SYSTEMIC LUPUS ERYTHEMATOSUS ASSOCIATED WITH CHOLESTATIC HEPATITIS IN A CHILD. A CASE REPORT
ABSTRACT: Systemic Lupus
Erythematosus is an autoimmune disease with the prevalence in children
approximately 1 per 100,000. The clinical manifestations are divers, and
hepatic involvement is very rare. The patient was a 12 years old girl, admitted
to the hospital with the main complaint of prolonged fever and jaundice.
Physical and laboratory examinations found 6 criteria of American Rheumatism
Association for SLE, justify the diagnosis of SLE. Liver function tests
yielded: direct bilirubin 5.36 and total bilirubin 6.82; ALT 565 IU/L and AST
77 IU/L. Viral hepatitis markers were negative. Histopathology examination of liver
tissue revealed periportal lymphocytic infiltration, ballooning degeneration,
disarray of porta hepatica, and intra-cytoplasmic bilirubin. Prednison
induction was given with a dosage 2 mg/kg/day for 30 days. Theoretically combination with azathioprine
may give best result, but in this case prednisone alone resulted a good
response after 1 week, and consideration of hepatotoxic effect of azathioprine,
so azathioprine was cancelled. The results of treatment was good, the patient
was discharged from the hospital uneventfully. There is still possibility of
relapse.
Author: Zahrah Hikmah,
Ariyanto Harsono
Journal Code: jpkedokterangg050053
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