Lupus associated hepatitis in active lupus nephritis patient: A case report

Introduction: systemic lupus erythematosus and autoimmune hepatitis (AIH) both are autoimmune disease causing inflammation of the liver. It is important to differentiate lupus hepatitis from AIH for diagnosis, treatment and prognosis of the disease. case report: Herein, we report a case of a 17-year-old female with a two-year history of multiple joint pain, sixmonth history of swelling, rash, mouth ulcers and a 15-day history of jaundice. An investigation revealed positive antinuclear antibody, positive anti-DsDNA, low serum c3, c4, very high serum bilirubin, high sGOt/sGPt and nephrotic range proteinuria. Antibody tests for autoimmune hepatitis were negative. renal biopsy showed focal proliferative lupus nephritis. Liver biopsy was suggestive of lupus-hepatitis. Jaundice responded to steroid therapy dramatically. conclusion: Lupus associated hepatic disease must be differentiated from hepatitis caused by drugs, toxins, viral and other autoimmune diseases. Liver histology may be necessary to confirm a diagnosis.