An elderly autoimmune hepatitis patient with a fulminant course

Abstract

An elderly patient with autoimmune hepatitis progressing to fulminant hepatitis is reported herein An 82-year-old woman had been aware of lassitude and noticed brown urine 2-3 weeks prior to admission. She was hospitalized because of jaundice. There was no history of liver damage. Laboratory data included elevated total bilirubin (16.6 mg/dL), ALT (711 U/L), and IgG (4,608 mg/dL). Antinuclear antibody (× 80) was positive Prothrom-bin time was delayed (36.5%). Flapping tremor and hepatic encephalopathy grade II appeared the next day, and she was diagnosed as having fulminant hepatitis of the subacute type due to autoimmune hepatitis. Steroid pulse treatment and sequential oral prednisolone were effective and her liver functions improved Early diagnosis and corticosteroid treatment were confirmed to be important for managing this elderly patient with autoimmune hepatitis showing an acute presentation, because she recovered with prompt medical treatment. © 2014 The Japan Society of Hepatology.