Epatite giganto cellulare post-infantile. Risposta clinica ed istologica alla terapia immunosoppressiva

Giant cell transformation of hepatocytes combined with variable degrees of hepatocyte necrosis and liver fibrosis is distinctly uncommon in adults. In this age group it has most often been associated with autoimmunity, drug reaction and viral infection. Prognosis is considered quite severe ranging from mild fibrosis to established cirrhosis. We report a case of giant cell hepatitis that occurred in a 30 yrs old man, who had been taking ticlopidine for 3 years. The causative role of the drug is uncertain because aminotransferase did not fall after withdrawal. The patient fulfilled most of the criteria for a diagnosis of autoimmune hepatitis and was treated accordingly with prednisolone and azathioprine. Immunosuppressive therapy led to a clinical, biochemical and histological response.