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29 June 2022: Articles

Acute Hepatitis with Positive Autoantibodies: A Case of Natalizumab-Induced Early-Onset Liver Injury

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction , Educational Purpose (only if useful for a systematic review or synthesis)

Marlone Cunha-Silva ** , Priscilla Brito Sena de Moraes * , Pedro Rodrigues de Carvalho A , Larissa Bastos Eloy da Costa B , Guilherme Rossi Assis-Mendonça B , Cristina Alba Lalli B , Gisele Conte Alves Fernandes B , Fernanda Bocchi Monteiro B , Gustavo Manginelli Lamas B , Alfredo Damasceno B , Daniel Ferraz de Campos Mazo C , Tiago Sevá-Pereira D

DOI: 10.12659/AJCR.936318

Am J Case Rep 2022; 23:e936318

Table 1. Initial laboratory tests.

Blood testsPatientNormal rangeImmunology
Hemoglobin15.812–16 g/dLHBsAgNegative
Leucocytes11 6304000–10 000/mmAnti-HBcNegative
Platelets154 000150 000–400 000/mmAnti-HBsNegative
ALT1151Anti-HAV IgGPositive
AST1790Anti-HAV IgMNegative
Total bilirubin35.90.3–1.2 mg/dLCytomegalovirus IgGPositive
Direct bilirubin26.5Cytomegalovirus IgMNegative
Albumin3.13.5–5.2 g/dLSyphilisNegative
INR1.27Epstein-Barr virus IgMNegative
Urea1717–43 mg/dLAnti-smooth muscle AB1: 40
Creatinine1.0Anti-mitochondrial ABNegative
IgG552950–1500 mg/dLAnti-nuclear AB1: 80
Ceruloplasmin4520–60 mg/dLRT-PCR-SARS-CoV-2Negative
ALT – alanine aminotransferase; AST – aspartate aminotransferase; AP – alkaline phosphatase; GGT – gamma-glutamyl transferase; INR – international normalized ratio; IgG – immunoglobulin G; IgM – immunoglobulin M; HAV – hepatitis A virus; HCV – hepatitis C virus; HIV – human immunodeficiency virus; AB – antibody; RT-PCR-SARS-CoV-2 – reverse transcriptase-polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923