A rare cause of fever of unknown origin : Autoimmune hepatitis

Abstract

Fever of unknown origin is difficult to diagnose, and it is seen in the course of infection, malignancy, inflammatory diseases and many other diseases. In this report, a case who presented with fever of unknown origin and was diagnosed with autoimmune hepatitis progressed to acute liver failure is presented. Our case showed a rapid and progressive clinical course, and liver biopsy performed in the early period was useful in the diagnosis. However, mortality developed on the fifteenth day of follow up.

Keywords

• Biopsy
• fever of unknown origin
• autoimmune hepatitis

References

1. Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961;40:1-30. doi:10.1097/00005792-196102000-00001
2. Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11:35-51.
3. Akbayır N. Otoimmün hepatit. Maltepe Tıp Dergisi. 2019;11:55-67.
4. Mourad O, Palda V, Detsky AS. A comprehensive evidencebased approach to fever of unknown origin. Arch Intern Med. 2003;163(5):545-551. doi:10.1001/archinte.163.5.545
5. Yenilmez E, Kakalicoglu D, Bozkurt F, et al. Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey. Int J Clin Pract. 2021;75(6):e14138. doi:10.1111/ijcp.14138
6. Mitchell DP, Hanes TE, Hoyumpa AM Jr, Schenker S. Fever of unknown origin. Assessment of the value of percutaneous liver biopsy. Arch Intern Med. 1977;137(8):1001-1004.
7. Holtz T, Moseley RH, Scheiman JM. Liver biopsy in fever of unknown origin. A reappraisal. J Clin Gastroenterol. 1993;17(1):29-32. doi:10.1097/00004836-199307000-00009
8. Czaja AJ. Challenges in the diagnosis and management of autoimmune hepatitis. Can J Gastroenterol. 2013;27(9):531-539. doi:10.1155/2013/981086

9. Yasui S, Fujiwara K, Yonemitsu Y, Oda S, Nakano M, Yokosuka O. Clinicopathological features of severe and fulminant forms of autoimmune hepatitis. J Gastroenterol. 2011;46(3):378-390. doi:10.1007/s00535-010-0316-3
10. Fujiwara K, Fukuda Y, Yokosuka O. Precise histological evaluation of liver biopsy specimen is indispensable for diagnosis and treatment of acute-onset autoimmune hepatitis. J Gastroenterol. 2008;43(12):951-958. doi:10.1007/s00535-008-2254-x
11. Urzúa Á, Pizarro C, Gajardo A, et al. Autoimmune Hepatitis with Acute Presentation: Clinical, Biochemical, and Histological Features of 126 Patients. Can J Gastroenterol Hepatol. 2022;2022:6470847. doi:10.1155/2022/6470847