AUTOIMMUNE HEPATITIS IN A GIRL WITH PRESENCE OF ANTI-LIVER KIDNEY MICROSOME ANTIBODIES - REPORT OF ONE CASE/

Autoimmune hepatitis is an inflammatory liver disease characterized by dense mononuclear cell infiltrate in the portal tract, and serologica lly by the presence of non-organ and liver-specific autoantibodies and increased levels of gammaglobulins in the absence of a known etiology . Three subgroups of autoimmune hepatitis have been recognized, depend ing on the nature of the autoantibody present in the serum: Type 1 aut oimmune hepatitis, associated with smooth-muscle (SMA) or antinuclear antibody (ANA) seropositivity; type 2, with anti-liver/kidney microsom e antibody (anti-LKM1), and type 3, with the absence of ANA, SMA and a nti-LKM1 and presence of other autoantibodies such as anti-soluble liv er antigen (SLA). Subtypes of chronic autoimmune hepatitis have clinic ally different features and prognoses. An 8 year old female patient pr esented mild jaundice of insidious onset. The liver was tender and enl arged. Serologic markers for A, B, C, E, Epstein Barr and citomegalovi rus were negative. The liver biopsy showed a histological picture cons istent with chronic active hepatitis. High titers of anti-liver/kidney -microsome antibody were found by indirect immunofluorescence test, an d this finding was confirmed by Western blot against specific liver mi crosome antigens. Therapy with prednisolone induced a clinical and bio chemical remision after four weeks. The suspension of therapy under st rict medical control produced a rapid relapse of clinical and biochemi cal features. The reinitiation of prednisolone was successful, and alt ernate-day program was started and maintained until 8 months follow-up .