A case of autoimmune hepatitis presents giant cell hepatitis on liver histology

A 59-year-old man was admitted to the emergency unit in Dokkyo University Hospital on 24th, December, 2004 with anorexia and dark-colored urine. Physical examination revealed jaundice and hepatomegaly. Abnormal liver function test and EBV-VCA-IgG elevation implied possible first EBV infection. Serological tests also showed positive results in anti-nuclear antibody and anti-mitochondrial M2 antibody, which suggested of autoimmune hepatitis. To determinate etiology of liver dysfunction, echo-guided liver biopsy was performed. The pathology of interface hepatitis with abundant lymphocytes and plasma cells is strongly suggestive for its autoimmune etiology and multi-nucleated giant liver cells were recognized. Therefore the present case suggests that the autoimmune mechanism appears to be important etiology for giant cell hepatitis.