CLINICAL INFORMATION :

59 year-old woman. Vasculitis. Cytolysis and cholestasis. No risk factors for HCV. Autoimmune hepatitis ? Sinds 5 years : URFADYN* (nifurtoïnol), REDOMEX* (Amytryptiline), ESTULIC* (Guanfacine).

HISTOLOGY :

• Hepatitis - severe activity (A3) - Portal fibrosis with porto-portal and porto-central bridging (F3)
• Chronic or acute ? (see biology : hepatic alterations < or > 6 months ?)
• Etiology ?
  Autoimmune ? ==> serology negative / no plasmatocytes
  Toxic ? cf. microgranuloma - steatosis (Fig. 28)
  URFADYN* : ==> In the literature : severe hepatitis with important " piece meal necrosis " (Fig.26) and condensations of the hepatocytes (Fig. 27) . Sometimes : granulomas (Fig 28).

fig. 26		fig. 27
fig. 28