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We describe a case of autoimmune hepatitis triggered by an acute hepatitis A infection. A young woman presented with a 10 day history of nausea and dark urine having returned from Tunisia a month previously. She had marked transaminitis. Viral serology demonstrated positive hepatitis A immunoglobulin M. Other viral serology was negative. Autoantibody screening revealed positive antismooth muscle antibodies (titre 1 in 80) but negative antinuclear (ANA), antimitochondrial, and antiliver, kidney and pancreas (LKM) antibodies. Immunoglobulin levels revealed normal IgA and IgG levels …
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