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Case Reports in Gastrointestinal Medicine
Volume 2013 (2013), Article ID 872987, 3 pages
http://dx.doi.org/10.1155/2013/872987
Case Report

Autoimmune Hepatitis: Diagnostic Dilemma in the Setting of Suspected Iron Overload

Department of Medicine, Clinical Center, Michigan State University, 788 Service Road, East Lansing, MI 48824, USA

Received 1 June 2013; Accepted 22 July 2013

Academic Editors: P. Abraham, A. J. Lembo, and E. Savarino

Copyright © 2013 In Chul An et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Autoimmune hepatitis (AIH) is an inflammatory condition of the liver that has a multitude of clinical presentations from chronic hepatitis to acute fulminant hepatitis. AIH diagnosis is typically suspected after ruling out other causes of hepatitis (such as vial hepatitis, hemochromatosis, Wilson’s disease, and primary biliary cirrhosis) through serological tests and by findings of high titers of certain autoantibodies (ANA and anti-SMA for type 1 AIH and anti-LKM-1 for type 2 AIH). AIH like most inflammatory conditions is associated with increased ferritin levels (acute-phase reactant) but typically near-normal transferrin saturation. The presence of excessive ferritin level in absence of high-transferrin saturation helps differentiate secondary iron overload from hemochromatosis where transferrin saturation is typically high. We herein describe a case of AIH that presented with high ferritin levels and transferrin saturation suggesting a diagnosis of hemochromatosis and needed arduous work-up to arrive at accurate diagnosis of AIH.