A 69-year-old woman with no previous or usual diseases began in September 1999 with a 15-day history of progressive urticaria, choluria, hypocholia, asthenia and intermittent epigastric pain.
Physical examination revealed only mucocutaneous jaundice and hepatomegaly.
Abdominal imaging, ultrasound and computerized axial tomography (CAT) showed only homogeneous hepatomegaly.
Hepatitis B virus (ALTH), hepatitis B virus (ALTH), hepatitis B virus (ALTH), transaminases glutamic-pyruvic transaminase (ALTH), hepatitis B virus (ALTH), alkaline phosphatase
The condition resolved completely in one month without treatment, with normalization of all parameters previously altered.
Four months later, the patient developed a new episode of jaundice, choluria, acholia, asthenia and pain in the right hypochondrium for 10 days.
The imaging tests showed only a homogeneous hepatomegaly.
Autoanalyzer parameters showed a TOG of 1665 IU/L, PTG of 1366 IU/L, GGT of 69 IU/L, AF of 380 IU/L and bilirubin positive for the rest ANA antibody.
A biopsy was performed which showed a certain degree of distortion of the hepatic architecture with portal spaces widened by lymphocytic infiltrate, neutrophils and scarce eosinophils, with peripheral ductular hyperplasia and focal necrosis of the parenchymal membrane.
Treatment was established with prednisone and azathioprine, which was maintained for one year, obtaining complete remission, both clinical and analytical.
After three years of follow-up, the patient remains asymptomatic.
