Autoimmune hepatitis in a genetically susceptible patient: is it triggered by acute viral hepatitis A?

Dig Dis Sci. 1999 Oct;44(10):1950-2. doi: 10.1023/a:1026645629103.

Abstract

The pathogenic mechanisms for autoimmune hepatitis (AIH) are not completely known. Susceptibility to AIH is associated with the human leukocyte antigens (HLA) class II: DR3 and DR4. Nevertheless, AIH does not have a strong genetic predisposition, suggesting that other factors are involved. Perhaps the strongest evidence of a viral cause for AIH exists for hepatitis C virus. AIH has been reported to develop rarely after acute infection with hepatitis A virus. We report on a 55-year-old woman in whom AIH developed during the convalescence period of serologically proven acute viral hepatitis type A. HLA class II DRB1*0401, which was reported to be associated with AIH with a moderate coarse and late appearance in life, was found in this patient. Steroid therapy was followed by a complete clinical remission. Our case supports the possibility that acute hepatitis A may trigger the development of AIH in a genetically susceptible subject.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Female
  • Genetic Predisposition to Disease
  • HLA Antigens / analysis
  • HLA-DQ Antigens / analysis
  • HLA-DR Antigens / analysis
  • Hepatitis A / immunology*
  • Hepatitis, Autoimmune / genetics*
  • Hepatitis, Autoimmune / immunology
  • Humans
  • Middle Aged

Substances

  • HLA Antigens
  • HLA-DQ Antigens
  • HLA-DR Antigens