Liver biopsy revealing anti-neutrophil cytoplasmic antibody-associated vasculitis: a tale for a challenging diagnosis

Figures & data

Table 1. Evolution of blood analysis values.

Blood analysis values	Initial hospitalization (July 2022)	Second admission (August 2022)	Reference range
Hemoglobin	10.5	10.9	12–16 g/dl
White blood count	13,450	18,100	4000–10,000/mm^3
Neutrophils	11,100	13,900	2000–7500/mm^3
Eosinophils	400	500	400–500/mm^3
Lymphocytes	1530	3000	1000–4000/mm^3
Basophils	0	0	<100/mm^3
Monocytes	380	550	200–1000/mm^3
C-reactive protein	165	180	<5 mg/l
Erythrocyte sedimentation rate	106	120	<20 mm
Bilirubin level	35	70	0.1–1.2 mg/dl
Alanine aminotransferase	45	133.7	4–36 UI/l
Aspartate aminotransferase	57	153.2	8–33 UI/l
Gamma-glutamyltransferase	170	376	5–40 U/l
Alkaline phosphatase	230	378	44–147 UI/l

Figure 1. Histological findings.

Microscopic features of liver biopsy demonstrated granulomatous necrotizing vasculitis (H&E staining X200 (A) and X400 (B)).

Figure 2. Timeline of patient evolution.