[Hepatocellular damage, proteinuria and autoimmunity: multisystemic disorder or coexistence of diseases?]

Rev Med Chil. 2018 Jun;146(6):808-812. doi: 10.4067/s0034-98872018000600808.
[Article in Spanish]

Abstract

We report a 19 years old male presenting with knee pain, elevated liver enzymes and proteinuria. Further investigation found positive antinuclear and anti-smooth muscle antibodies and a liver biopsy revealed the presence of an autoimmune hepatitis. Treatment with corticosteroids and azathioprine was started, resulting in normalization of liver enzymes but proteinuria persisted and a kidney biopsy disclosed a focal segmental glomerulosclerosis. The use of lisinopril resulted in a significative reduction of proteinuria and, after 30 months of follow up, he continues with azathioprine, lisinopril and a low prednisone dose without evidence of liver or kidney disease activity.

Publication types

  • Case Reports

MeSH terms

  • Autoimmunity
  • Diagnosis, Differential
  • Glomerulosclerosis, Focal Segmental / complications*
  • Glomerulosclerosis, Focal Segmental / diagnosis
  • Glomerulosclerosis, Focal Segmental / immunology
  • Hepatitis, Autoimmune / complications*
  • Hepatitis, Autoimmune / diagnosis
  • Hepatitis, Autoimmune / immunology
  • Humans
  • Immunohistochemistry
  • Kidney / pathology
  • Liver / pathology
  • Male
  • Proteinuria / complications*
  • Proteinuria / diagnosis
  • Proteinuria / drug therapy
  • Proteinuria / immunology
  • Young Adult