# Autoimmune Hepatitis Presenting With Severe Pruritus in a 27-Year-Old Male

## TL;DR

A 27-year-old man with severe itching was diagnosed with autoimmune hepatitis, a rare presentation of the disease.

## Contribution

Highlights pruritus as an uncommon but important symptom of autoimmune hepatitis.

## Key findings

- A 27-year-old male presented with severe pruritus and was diagnosed with autoimmune hepatitis.
- High-dose prednisolone therapy improved symptoms and normalized liver biochemistry.
- Pruritus can be a primary presentation of autoimmune hepatitis without cholestasis.

## Abstract

Autoimmune hepatitis (AIH) is a chronic immune-mediated liver disorder characterized by progressive hepatocellular inflammation and elevated autoantibodies. Although most patients present with jaundice, fatigue, or nonspecific hepatic symptoms, pruritus as the primary complaint is uncommon, especially in the absence of overt cholestasis. We report a case of a 27-year-old male presenting with severe generalized pruritus who was ultimately diagnosed with AIH. Laboratory evaluation revealed a hepatocellular injury pattern, strongly positive autoimmune serology, and elevated IgG levels, consistent with AIH. High-dose prednisolone therapy led to marked symptomatic improvement and rapid biochemical normalization. This case highlights pruritus as an uncommon but important presentation of AIH and underscores the need to consider AIH in patients with persistent, unexplained pruritus.