Autoimmune hepatitis in a Northern Nigerian woman

Abstract

Autoimmune hepatitis is an unrelenting inflammation of the liver of unknown etiology. It is a relatively rare disease that commonly affects women and mostly present as chronic hepatitis. It is basically classified into types 1 and 2. The patient is a 56 year old Northern Nigerian woman with background thyroid disease and rheumatoid arthritis who presented with jaundice and fatigue and elevated liver enzymes with increased serum total protein and low serum albumin. Further evaluation showed non-reactive hepatitis B and C markers, features of chronic liver disease on abdominal ultrasound scanning, elevated anti-nuclear and anti-smooth muscle antibodies and increased serum IgG. Liver histology showed features of chronic hepatitis consistent with AIH. Diagnosis of AIH type 1 was eventually made and patient was started on prednisolone and azathioprine combination therapy with improvement of liver function test few weeks after commencement of therapy. To the best of our knowledge, only 2 cases of AIH has been reported in Nigeria, all from Ibadan, Southern Nigeria. No report of AIH from Northern Nigeria. We therefore report a case of AIH type 1 to increase awareness among clinicians.