Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis.

IF 2.4 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Future Science OA Pub Date : 2024-12-31 Epub Date: 2024-08-07 DOI:10.2144/fsoa-2023-0222
Bahaeddine Lahbacha, Abir Chaabane, Wafa Garbouj, Roua Mankai, Amina Bani, Amal Khsiba, Raja Amri, Salwa Nechi, Emna Chelbi
{"title":"Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis.","authors":"Bahaeddine Lahbacha, Abir Chaabane, Wafa Garbouj, Roua Mankai, Amina Bani, Amal Khsiba, Raja Amri, Salwa Nechi, Emna Chelbi","doi":"10.2144/fsoa-2023-0222","DOIUrl":null,"url":null,"abstract":"<p><p>A 62-year-old woman presented with a chronic fever and fatigue. Biological investigations showed leukocytosis and elevation of acute phase markers. Liver blood tests showed deterioration with both cholestatic and hepatocellular patterns (there were, respectively, elevations in serum alkaline phosphatase levels as well as in serum alanine and aspartate aminotransferases). Viral serologies were negative. Mycobacterial infection and endocarditis were excluded. Results from blood cultures were negative. Autoantibody tests including ANCA (anti-neutrophil cytoplasmic antibody), anti-nuclear, anti-smooth muscle and anti-mitochondria were all negative. A liver biopsy revealed epithelioid granulomatous necrotizing vasculitis. Subsequently, immunological testing was repeated revealing MPO-ANCA (myeloperoxidase-ANCA). A diagnosis of ANCA-associated vasculitis with liver involvement was then made. The patient was started on steroids and her clinical state gradually improved.</p>","PeriodicalId":12568,"journal":{"name":"Future Science OA","volume":"10 1","pages":"2340262"},"PeriodicalIF":2.4000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318729/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future Science OA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2144/fsoa-2023-0222","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0

Abstract

A 62-year-old woman presented with a chronic fever and fatigue. Biological investigations showed leukocytosis and elevation of acute phase markers. Liver blood tests showed deterioration with both cholestatic and hepatocellular patterns (there were, respectively, elevations in serum alkaline phosphatase levels as well as in serum alanine and aspartate aminotransferases). Viral serologies were negative. Mycobacterial infection and endocarditis were excluded. Results from blood cultures were negative. Autoantibody tests including ANCA (anti-neutrophil cytoplasmic antibody), anti-nuclear, anti-smooth muscle and anti-mitochondria were all negative. A liver biopsy revealed epithelioid granulomatous necrotizing vasculitis. Subsequently, immunological testing was repeated revealing MPO-ANCA (myeloperoxidase-ANCA). A diagnosis of ANCA-associated vasculitis with liver involvement was then made. The patient was started on steroids and her clinical state gradually improved.

肝活检发现抗中性粒细胞胞浆抗体相关性血管炎:一个具有挑战性诊断的故事。
一名 62 岁的妇女因长期发烧和疲劳而就诊。生物检查显示白细胞增多,急性期标志物升高。肝脏血液检查显示病情恶化,有胆汁淤积性和肝细胞性两种模式(血清碱性磷酸酶水平以及血清丙氨酸和天冬氨酸转氨酶分别升高)。病毒血清学检测呈阴性。排除了分枝杆菌感染和心内膜炎。血液培养结果为阴性。包括抗中性粒细胞胞浆抗体(ANCA)、抗核抗体、抗平滑肌抗体和抗线粒体抗体在内的自身抗体检测结果均为阴性。肝脏活检显示患者患有上皮样肉芽肿坏死性血管炎。随后,再次进行免疫学检测,发现 MPO-ANCA(髓过氧化物酶-ANCA)。诊断结果为 ANCA 相关性血管炎并累及肝脏。患者开始服用类固醇,临床症状逐渐好转。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Future Science OA
Future Science OA MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
5.00
自引率
4.00%
发文量
48
审稿时长
13 weeks
期刊介绍: Future Science OA is an online, open access, peer-reviewed title from the Future Science Group. The journal covers research and discussion related to advances in biotechnology, medicine and health. The journal embraces the importance of publishing all good-quality research with the potential to further the progress of research in these fields. All original research articles will be considered that are within the journal''s scope, and have been conducted with scientific rigour and research integrity. The journal also features review articles, editorials and perspectives, providing readers with a leading source of commentary and analysis. Submissions of the following article types will be considered: -Research articles -Preliminary communications -Short communications -Methodologies -Trial design articles -Trial results (including early-phase and negative studies) -Reviews -Perspectives -Commentaries
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信