Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis
A 62-year-old woman presented with a chronic fever and fatigue. Biological investigations showed leukocytosis and elevation of acute phase markers. Liver blood tests showed deterioration with both cholestatic and hepatocellular patterns (there were, respectively, elevations in serum alkaline phospha...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Future Science OA |
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| Online Access: | https://www.tandfonline.com/doi/10.2144/fsoa-2023-0222 |
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| _version_ | 1849431074677981184 |
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| author | Bahaeddine Lahbacha Abir Chaabane Wafa Garbouj Roua Mankai Amina Bani Amal Khsiba Raja Amri Salwa Nechi Emna Chelbi |
| author_facet | Bahaeddine Lahbacha Abir Chaabane Wafa Garbouj Roua Mankai Amina Bani Amal Khsiba Raja Amri Salwa Nechi Emna Chelbi |
| author_sort | Bahaeddine Lahbacha |
| collection | DOAJ |
| description | A 62-year-old woman presented with a chronic fever and fatigue. Biological investigations showed leukocytosis and elevation of acute phase markers. Liver blood tests showed deterioration with both cholestatic and hepatocellular patterns (there were, respectively, elevations in serum alkaline phosphatase levels as well as in serum alanine and aspartate aminotransferases). Viral serologies were negative. Mycobacterial infection and endocarditis were excluded. Results from blood cultures were negative. Autoantibody tests including ANCA (anti-neutrophil cytoplasmic antibody), anti-nuclear, anti-smooth muscle and anti-mitochondria were all negative. A liver biopsy revealed epithelioid granulomatous necrotizing vasculitis. Subsequently, immunological testing was repeated revealing MPO-ANCA (myeloperoxidase-ANCA). A diagnosis of ANCA-associated vasculitis with liver involvement was then made. The patient was started on steroids and her clinical state gradually improved. |
| format | Article |
| id | doaj-art-e245c0a823314ffa95dad784cb4b57e9 |
| institution | Kabale University |
| issn | 2056-5623 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Future Science OA |
| spelling | doaj-art-e245c0a823314ffa95dad784cb4b57e92025-08-20T03:27:44ZengTaylor & Francis GroupFuture Science OA2056-56232024-12-0110110.2144/fsoa-2023-0222Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosisBahaeddine Lahbacha0Abir Chaabane1Wafa Garbouj2Roua Mankai3Amina Bani4Amal Khsiba5Raja Amri6Salwa Nechi7Emna Chelbi8Department of Pathology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Pathology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Internal Medicine, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Internal Medicine, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Pathology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Gastroenterology & Hepatology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Internal Medicine, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Pathology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaDepartment of Pathology, Mohamed Taher Maamouri University Hospital, Nabeul, 8000, TunisiaA 62-year-old woman presented with a chronic fever and fatigue. Biological investigations showed leukocytosis and elevation of acute phase markers. Liver blood tests showed deterioration with both cholestatic and hepatocellular patterns (there were, respectively, elevations in serum alkaline phosphatase levels as well as in serum alanine and aspartate aminotransferases). Viral serologies were negative. Mycobacterial infection and endocarditis were excluded. Results from blood cultures were negative. Autoantibody tests including ANCA (anti-neutrophil cytoplasmic antibody), anti-nuclear, anti-smooth muscle and anti-mitochondria were all negative. A liver biopsy revealed epithelioid granulomatous necrotizing vasculitis. Subsequently, immunological testing was repeated revealing MPO-ANCA (myeloperoxidase-ANCA). A diagnosis of ANCA-associated vasculitis with liver involvement was then made. The patient was started on steroids and her clinical state gradually improved.https://www.tandfonline.com/doi/10.2144/fsoa-2023-0222ANCAgranulomalivervasculitis |
| spellingShingle | Bahaeddine Lahbacha Abir Chaabane Wafa Garbouj Roua Mankai Amina Bani Amal Khsiba Raja Amri Salwa Nechi Emna Chelbi Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis Future Science OA ANCA granuloma liver vasculitis |
| title | Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis |
| title_full | Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis |
| title_fullStr | Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis |
| title_full_unstemmed | Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis |
| title_short | Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis |
| title_sort | liver biopsy revealing anti neutrophil cytoplasmic antibody associated vasculitis a tale for a challenging diagnosis |
| topic | ANCA granuloma liver vasculitis |
| url | https://www.tandfonline.com/doi/10.2144/fsoa-2023-0222 |
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