was in keeping with likely undifferentiated connective tissue disease (UCTD) with polyarthralgia, early morning stiffness, Raynaud's and nailfold infarcts with capillaritis on nail bed examination. Further testing confirmed triple-positive antiphospholipid antibodies twice 12 weeks apart (immunoglobulin M [IgM] anti beta-2 glycoprotein antibodies, lupus anticoagulant and IgM anticardiolipin antibody). He was treated with mycophenolate and hydroxychloroquine with resolution of symptoms. Giant cell hepatitis is uncommon, with only 100 cases reported worldwide. To our knowledge, this is the only report of GCH in the context of UCTD, highlighting the significance of careful evaluation of liver disease overlap and the successful role of mycophenolate mofetil (MMF) in this setting.
Identifiants
pubmed: 32467874
doi: 10.31138/mjr.30.4.224
pii: MJR-30-4-224
pmc: PMC7241662
doi:
Types de publication
Case Reports
Langues
eng
Pagination
224-227Informations de copyright
© 2019 The Mediterranean Journal of Rheumatology (MJR).
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