PMC8165172_01
PMC8165172_02
Lymphocytic infiltration with lymphoid follicles was accumulated and enlarged in the portal tract (A). Cirrhosis was observed by immunolabeling with CD34 staining (brown) and Warthin-Starry (black) staining respectively (B, C).
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F1
A 48-year-old woman was diagnosed with AIH (Child-Pugh class A; MELD score, 18) when she presented with the typical histological feature of interface hepatitis on Aug, 2018 (Figure 1).
PMC8165172_03
Monitoring of clinical parameters related to liver functions of the 3 cases (A, patient 1; B, patient 2; C, patient 3) during hospital treatment. Solid line, abnormal liver function parameters; dashed line, normal liver function parameters.
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F2
AST, 169 U/L; ALT, 201.3 U/L; GGT, 180.3 U/L; and ALP, 115 U/L. Although viral serologies for hepatitis A, B, C, and E were still negative, serum immunoglobulin was 700.2 mg/dL (Figure 2A). Due to this immunosuppressant therapy, although her ALT, AST, ALP, and total protein (TP) levels were in normal range, she had jaundice with elevated TB (29 mumol/L) and GGT (64 U/L) levels (Figure 2B). COVID-19 hospitalization revealed evidently elevated liver enzymes: AST, 49 U/L; ALT, 142 U/L; GGT, 200 U/L; ALP, 114 U/L; and TP, 62 g/L (Figure 2C). Compared to her liver function before COVID-19, her AIH score elevated to 14 with a positive LKM-1 antibody titer>1:80. Normal liver function was restored in all patients post therapy (Figure 2), and the liver assessment score decreased (Table 3).