Case reports Case 1 An 11 year-old girl with jaundice,fever,abdominal distension, fatique and weight loss wass admitted to our

hospital. The laboratory exams showed aspartate aminutransferase (AST) 1125 IU/L (normal 0-20 IU/L) , alanine aminotransferase (ALT) 595IU/L (NORMAL 6-20IU/L), -glutamyl transpeptidase (GGT) 221 g/dL (normal 14-26 g/dL), alkaline phosphatase (APHOS) 1608 IU/L normal 60-350), total bilirubin (DB) 20.1 mg/Dl (normal 0.05 0.3 mg/dL), direct bilirubin (DB) 13.5 MG/dL (normal 0.1-0.6 mg/Dl), globulin 4.09g/dL (normal 3.2-3.9 mg/dL) and prothrombin time (PT) 14.5 seconds (normal 13.1 s). serum immunoglobulin G (igG) was 4359 mg/dl (normal 952-1538 mg/dl),igM 246 mg/dl (normal 73171) mg/dl),igA 121 mg/dl (normal 0-1 mg/dl). Serum level of C3 was 0.49 g/L (normal 0.5-1.8), C4 <0.05 g/L (normal 0.1-0.4) and factor V 120% (normal 70-150%). Immunological tests showed positive test for serum antibodies as follows: antinuclear antibodies. (ANA) 1:1280 and anti-smooth muscle (anti-SMA). All serologic tests (hepatitis virus A, hepatitis virus B, hepatitis virus C, Epstein-barr virus [EBV], cytomegalovirus [CMV] and human immunodeficiency virus [HIV]