Cytomegalovirus Hepatitis Occurring in a Young Patient With Autoimmune Polyglandular Syndrome and Pediatric-Onset Autoimmune Hepatitis

ABSTRACT Cytomegalovirus (CMV) hepatitis is rare in patients with autoimmune hepatitis (AIH) on long-term immunosuppression. We report a 28-year-old woman with a history of autoimmune polyglandular syndrome and pediatric-onset AIH who presented with fatigue, fever, and elevated liver enzymes, found to have CMV hepatitis without active AIH. Early initiation of antiviral therapy led to normalization of liver function tests and resolution of viremia. This case highlights the importance of early diagnosis of CMV hepatitis and the therapeutic challenge of treating CMV while also reintroducing immunosuppression for AIH.