LIVER-CIRRHOSIS ASSOCIATED WITH SEVERE HEMOLYTIC-ANEMIA INTERSTITIAL LUNG-DISEASE AND AUTOIMMUNE-THYROIDITIS

Objective: To report a case of liver cirrhosis associated with multipl e autoimmune diseases. Design: Case report and literature review. Pati ent: A 63-year-old woman with liver cirrhosis, clinical and laboratory evidence of autoimmunity, antibodies to hepatitis C virus (HCV) by se cond generation recombinant immunoblot assay and negative plasmatic HC V-RNA, was found to have three different autoimmune conditions: autoim mune haemolytic anaemia, interstitial lung disease and antoimmune hypo thyroidism. Conclusion: Although combinations of one or two of these i mmunologic conditions have been described in the literature, this type of multiple association has not been described previously. This case illustrates the possibility of severe autoimmune conditions developing in the context of liver cirrhosis of autoimmune aetiology, with conco mitant anti-HCV antibodies consistent with previous infection or with cross-reactivity by an epitope of HCV.