Cirrhosis of the Liver: A Case Report and Literature Review of a Rare Case Presentation of Autoimmune Hepatitis With Systemic Sclerosis

Abstract

Systemic sclerosis (SSc) is a chronic systemic disease that affects the skin, heart, lungs, kidneys, gastrointestinal tract, and musculoskeletal system. Although gastrointestinal involvement has been reported in approximately 90% of scleroderma patients, liver involvement is uncommon. A 51-year-old female was admitted to the hospital due to abdominal distension and pedal edema. She had a history of Raynaud's syndrome and multiple hypopigmented and hyperpigmented patches over her body for the last year. Her ascetic fluid analysis was transudative with a serum ascites albumin gradient >1.1, and the abdomen and pelvis ultrasonography reported liver cirrhosis with splenomegaly with perisplenic varices. Her antinuclear antibody and anti-centromere antibody were positive. Skin thickening was visible. Her alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum globulin were raised. Viral serology was negative. We managed her with diuretics, beta-blockers, prednisolone (30 mg/day administered orally), angiotensin-converting enzyme inhibitors, and calcium channel blockers. Edema and abdominal distension decreased with this management, and no Raynaud's phenomenon was observed during the hospital stay.