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  • Postinfantile giant cell hepatitis in the setting of autoimmune hepatitis: exclusively a histological pattern or a prognosis predictor?

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Case report
Postinfantile giant cell hepatitis in the setting of autoimmune hepatitis: exclusively a histological pattern or a prognosis predictor?
  1. Carolina Teles1,
  2. Rui Santos1,2,
  3. Carlos Dias Silva1,2 and
  4. Teresa Vaio1,2
  1. 1Department of Internal Medicine, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  2. 2Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Carolina Teles; carolina.m.teles{at}outlook.com

Abstract

Autoimmune hepatitis (AIH) is a rare chronic liver disease with a non-specific clinical presentation. Its physiopathology is not fully understood and, if untreated, can progress to cirrhosis and even fulminant liver failure. Here, we describe a case of a 73-year-old patient with an 11-month history suggestive of liver disease, who was concomitantly diagnosed with AIH and the extremely rare postinfantile giant cell hepatitis (PIGCH). Despite standard immunosuppressive therapy, the patient presented a severe clinical course, culminating in acute-on-chronic liver failure and death. This case reminds physicians of the importance of an early diagnosis, close monitoring and timely treatment of AIH. It also highlights the significant role in prognosis of the specific histological pattern of PIGCH, which has been mainly associated with a serious clinical outcome and unpredictable response to immunosuppressive therapy. Triggers of both AIH and PIGCH, such as viral infections, must be excluded, given their treatment implications.

  • liver disease
  • hepatitis other

http://dx.doi.org/10.1136/bcr-2021-243660

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    Footnotes

    • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. All the authors, CT, RS, CDS, TV, have approved this submission. Specific contributions made by each author are indicated bellow: CT—acquisition of data, planning, drafting of the manuscript, case discussion, final revision of the manuscript, RS—planning, case discussion, revision of the manuscript for important intellectual content and final revision, CDS—case discussion, revision of the manuscript for important intellectual content and final revision, TV—case discussion, revision of the manuscript for important intellectual content and final revision.

    • 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.

    • Competing interests None declared.

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