Autoimmune Hepatitis Complicated by Undiagnosed Factor VII Deficiency: A Pitfall of Coagulopathy

Intern Med. 2024 Jul 15;63(14):2011-2014. doi: 10.2169/internalmedicine.2854-23. Epub 2023 Nov 20.

Abstract

Prothrombin time (PT) is a key parameter for assessing the severity of liver disease. We present the case of a 37-year-old woman with severe acute liver injury due to autoimmune hepatitis. Although prednisolone drastically improved her hepatocyte function, her PT did not recover to the reference range. A review of her medical records revealed that the patient had normal transaminase levels and prolonged PT 2 years previously. Further examinations of her coagulopathy revealed that she had low factor VII activity, suggesting a diagnosis of factor VII deficiency. Our experience suggests that altered coagulopathy should be considered in cases of liver injury with an extraordinary PT.

Keywords: autoimmune hepatitis; factor VII deficiency; hepatic failure; prothrombin time.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Coagulation Disorders / diagnosis
  • Blood Coagulation Disorders / etiology
  • Factor VII Deficiency* / complications
  • Factor VII Deficiency* / diagnosis
  • Female
  • Hepatitis, Autoimmune* / blood
  • Hepatitis, Autoimmune* / complications
  • Hepatitis, Autoimmune* / diagnosis
  • Humans
  • Prothrombin Time