Autoimmunity and liver involvement “report of clinical case”

Abstract

Liver damage is manifested in several entities of immunological origin such as systemic lupus erythematosus (SLE), primary biliary cholangitis, sclerosing cholangitis, autoimmune hepatitis (AIH). The elevation of cytolysis liver enzymes in the context of autoimmunity forces to differentiate between hepatitis associated with SLE and AIH, sharing both pathologies several clinical and laboratory characteristics that make difficult their diagnosis; emphasizing also that AIH can concur with other diseases of immune origin such as autoimmune thyroiditis, autoimmune thrombocytopenia and several connective tissue diseases. We present the case of a female patient with a picture characterized by purplish-red pruritic skin lesions on lower limbs, accompanied by arthralgias of small joints, anorexia, night sweats, marked asthenia and elevation of cytolytic liver enzymes with antinuclear antibody (ANA) positivity and polyclonal hypergamaglobulinemia. It was concluded that the patient had liver cirrhosis with portal hypertension, and after ruling out all causes of elevated transaminases of non-autoimmune origin, the liver involvement was classified as secondary to autoimmune hepatitis.