MELLOW YELLOW: A CASE OF AUTOIMMUNE HEPATITIS IN A 2 YEAR OLD FEMALE

Purpose: The following case report discusses the significance of promptly diagnosing and managing a child with AIH to prevent irreparable damage to vital organs. Methods: The methods used to evaluate this patient were primarily laboratory studies, which included serial liver enzyme levels, antibodies, abdominal ultrasound, and liver biopsy. Results: On admission, liver enzymes were elevated with AST >1900 u/L and ALT >1400 u/L. Total bilirubin and direct bilirubin were increased at 12.2 mg/dl and 10.2 mg/dl, respectively. These values remained high for one week. Total IgG was elevated to 3200 mg/dl. Antinuclear antibody (ANA) was negative, but antismooth muscle antibody (SMA) and liver-kidney-microsome antibody (anti-LKM) were positive. Ultrasound revealed liver cirrhosis, and liver biopsy was consistent with hepatitis. Conclusions: The results reinforced the diagnosis of Type II AIH. The management for this patient included immunosuppressive therapy and monitoring of pertinent lab values. Since the presentation of AIH in children is variable, the importance of timely diagnosis allows for a child to receive suitable treatment in an efficient manner.