Why the study?
False-positive hepatitis A virus immunoglobulin M test results can interfere with the serological diagnosis of acute hepatitis A virus infection.
False-positive HAV-IgM can occur in autoimmune hepatitis and resolves with corticosteroid treatment.
Answers are grounded in this paper and cite their sources.
Clinicians should consider autoimmune hepatitis with false-positive HAV-IgM; this case leaves open whether steroids reliably resolve seropositivity.
Hepatitis A virus immunoglobulin M (HAV-IgM) is often used to diagnose acute hepatitis A virus (HAV) infection serologically. However, false-positive test results can interfere with the diagnosis. A 56-year-old woman was readmitted to the hospital owing to abnormal liver function tests for the last 18 months. She had been diagnosed with acute HAV and was hospitalized in isolation based on a positive HAV-IgM test 18 months ago. Regular follow-up after discharge showed abnormal liver function and an elevated level of antinuclear antibodies and immunoglobulin G. For the last 15 days, the patient had fatigue, decreased appetite, and yellow urine, signaling recrudescence. Liver function tests were also abnormal. Liver biopsy revealed histological changes consistent with typical autoimmune hepatitis. After 2 months of methylprednisolone treatment, liver function returned to normal, and HAV-IgM turned negative. The diagnosis of acute HAV in nonendemic areas requires a comprehensive analysis of epidemic history, clinical characteristics, etiology, etc.
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Tan et al. (2021) studied this question.
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