Daño hepatocelular, proteinuria y autoinmunidad: ¿enfermedad multisistémica o coincidencia de enfermedades? Caso clínico

• Autores: Patricio Herrera, Alex Ruiz, Daniel Carpio, Leopoldo Ardiles
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 146, Nº. 6, 2018, págs. 808-812
• Idioma: español
• Títulos paralelos:
  • Hepatocellular damage, proteinuria and autoimmunity: multisystemic disorder or coexistence of diseases?
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• Resumen

  • 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.