Successful treatment of a Korean infant with giant cell hepatitis with autoimmune hemolytic anemia using rituximab

Young Ho Kim, Ju Whi Kim, Eun Joo Lee, Gyeong Hoon Kang, Hyoung Jin Kang, Jin Soo Moon, Jae Sung Ko

Research output: Contribution to journalArticle

Abstract

Giant cell hepatitis with autoimmune hemolytic anemia (AHA) is a rare disease of infancy characterized by the presence of both Coombs-positive hemolytic anemia and progressive liver disease with giant cell transformation of hepatocytes. Here, we report a case involving a seven-month-old male infant who presented with AHA followed by cholestatic hepatitis. The clinical features included jaundice, pallor, and red urine. Physical examination showed generalized icterus and splenomegaly. The laboratory findings suggested warm-type AHA with cholestatic hepatitis. Liver biopsy revealed giant cell transformation of hepatocytes and moderate lobular inflammation. The patient was successfully treated with four doses of rituximab. Early relapse of hemolytic anemia and hepatitis was observed, which prompted the use of an additional salvage dose of rituximab. He is currently in clinical remission.

Original languageEnglish
Article number180
Pages (from-to)180-187
Number of pages8
JournalPediatric Gastroenterology, Hepatology and Nutrition
Volume23
Issue number2
DOIs
StatePublished - Mar 2020

Keywords

  • Autoimmune hemolytic anemia
  • Hepatitis
  • Rituximab

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