|
Current issue
Archive
Manuscripts accepted
About the journal
Editorial board
Abstracting and indexing
Contact
Instructions for authors
Ethical standards and procedures
Editorial System
Submit your Manuscript
 
|
1/2020
vol. 95 abstract:
Original paper
Autoimmune hepatitis, Wilson’s disease, or both? An analysis of challenging cases
Magdalena Naorniakowska
1
,
Małgorzata Woźniak
2
,
Maciej Pronicki
2
,
Wiesława A. Grajkowska
2
,
Diana Kamińska
1
,
Wojciech Jańczyk
1
,
Maciej Dądalski
1
,
Bożena Cukrowska
2
,
Piotr Socha
1
Pediatr Pol 2020; 95 (1): 18–24
Online publish date: 2020/03/31
View
full text
Get citation
ENW EndNote
BIB JabRef, Mendeley
RIS Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
Introduction
The comorbidity of autoimmune hepatitis (AIH) and Wilson’s disease (WD) can be considered, but has never been proven based on therapeutic response. There is a risk of misdiagnosis with standard diagnostic approaches. We describe a case of a challenging patients where final diagnosis could not be established with primary diagnostic approaches, and we question the coexistence of AIH and WD. Material and methods We identified four cases among 165 patients with WD and 321 with AIH treated in our hospital, whose primary diagnosis was changed or questioned, analysis of which shows the difficulty in differentiating between these two diseases. Results We presented four patients – three of them were diagnosed because of elevated serum aminotransferases activity and one due to acute hepatic failure. The three children were initially diagnosed as AIH, but after meticulous screening, WD was diagnosed. In the fourth case, WD was diagnosed from the beginning, but some autoimmune features and an incomplete response to the treatment prompted us to use steroids to achieve full recovery. Conclusions WD can usually be distinguished from AIH, but in selected cases differential diagnosis is challenging. It seems to be extremely important to carry out a complete diagnostic set for WD in patients with initial diagnosis of AIH with poor response to steroids. In a large cohort of patients with WD and with AIH, only one seemed to have comorbidity, but even in this case AIH was not fully confirmed. keywords:
hepatitis, comorbidity, differential diagnosis, autoantibodies |
POLSKI
