Primary and secondary liver/kidney microsomal autoantibody response following infection with hepatitis C virus

Liver/kidney microsomal autoantibody type 1 (LKM-1), which characterizes a subtype of autoimmune hepatitis, is also found in some patients with chronic hepatitis C virus (HCV) infection. Whether HCV and LKM-1 are accidentally or causally related is unknown. This case report describes a child who bec...

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Veröffentlicht in:Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1994-06, Vol.106 (6), p.1672-1675
Hauptverfasser: Mackie, Fiona D., Peakman, Mark, Yun, Ma, Sallie, Richard, Smith, Heather, Davies, Edward T., Mieli-Vergani, Giorgina, Vergani, Diego
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Sprache:eng
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Zusammenfassung:Liver/kidney microsomal autoantibody type 1 (LKM-1), which characterizes a subtype of autoimmune hepatitis, is also found in some patients with chronic hepatitis C virus (HCV) infection. Whether HCV and LKM-1 are accidentally or causally related is unknown. This case report describes a child who became infected by HCV after liver transplantation for end-stage liver disease caused by α1-antitrypsin deficiency. LKM-1 was detected by immunofluorescence, anti-microsomal reactivity by Western blotting, anti-HCV and anti-GOR by immunoenzymatic assays, and HCV RNA by polymerase chain reaction. Two weeks after HCV infection, immunoglobulin (lg) M LKM-1 appeared, followed by lgG1 LKM-1, with titers increasing to 1/2560; antibodies to a 50-kilodalton liver microsomal protein appeared 2 months later. Sera from day 1 posttransplant became positive for HCV RNA. HCV RNA was also detected in a liver biopsy specimen obtained 3 months after surgery. The patient did not produce anti-HCV and anti-GOR antibodies throughout the study and had no histological evidence of hepatitis. The temporal relationship between HCV infection and LKM-1 production suggests that HCV may trigger a primary autoimmune response. The lack of liver damage attributable to autoimmunity or viral infection may be caused by immunosuppression.
ISSN:0016-5085
1528-0012
DOI:10.1016/0016-5085(94)90426-X