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自身免疫性肝炎(AIH)在我国属少见病,且其临床表现是以肝损害为主的综合征,临床医师易误诊、漏诊,为提高对AIH的认识,正确诊断该病,将收治的4例患者报告如下。1病例资料1.1一般资料4例患者均为女性,年龄分别为14、18、45、65岁,平均35.5岁。2例呈急性发病,其中1例呈暴发性肝功能衰竭表现;2例呈慢性发病。首发症状以乏力、食欲减退、黄疸、腹胀为主3例,胸闷、胸痛伴黄疸1例。体征:皮肤巩膜黄染、肝掌阳性4例。脾大、腹水征阳性1例。病史1个月-13年,确诊时间1个月-13年。既往有自身免疫性溶血史1例,类风湿性关节炎史1例。无输血史、饮酒史、服用损肝药物史。肝炎病毒血清标志物(HAV-HEV)(包括HBV-DNA、HCV-RNA)均阴性,抗EBV、抗CMV阴性;血清铜、铜
Autoimmune hepatitis (AIH) is a rare disease in our country, and its clinical manifestations are liver damage-based syndromes, clinicians are misdiagnosed and missed diagnosis. To improve the understanding of AIH, the correct diagnosis of the disease will be treated 4 Cases of patients reported as follows. 1 Case Information 1.1 General Information 4 patients were female, the age was 14,18,45,65 years, mean 35.5 years old. 2 cases showed acute onset, of which 1 case showed fulminant hepatic failure; 2 cases were chronic. The first symptom to fatigue, loss of appetite, jaundice, abdominal distension in 3 cases, chest tightness, chest pain with jaundice in 1 case. Signs: sclera yellow skin, liver palpable in 4 cases. Splenomegaly, ascites sign positive in 1 case. A history of 1 month - 13 years, diagnosed for 1 month to 13 years. Past history of autoimmune hemolysis in 1 case, history of rheumatoid arthritis in 1 case. No history of blood transfusion, history of alcohol consumption, history of taking liver medicine. Hepatitis virus serum markers (HAV-HEV) (including HBV-DNA, HCV-RNA) were negative, anti-EBV, anti-CMV negative; serum copper, copper