A CASE OF INFANTILE HEPATITIS CAUSED BY AUTO-ANTIBODY DERIVED FROM MOTHER WITH LUPOID HEPATITIS

• Published in: Japanese Journal of National Medical Services Vol. 57; no. 9; pp. 567 - 571
• Main Authors: HAMADA, Yoshinori, TSUJI, Masako, NAGAMACHI, Norio, UTSUNOMIYA, Masahiro, MINO, Masahiro, INOSHITA, Kenji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 20.09.2003
• Subjects: autoimmune hepatitis; feto-maternal immunity; infantile hepatitis; SLE; SS-A antibody
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.57.567

Discoid skin rashes and hepatosplenomegaly were seen from one month after birth in a baby born to a mother with autoimmune hepatitis. One year before giving birth, the mother was found to have antinuclear antibody and hypergammaglobulinemia, and she was treated for systemic lupus erythematosus. Her liver function had been normal during her pregnancy, but from the 10th postpartum day, for 12 days, she had a fever reaching 39°C. At the same time, she showed a GOT of 183IU/L and a GPT of 113IU/L, and autoantibodies appeared:antinuclear antibody of 1:1, 280 and anti-DNA antibody of 1:80. Lupoid hepatitis was diagnosed. The child was born at 40 weeks' gestation, and had a birth weight of 3, 310g. At the age of one month, stomatitis and diarrhea developed, and discoid skin rashes appeared on the face, chest and upper extremities. On admission to hospital, the infant showed the following values:GOT, 282IU/L;GPT, 311IU/L;anti-SS-A antibody, 1:16;anti-SS-B antibody, 1:2;and antinuclear antibody, 1:80;and it was considered that SLE-related antibody had been transferred from the mother, causing the hepatic dysfunction in the baby. Both anti-SS-A and anti-SS-B antibodies decreased to low levels at 4 months;and together with the fall in antibody levels, GOT and GPT were normalized at 5 months.