Complete Remission of Acute-onset Autoimmune Hepatitis Following Transcatheter Splenic Arterial Embolization and Splenectomy for Spontaneous Splenic Rupture

A 62-year-old woman presented with jaundice and fatigue. A blood examination revealed markedly elevated serum transaminase and bilirubin levels and negative hepatitis virus markers. A radiographic examination revealed no bile duct abnormalities. Serum transaminase levels decreased and normalized without immunosuppression after transcatheter arterial embolization and splenectomy for spontaneous splenic rupture, respectively. The pathological findings of the liver biopsy specimens were consistent with those of acute-onset autoimmune hepatitis (AIH), despite normal serum IgG levels. The clinical course of the present case suggests that pathogenic immune responses associated with acute-onset AIH may arise in the spleen, but not in the liver.