A Novel Presentation of Autoimmune Hepatitis with IgG1 Elevation

Yujiao Zhang; Bilal Niazi; Auda Auda; Angel Ann Chacko; Amer Jarri; Abdifatah Mohamed; Saad Ali; Hongfa Zhu; Syed Sirajuddin

doi:10.1159/000530517

A Novel Presentation of Autoimmune Hepatitis with IgG1 Elevation

Case Rep Gastroenterol. 2023 Sep 28;17(1):281-286. doi: 10.1159/000530517. eCollection 2023 Jan-Dec.

Authors

Yujiao Zhang¹, Bilal Niazi¹, Auda Auda¹, Angel Ann Chacko¹, Amer Jarri¹, Abdifatah Mohamed¹, Saad Ali², Hongfa Zhu³, Syed Sirajuddin¹

Affiliations

¹ Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA.
² Department of Gastroenterology, HMH-Palisades Medical Center, North Bergen, NJ, USA.
³ Department of Pathology, HMH-Palisades Medical Center, North Bergen, NJ, USA.

Abstract

Autoimmune hepatitis (AIH) is a common and debilitating pathology that has acute, subacute, and chronic presentation, requiring prompt diagnosis and early intervention. Several serologic markers are found to be associated with the pathogenesis and progression of autoimmune hepatitis, most notably antinuclear antibodies and anti-smooth muscle antibodies [Front Immunol. 2018;9:609]. In addition, AIH is also characterized by the elevation of gamma globulin levels, mainly immunoglobulin G (IgG) [World J Gastroenterol. 2015;21(1):60-83]. Although the literature has well established the presence of increased IgG levels in AIH, few studies have evaluated the subtypes of IgG and their differential levels associated with AIH. Here, we present a rare case of AIH that lacks the common serologic markers but instead reveals an elevation in IgG1 level. Our patient was subsequently placed on corticosteroids, and her symptoms quickly resolved. We intend to introduce this case to the medical community in the hope of aiding in the proper diagnosis and timely intervention of subsequent cases with similar presentations.

Keywords: Autoimmune hepatitis; IgG1.