Global Journal of Digestive Diseases

Shoulder and elbow tendinitis as initial manifestation of autoimmune hepatitis

Introduction: The tendinitis is commonly defined as an inflammation of the tendon, which is what connects bones to muscle. On the major literature, tendinitis is usually caused by repetition of movements and lack of stretching. However, the cause was never before associated to a disease in the liver, such as autoimmune hepatitis. According to traditional Chinese medicine (TCM), tendons are governed by the energy of the Gallbladder meridian, which is attached to the Liver energy. 
Purpose: The aim of this study is to demonstrate that tendinitis may be an early manifestation of autoimmune hepatitis.
Methods:  Through a clinical case report of a female patient, M.C., 42 years old, with chronic pain in shoulder and elbow, resistant to conventional treatments with anti-inflammatories and physiotherapy. She sought acupuncture treatment, and even so, the improvement presented was scarce. In her physical examination, a bulging was detected in the right ear, on the area that corresponds to the Liver, according to auricular medicine. Laboratory tests were requested to see if there could be any undiagnosed liver disease until then. The only exam that was initially altered was the prothrombin time of 89%. More tests were ordered to see whether anti-bodies were present. Anti-nuclear, anti-smooth muscle, anti-microsomal.
Results: To the physician's surprise, the patient had a 1:160 anti-nucleus reagent.
Conclusion: The conclusion of this study is that tendinitis may be the initial manifestation of an autoimmune hepatitis.

Author(s):

Huang Wei Ling

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