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Asymptomatic giant cell hepatitis: a subtype of post-infantile giant cell hepatitis?

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Abstract

Giant cell hepatitis in adults is considered a rapidly progressive and life-threatening disease, but there are few descriptions of a prolonged disease course. A 36-year-old Japanese man was referred to our hospital for further evaluation of abnormal liver function test results. Although asymptomatic, he had undergone follow-up for 9 years with these abnormalities. Because the cause of liver injury was not identified despite extensive noninvasive examinations, the patient underwent needle biopsy. He was finally diagnosed with post-infantile giant cell hepatitis (PIGCH) based on the presence of small numbers of giant multinucleated hepatocytes scattered primarily around the portal area. Necroinflammatory changes were very mild in the portal tracts and hepatic parenchyma. According to the histological findings as well as the accepted international diagnostic scoring system for autoimmune hepatitis (AIH), which is closely related to PIGCH, AIH was unlikely, although antinuclear antibody was positive at a titer of 1:160. The present case may describe an unknown subtype of PIGCH, characterized by insidious disease onset and progression with concurrent, mildly active underlying hepatitis, which is in contrast with the well-documented aggressive nature of PIGCH.

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Acknowledgements

The authors are particularly grateful to Kei Hamazaki, (Assistant Professor, Department of Public Health, Faculty of Medicine, University of Toyama) for his document retrieval and constructive comments and criticisms.

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Authors and Affiliations

  1. Department of Internal Medicine, Asanogawa General Hospital, Kosaka-machi Naka 83, Kanazawa 920-8621, Japan

    Takahiro Zenda & Ichiro Araki

  2. Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

    Motoko Sasaki

Authors
  1. Takahiro Zenda
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  2. Ichiro Araki
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  3. Motoko Sasaki
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Correspondence to Takahiro Zenda.

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All authors (Takahiro Zenda, Ichiro Araki, and Motoko Sasaki) declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Zenda, T., Araki, I. & Sasaki, M. Asymptomatic giant cell hepatitis: a subtype of post-infantile giant cell hepatitis?. Clin J Gastroenterol 12, 367–371 (2019). https://doi.org/10.1007/s12328-019-00950-6

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  • DOI: https://doi.org/10.1007/s12328-019-00950-6

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