case_images: PMC4283356_01
case_images: (a) Liver biopsy demonstrating features of active hepatitis, impressive inflammatory process involving both portal areas, and the lobules displaying also a pattern of sinusoidal lymphocytosis. (b) Bone marrow biopsy showing severe marrow hypocellularity.
case_images: CRIHEP2014-216570.001.jpg
case_images: PMC4283356_01_CRIHEP2014-216570.001.jpg
case_images: fig1
case_images: For further confirmation, he underwent a liver biopsy (Day 5) which revealed quite an impressive inflammatory process involving both portal areas and the lobules displaying also a pattern of sinusoidal lymphocytosis (Figure 1). He underwent a bone marrow biopsy and flow cytometry analysis which showed severe hypocellular bone marrow (less than 5%) with dyserythropoiesis (Figure 1).
case_images: Graphical trends of the laboratory parameters of HAAA over six months.
case_images: CRIHEP2014-216570.002.jpg
case_images: PMC4283356_01_CRIHEP2014-216570.002.jpg
case_images: fig2
case_images: His follow-up monitoring laboratory testing 6 weeks later showed continued improvement in AH (Figure 2) while he stayed on low dose ursodiol. IST was continued as cyclosporine monotherapy and further improvement in cell counts was seen (Figure 2).