Hepatitis autoinmune desencadenada por una hepatitis aguda por virus de la hepatitis A

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Resumen

Presentamos el caso de un varón de 27 años que padeció una hepatitis aguda por virus A y que durante las semanas siguientes mantuvo elevación de las transaminasas e ictericia. Se detectaron anticuerpos antinucleares y antimúsculo liso, hipergammaglobulinemia y necrosis periportal en la biopsia hepática. Fue diagnosticado de hepatitis autoinmune y respondió favorablemente al tratamiento con inmunodepresores. Este caso y otros publicados sugieren que, en ciertos individuos, una hepatitis A aguda puede ser el factor desencadenante de una hepatitis autoinmune.

We describe the case of a 27-year-old man who presented acute hepatitis due to hepatitis A virus infection. Over the following weeks he consistently presented elevated transaminase levels and jaundice. Antinuclear and anti-smooth muscle antibodies, hypergammaglobulinemia and periportal necrosis were detected in the liver biopsy. The patient was diagnosed with autoimmune hepatitis and responded well to treatment with immunosuppressive drugs. This case, as well as other published reports, suggest that in certain individuals, acute hepatitis A may be the decisive factor leading to autoimmune hepatitis.

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