The present observations might suggest a hitherto unreported form of acute hepatitis of unknown etiology, distinct from other liver diseases in which liver/kidney microsomal antibodies have been described so far. HLA typing for class 1 and 2 antigens was positive for the HLA haplotype DQ2, but negative for HLA B4, B8, DR3 and DR4.

Concomitant autoimmune disease was not detectable. Hepatitis C and D virus infection were excluded by repeated serological testing exposure to drugs or chemicals was not evident. During the acute phase, serum titer for liver/kidney microsomal-1 antibodies (detected by indirect immunofluorescence, ELISA and Western blot analysis) was exceedingly high and decreased gradually thereafter. The acute icteric episodes were followed by spontaneous remission with complete normalization of liver function tests and liver histology. Patients were studied using clinical, biochemical, serological and immunological methods, as well as liver biopsy. Unlike these, acute hepatitis of unknown etiology associated with high-titer liver/kidney microsomal-1 antibodies (cytochrome P450 2D6) is reported in identical twin brothers. Twin brothers in a gospel group struggle to find balance of life, love, faith and religion while under the strict rule of their father and Reverend of a. in autoimmune hepatitis, chronic hepatitis C and D virus infection and in drug-induced liver disease.

Liver/kidney microsomal antibodies have been noted in liver disease of different etiology, e.g.

Twin of brothers episode 1