TAILIEUCHUNG - Báo cáo y học: "Human immunodeficiency virus infection and autoimmune hepatitis during highly active anti-retroviral treatment: a case report and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Human immunodeficiency virus infection and autoimmune hepatitis during highly active anti-retroviral treatment: a case report and review of the literature. | Daas et al. Journal of Medical Case Reports 2011 5 233 http content 5 1 233 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Human immunodeficiency virus infection and autoimmune hepatitis during highly active anti-retroviral treatment a case report and review of the literature 11 2 3 3 1 Hanady Daas Riad Khatib Haitham Nasser Farah Kamran Martha Higgins and Louis Saravolatz Abstract Introduction The emergence of hepatic injury in patients with human immunodeficiency virus infection during highly active therapy presents a diagnostic dilemma. It may represent treatment side effects or autoimmune disorders such as autoimmune hepatitis emerging during immune restoration. Case presentation We present the case of a 42-year-old African-American woman with human immunodeficiency virus infection who presented to our emergency department with severe abdominal pain and was found to have autoimmune hepatitis. A review of the literature revealed 12 reported cases of autoimmune hepatitis in adults with human immunodeficiency virus infection only three of whom were diagnosed after highly active anti-retroviral treatment was initiated. All four cases including our patient were women and one had a history of other autoimmune disorders. In our patient the one patient case we are reporting a liver biopsy revealed interface hepatitis necrosis with lymphocytes and plasma cell infiltrates and variable degrees of fibrosis. All four cases required treatment with corticosteroids and or other immune modulating agents and responded well. Conclusion Our review suggests that autoimmune hepatitis is a rare disorder which usually develops in women about six to eight months after commencing highly active anti-retroviral treatment during the recovery of CD4 lymphocytes. It represents either re-emergence of a pre-existing condition that was unrecognized or a de novo manifestation during immune reconstitution. Introduction Impaired immunity in individuals with .

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