The Acute Onset of Autoimmune Hepatitis During Pregnancy in the Absence of Hypergammaglobulinemia and Autoantibodies.

Abstract

The onset of autoimmune hepatitis (AIH) during pregnancy is rare and often poses a diagnostic challenge. A 29-year-old Japanese woman experienced epigastric pain and nausea during the third trimester of her third pregnancy. Three days after the symptom onset, an emergency Caesarean section was performed because of suspected acute fatty liver of pregnancy; however, the patient's liver dysfunction worsened afterward. Despite normal serum IgG concentration and absence of autoantibodies, biopsy-proven severe hepatitis with centrilobular zonal necrosis and good biochemical response to corticosteroids led to a diagnosis of AIH. Therefore, AIH should be included in the differential diagnosis of liver dysfunction during pregnancy.

• Authors: Ai Kawada, Shinichi Iwamura, Kenji Yorita, Rikiya Daike, Yu Tanaka, Naoto Kuroda, Yoh Zen, Michiyo Okazaki, Kunihisa Uchita
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 60 Issue 20 Pg. 3231-3237 (Oct 15 2021) ISSN: 1349-7235 [Electronic] Japan
• PMID: 33840701 (Publication Type: Case Reports, Journal Article)

Chemical References

• Autoantibodies

Topics

• Adult
• Autoantibodies
• Cesarean Section
• Fatty Liver
• Female
• Hepatitis, Autoimmune (diagnosis)
• Humans
• Hypergammaglobulinemia
• Pregnancy