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首页> 外文期刊>Acta gastro-enterologica Belgica >Autoimmune hepatitis in a patient with thymectomy: the benefit of histology and MUM-1 immunostaining
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Autoimmune hepatitis in a patient with thymectomy: the benefit of histology and MUM-1 immunostaining

机译：胸膜切除术患者的自身免疫性肝炎：组织学和妈妈-1免疫染色的益处

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To the Editor, A 61 years-old female patient, with a history of myaesthenia gravis since 1992, for which she underwent a thymectomy and is treated by pyridostigmine 60 mg once daily, was referred to our outpatient clinic by her general practioner for symptoms of nausea, lack of appetite and pyrosis. Abdominal clinical examination and upper gastrointestinal tract endoscopy were normal. Routine biological testing showed an important liver enzyme perturbation, with a typical hepatocellular injury pattern: aspartate aminotransferase level (AST) at 1449 U/L, alanine aminotransferase level (ALT) at 1856 U/L, alkaline phosphatase level (ALP) at 211 U/L, gamma-glutamyl transpeptidase level (GGT) at 211 U/L, lactate dehydrogenase level (LDH) at 796 UI/L, total bilirubinemia was 5.85 mg/dL, direct bilirubinemia was 5.18 and ferritinemia was above 2000 ng/ml. Peripheral blood cells showed 2670 leucocytes/μL (with 46.3% of neutrophils and 25.7% of lymphocytes). Abdominal ultrasound was normal. No indirect signs of lymphoma such as splenomegaly or adenopathy were found. Hepatitis A serology was positive for IgG and negative for IgM, whereas other viral hepatitis (B, C and E) serological markers were all negative. Epstein-Barr Virus (EBV) serology showed a past history of contact/infection, with EBV IgG at 60 U/mL, EBV IgM negative. Cytomegalovirus IgM and IgG were negative.
机译：向编辑，一名61岁的女性患者，自1992年以来，史医学历史，她经历了胸膜切除术，并通过吡哆猴每天治疗吡哆术治疗，通过她的一般实例对症状提到我们的门诊诊所恶心，缺乏食欲和脱毛。腹部临床检查和上胃肠道内窥镜检查正常。常规生物检测显示了重要的肝酶扰动，具有典型的肝细胞损伤模式：在2111U的1856 U / L，碱性磷酸酶水平（ALP）的1449 U / L，丙氨酸氨基转移酶水平（ALT）下的天冬氨酸氨基转移酶水平（AST） / L，γ-谷氨酸二肽酶水平（GGT）在211 U / L，乳酸脱氢酶水平（LDH）在796 UI / L，总胆红素血症为5.85mg / dL，直接胆红素血症为5.18，铁炎血症高于2000ng / ml。外周血细胞显示2670个白细胞/μl（46.3％的中性粒细胞和25.7％的淋巴细胞）。腹部超声是正常的。没有发现淋巴瘤等淋巴瘤或腺肿等间接迹象。甲型肝炎血液学对于IgG和阴性的α是阳性的，而其他病毒肝炎（B，C和E）血清学标记均为阴性。 Epstein-Barr病毒（EBV）血清学显示了过去的接触/感染历史，EBV IgG在60 u / ml，EBV IgM阴性。 Cytomegalovirus IgM和IgG是阴性的。

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