CRYPTOGENIC CHRONIC HEPATITIS

A 46 years old female patient was admitted with jaundice, fatigue and dull right upper abdominal pain. Transaminases were markedly elevated. By liver biopsy chronic active hepatitis could be proven histological ly without establishing a cause exhausting all diagnostic possibilitie s. The hepatitis was therefore classified as cryptogenic. The gall bla dder was removed when showing signs of cholecystitis without essential changes in symptoms (histologically chronic acalculous cholecystitis) . As there are cases of seronegative autoimmune hepatitis and as there was evidence for autoimmune hepatitis from several findings, a therap eutic trial with steroids was initiated. Rapidly symptoms disappeared, transaminases decreased to normal values and the inflammatory activit y was markedly reduced on control liver biopsy after six months.