Autoimmune Hepatitis as a Part of Polyglandular Autoimmune Syndrome Type II: Case Report and Literature Review

摘要

A 48-year-old Caucasian man was admitted for fatigue, abdominal discomfort, and jaundice. His history showed 10 pounds weight loss, dark urine, and light-colored stool for 2 weeks prior to admission. Five days prior to admission he began to experience marked decrease in appetite and abdominal discomfort. He decided to perform an internet search and the word "jaundice" was mentioned very frequently. At this point he noticed the yellow hue of his skin and he visited his primary-care physician who directed the patient to the emergency room. The laboratory evaluation revealed acute hepatitis and he was admitted for further evaluation. His past medical history was significant for autoimmune diabetes diagnosed 2 years ago. He was found to be at low risk for viral hepatitis from social, sexual, and travel history. He refrained from alcohol use. Medications prior to admission were metformin, ramipril, aspirin, and multivitamin, but no alternative or herbal medications. On physical examination he was noted to be icteric, his thyroid gland was nontender and normal sized, and his abdomen was soft with no palpable hepatomegaly or Murphy's sign.