Folia Medica Indonesiana
ISSN 0303-7932
Vol. 41 / No. 4 / Published : 2005-10
Order : 9, and page :299 - 305
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Original Article :
Systemic lupus erythematosus associated with cholestatic hepatitis in a child. a case report
Author :
- Zahrah Hikmah*1
- Ariyanto Harsono*2
- Department of Child Health Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
- Department of Child Health Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
Abstract :
Systemic Lupus Erythematosus is an autoimmune disease with the prevalence in children approximately 1 per 100,000. The clinical manifestations are divers, and hepatic involvement is very rare. The patient was a 12 years old girl, admitted to the hospital with the main complaint of prolonged fever and jaundice. Physical and laboratory examinations found 6 criteria of American Rheumatism Association for SLE, justify the diagnosis of SLE. Liver function tests yielded: direct bilirubin 5.36 and total bilirubin 6.82; ALT 565 IU/L and AST 77 IU/L. Viral hepatitis markers were negative. Histopathology examination of liver tissue revealed periportal lymphocytic infiltration, ballooning degeneration, disarray of porta hepatica, and intra-cytoplasmic bilirubin. Prednison induction was given with a dosage 2 mg/kg/day for 30 days. Theoretically combination with azathioprine may give best result, but in this case prednisone alone resulted a good response after 1 week, and consideration of hepatotoxic effect of azathioprine, so azathioprine was cancelled. The results of treatment was good, the patient was discharged from the hospital uneventfully. There is still possibility of relapse.
Keyword :
systemic Lupus Erythematosus, cholestasis, hepatitis,
References :
Hallequa DS, Wallace DJ,(2002) Gastrointestinal and hepatic manifestation. In: Wallace DJ, Hannahs BH. Dubois' Lupus Erythemathosus 6th Ed Philadelphia : Williams and Wilkins
Klein MS, Gitelman, Miller ML,(2003) Systemic Lupus Erythematosus. In Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatric 17th Ed Philadelphia : -
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