Rare leptin in non-alcoho...

A 65-year-old male had a history of diffuse liver disease, chronic gastritis, and pulmonary tuberculosis and was a hepatitis B virus carrier. He presented mild fatigue, poor sleep, and weight loss and was diagnosed with liver cirrhosis not caused by viral hepatitis. During the admission, BP was 110/62 mmHg, height was 165 cm, and weight was 51.5 kg. The patient appeared to be undernourished, as evidenced by their emaciated appearance. The possibility of autoimmune hepatitis was confirmed through a liver biopsy. The patient was treated with liver protection and enzyme-lowering treatments, but the transaminase index did not decrease significantly after immunosuppression. Further examination revealed positive results for HBe, HBc, antinuclear antibodies, anti-SS-An, anti-SS-B, and anti-histone antibodies, with high levels of IgA and IgG. Plain and enhanced nuclear magnetic resonance imaging (MRI) of the upper abdomen (Figure 3) showed an enlarged left lobe of the liver. As there was a continuous increase in the levels of transaminase; therefore, a liver biopsy was performed. The tissue sample analysis revealed inflammation in 19 portal areas of small and medium size (Figure 4a). These areas were closely connected to the fibrous septum, which separated liver tissue; some had nodules (Figure 4b).