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Diffuse gallbladder wall thickening in autoimmune hepatitis: an unusual presentation
  1. Chitchai Rattananukrom1,2,
  2. Napat Angkathunyakul3,4 and
  3. Abhasnee Sobhonslidsuk2
  1. 1Department of Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
  2. 2Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  3. 3Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  4. 4Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  1. Correspondence to Dr Chitchai Rattananukrom; Chitra{at}kku.ac.th

Abstract

A 63-year-old woman presented with jaundice and epigastric pain for 2 weeks. Physical examination revealed marked jaundice, and palpable gallbladder with right upper quadrant tenderness. Liver function test was remarkable for hepatocellular injury pattern. Antinuclear antibody and anti-smooth muscle antibody were positive with high titre and serum IgG was elevated more than upper normal range. Ultrasound and CT scan demonstrated mildly diffuse periportal oedema of liver parenchyma and markedly diffuse gallbladder wall thickening up to 2 cm. Liver histology showed focal interface hepatitis with prominent plasma cell infiltration and cluster formation, moderate lobular spotty necrosis and emperipolesis consistent with autoimmune hepatitis. The patient was treated with steroid and azathioprine. She had complete resolution of symptoms and normal biochemical laboratory results. Diffuse gallbladder thickening was seen in acute hepatitis from definite autoimmune hepatitis.

  • liver disease
  • hepatitis other

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Footnotes

  • Contributors CR and AS took care of this patient. We wrote and revised this full case report. NA revealed liver histology and send the picture of liver pathology attached in this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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