Autoimmune Hepatitis Associated With Leprosy in a Child

Abstract

to needles and scalpels, confinement in communities, and hospitalization or treatment in poorly equipped health services (6).This unique case is the first documentation of coexistence of AIH and leprosy. A possible explanation is the stimulation of specific B lymphocytes for normal hepatic antigens by T lymphocytes activated against M leprae-infected hepatic cells. This leads to autoantibody production and consequent onset of AIH, although experimental models suggest that AIH can also be secondary to the dysregulated T-cell response. Moreover, the increased level of IFN-g observed may corroborate a T-cell abnormality. Whether this is due to the observed CD8þ T cell predominance, as shown by the liver biopsy, remains for future studies.The patient responded well to immunosuppression for AIH. Only later was treatment for leprosy provided with clofazimine and rifampicin administered. Dapsone was avoided due to several adverse effects including liver and dermatologic reactions (8).