| Literature DB >> 28970716 |
Gyanendra K Acharya1, Hung-I Liao2, Simona Frunza-Stefan2, Ronakkumar Patel2, Moe Khaing2.
Abstract
Elevated serum ferritin level is a common finding in iron overload syndrome, autoimmune and viral hepatitis, alcoholic and nonalcoholic fatty liver diseases. High transferrin saturation is not a common finding in above diseases except for iron overload syndrome. We encountered a challenging case of 73-year-old female who presented with yellowish discoloration of skin, dark color urine and dull abdominal pain. Initial laboratory tests reported mild anemia; elevated bilirubin, liver enzymes, and transferrin saturation. We came to the final diagnosis of autoimmune hepatitis after extensive workups. Autoimmune hepatitis is a rare disease, and the diagnosis can be further complicated by a similar presentation of iron overload syndrome. Markedly elevated transferrin saturation can simulate iron overload syndrome, but a liver biopsy can guide physicians to navigate the diagnosis.Entities:
Keywords: AIH, autoimmune hepatitis; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AMA, antimicrosomal antibody; ANA, antinuclear antibody; AST, aspartate aminotransferase; Autoimmune disease; Autoimmune hepatitis; BUN, blood urea nitrogen; CMV, cytomegalovirus; CT, computed tomography; Diagnostic dilemma; EBV, Epstein–Barr virus; ESR, erythrocyte sedimentation rate; HHC, hereditary hemochromatosis; HLA, human leukocyte antigen; INR, international normalized ratio; Ig, immunoglobulin; Iron overload syndrome; LDH, lactate dehydrogenase; LFT, liver function test; MRI, magnetic resonance imaging; PT, prothrombin time; PTT, partial thromboplastin time; PTU, propylthiouracil; RBC, red blood cell; TIBC, total iron binding capacity; Transferrin saturation; WBC, white blood cell; anti-LKM, anti-liver kidney microsomal; anti-SMA, anti-smooth muscle antibody
Year: 2017 PMID： 28970716 PMCID： PMC5620361 DOI： 10.1016/j.jceh.2017.03.006
Source DB: PubMed Journal: J Clin Exp Hepatol ISSN： 0973-6883