Autoimmune Hepatitis as Initial Presentation of Systemic Lupus Erythematosus
Philippine Journals Online
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| Title |
Autoimmune Hepatitis as Initial Presentation of Systemic Lupus Erythematosus
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| Creator |
Laniyati Hamijoyo; Section of Rheumatology, Clinical Immunology and Osteoporosis, University of Santo Tomas Hospital, Manila
Andrew Dysangco; Department of Internal Medicine, University of Santo Tomas Hospital, Manila Sandra V Navarra; Chief, Section of Rheumatology, Clinical Immunology and Osteoporosis, University of Santo Tomas Hospital, Manila, Chief, Section of Rhematology, Faculty of Medicine and Surgery, University of Santo Tomas, Manila |
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| Subject |
Rheumatology
Autoimmune hepatitis; lupus hepatitis; systemic lupus erythematosus |
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| Description |
Synopsis: This is a case of a 24 year old female with a strong family history of SLE who presented with autoimmune hepatitis and was eventually diagnosed to have SLE. Clinical presentation: Two months history of intermittent jaundice, tea colored urine, anorexia, easy fatigability, pruritus, colicky right upper quadrant pain, intermittent diarrhea. Physical findings: Normal Vital signs, fever of 38.3ÀC, jaundice, facial and bipedal edema, some tenderness over the right upper abdomen, no organomegaly. Laboratory work up: hemoglobin of 72g/L, Serum bilirubin 26.4U/L, ALT 281U/L, AST 355U/L, alkaline phosphatase 275U/L, albumin 2.9mg/dL, globulin 4.2mg/dL. C3 0.62g/L, negative serology for viral hepatitis, urinalysis: urine protein 3+ (0.9g/24hours), RBC loaded/hpf, WBC 4-8/hpf, hyaline and granular casts. ANA 1:2560 speckled, anti-dsDNA 34.3IU/ml, moderately positive anti-Ro/SSA, anti-cardiolipin antibodies-negative. Diagnosis: Systemic Lupus Erythematosus Treatment: Prednisone and supportive therapy Outcome: Improvement of hemoglobin, urinalysis, serum bilirubin, liver enzymes, serum creatinine levels 4 weeks after initiation of treatment. Significance: This case illustrates SLE presenting as autoimmune hepatitis. Recommendation: SLE should be considered in hepatitis when viral etiology has been ruled out. Keywords: Autoimmune hepatitis; lupus hepatitis; systemic lupus erythematosus DOI: 10.3860/pjim.v47i2.1648 Phil. J. Internal Medicine, 47: 89-92, March-April, 2009
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| Publisher |
The Philippine College of Physicians
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| Contributor |
—
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| Date |
2010-07-23
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| Type |
Peer-Reviewed Item
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| Format |
application/pdf
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| Identifier |
http://www.philjol.info/index.php/PJIM/article/view/1648
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| Source |
Philippine Journal of Internal Medicine; Vol 47, No 2 (2009); 89-92
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| Language |
en
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| Coverage |
Philippines
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