304. A 49-year-old female presents with increasing fatigue and is found to have elevated liver enzymes (AST and ALT). You follow her in your clinic and find over the next 9 months that her liver enzymes have remained elevated. All serologic tests for viral markers are within normal limits. A liver biopsy reveals chronic inflammation in the portal triads that focally destroys the limiting plate and "spills over" into the adjacent hepatocytes. There are no granulomas present, and there is no evidence of fibrosis surrounding any of the bile ducts within the portal triads. Anti-smoothmuscle antibodies and antinuclear antibodies are found in the patient's serum. An LE cell test is positive. What is the diagnosis?
a. Autoimmune hepatitis
b. Chronic persistent hepatitis
c. Primary biliary cirrhosis
d. Primary sclerosing cholangitis
e. Systemic lupus erythematosus
___________________ The Key to Succeed is Patience.
skyhigh Forum Guru
Topics: 105 Posts: 561
03/19/06 - 01:23 PM
#2
b?
lalitha Forum Junior
Topics: 9 Posts: 51
03/19/06 - 02:15 PM
#3
ans is A
hghooka Forum Newbie
Topics: 3 Posts: 20
03/20/06 - 01:47 AM
#4
isnt E
druas Forum Elite
Topics: 47 Posts: 331
03/20/06 - 04:27 AM
#5
i think its E...LE test positive ,plus ANA positive(though not specefic)and anti SM positive
vinaysaini19 Forum Junior
Topics: 15 Posts: 64
03/20/06 - 06:53 AM
#6
Ans. is A-Lupoid hepatitis.
Chronic persistent hepatitis occurs in viral conditions. No granuloma rules out biloary cirrhosis. Scelorising cholangitis will present with elevated ALP and GGT. SLE does not usually manifest in liver.
robin082006 Forum Hero
Topics: 471 Posts: 5,125
03/20/06 - 08:21 AM
#7
answer is A ___________________ The Key to Succeed is Patience.
docsrinu Forum Elite
Topics: 26 Posts: 213
09/03/06 - 06:16 PM
#8
why is E not the ans?
Leopard Forum Guru
Topics: 30 Posts: 401
09/03/06 - 06:45 PM
#9
docsrinu wrote: why is E not the ans?
Antismooth muscle antibodies are the diagnostic for autoimmune hepatitis whose other name is Lupoid hepatitis.
Best of luck
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