Giant cell hepatitis with autoimmune hemolytic anemia in a nine month old infant

查看全文 作　　者：Jihene [1]Bouguila;Sameh [2]Mabrouk;Samia [1]Tilouche;Dajla [3]Bakir;Amel [4]Trabelsi;Amel [1]Hmila;Lamia [1]Boughammoura 机构地区：[1]Department of Paediatrics,Hospital Farhat Hached,4000 Sousse,Tunisia;[2]Department of Paediatrics,Hospital Sahloul,4011 Sousse,Tunisia;[3]Department of Radiology,Hospital Farhat Hached,4000 Sousse,Tunisia;[4]Laboratory of Anatomopathology,Hospital Farhat Hached,4000 Sousse,Tunisia 出　　处：《World Journal of Hepatology》索引2013年第5卷第4期,共4页 摘　　要：Giant cell hepatitis(GCH)with autoimmune hemolytic anemia is a rare entity,limited to young children,with an unknown pathogenesis.We report the case of 9-mo old who presented with fever,diarrhea and jaundice four days before hospitalization.Physical examination found pallor,jaundice and hepatosplenomegaly.The laboratory workup showed serum total bilirubin at 101 μmol/L,conjugated bilirubin at 84 μmol/L,hemolytic anemia,thrombocytopenia and immunoglobulin G(IgG)and anti-C3d positive direct Coombs' test.The antinuclear,anti-smooth muscle and liver kidney microsomes 1 non-organ specific autoantibodies,antiendomisium antibodies were negative.Serological assays for viral hepatitis B and C,cytomegalovirus,herpes simplex and Epstein Barr virus were negative.The association of acute liver failure,Evan's syndrome,positive direct Coomb's test of mixed type(IgG and C3)and the absence of organ and non-organ specific autoantibodies suggested the diagnosis of GCH.The diagnosis was confirmed by a needle liver biopsy.The patient was treated by corticosteroids,immunomodulatory therapy and azathioprine but died with septicemia. 关 键 词：Giant cell HEPATITIS ANEMIA HEMOLYTIC AUTOIMMUNE Child