AUTOIMMUNE HEPATITIS - A HISTOLOGICAL VARIANT ASSOCIATED WITH PROMINENT CENTRILOBULAR NECROSIS

A patient presented with pruritus and recent elevation of aminotransfe rases. The case fulfilled most of the criteria for the diagnosis of au toimmune hepatitis and achieved clinical and complete biochemical resp onse to steroid therapy. However, the liver biopsy specimen revealed a n unusual histological pattern consisting of severe centrilobular necr osis demarcated by a thin rim of hepatitic reaction. In contrast, the portal tracts appeared almost normal. This histological appearance has not been associated with autoimmune hepatitis. This presentation and the histology may represent an early pattern of autoimmune injury to t he liver.